5-ALA Endoscope-Assisted Surgery of the Anterior Skull Base

Objective: In skull base surgery endoscopic techniques gain increasing importance. In gliomas 5-ALA fluorescence-guided surgery (FGS) could increase radicality and improve PFS. We proposed to establish the proof of principle to resect anterior skull meningiomas with help of a 5-ALA endoscope (5-ALA eFGS). Material and Methods: Two patients with anterior skull base meningiomas were operated using a special endoscope equipped for 5-ALA FGS. Results: Patient number 1 was operated by a combined transnasalendoscopic and transcranial approach. Patient number 2 was operated via an endoscope-assisted transeyebrow subfrontal approach. In both the patients fluorescing tumor was well visualized by the endoscope and it helped to detect a residual tumor at the end of surgery. Conclusion: We established the proof of principle to use a 5-ALA endoscope as an additional tool in anterior skull base surgery.