Fully Endoscopic Keyhole Surgery for Cranial Base Lesions

Kenichi Oyama; Ichiro Nakazato; Hisashi Ishikawa; Yusuke Tabei; Takeshi Suma; Akira Teramoto; Akira Matsuno

doi:10.1055/s-0043-1762293

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2023; 84(S 01): S1-S344
DOI: 10.1055/s-0043-1762293

Presentation Abstracts

Poster Abstracts

Fully Endoscopic Keyhole Surgery for Cranial Base Lesions

Authors

Kenichi Oyama

¹Department of Neurosurgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
Ichiro Nakazato

¹Department of Neurosurgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
Hisashi Ishikawa

¹Department of Neurosurgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
Yusuke Tabei

¹Department of Neurosurgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
Takeshi Suma

¹Department of Neurosurgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
Akira Teramoto

²Shonan University of Health Science, Kanagawa, Japan
Akira Matsuno

³Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Tokyo, Japan

Abstract

Full Text

Objectives: To show the utility of fully endoscopic keyhole surgery for various cranial base lesions.

Subjects and Methods: Between August 2016 and April 2022, thirteen cranial base lesions (9 cranial base tumors, 3 arachnoid cysts, 1 AVM) were treated via fully endoscopic keyhole transcranial surgery. We used an endoscope integrated with a pneumatic holder (Endoarm, Olympus Co.). Various keyhole approaches were performed, including supraorbital approach (2), transorbital approach (2), subtemporal approach (3), suboccipital approach (1), occipital transtentorial approach (3), and infratentorial supracerebellar approach (2).

Results: An endoscope seemed to provide more clear and better visualization of cranial base lesions through a key hole than a microscope. Among 9 tumors and 1 AVM, gross total and subtotal resection was achieved in 5 and 3 patients respectively. Effective cyst-cisternostomy was safely performed in 3 of 3 patients with arachnoid cyst. All patients had an uneventful postoperative course. One patient developed transient oculomotor palsy and one patient with a pineal tumor exhibited transient minor Parinaud syndrome. There was no mortality.

Conclusions: Fully endoscopic keyhole surgery is a safe and minimally invasive procedure and can be a considerable option in the management of various cranial base lesions.