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CC-BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 02): S227-S228
DOI: 10.1055/s-0037-1620246
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Endoscope-Assisted Microsurgical Removal of an Optic Foramen Meningioma through a Frontolateral Minicraniotomy

Peter Kurucz
1   Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany
,
Holger Opitz
1   Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany
,
Michael Buchfelder
2   Department of Neurosurgery, Friedrich-Alexander University, Erlangen-Nuremberg (FAU), Erlangen, Germany
,
Oliver Ganslandt
1   Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany
› Author Affiliations
Further Information

Address for correspondence

Peter Kurucz, MD
Neurochirurgische Klinik, Katharinenhospital
Kriegsbergstrasse 60, 70174
Deutschland   

Publication History

01 September 2017

12 December 2017

Publication Date:
15 January 2018 (online)

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Abstract

A 72-year-old male patient with visual disturbance of the right eye was diagnosed with a small meningioma of the right optic foramen extending to the carotid cistern. The operation was performed through an individually tailored frontolateral minicraniotomy via a curvilinear skin incision behind the hairline. Endoscope-assisted microsurgical technique was used to resect the lesion. The roof of the optic canal was partly removed to get access to the intraforaminal tumor parts. The lesion could be completely removed and the patient showed a satisfactory visual recovery in the follow-up examinations.

The link to the video can be found at: https://youtu.be/p8EZx7aryeQ.


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Keywords

optic foramen meningioma - frontolateral keyhole approach - endoscope-assisted microsurgery
Zoom Image
Fig. 1 (A, B) Preoperative contrast agent-enhanced MRI scans of the head revealed a small lesion of the right optic foramen just medially to the anterior clinoid process (red arrows). (C, D) Postoperative contrast agent-enhanced MRI scans of the head show complete tumor removal (red arrows). MRI, magnetic resonance imaging.
Zoom Image
Fig. 2 (A) Schematic representation of the supraoptic tumor parts and their relations to the surrounding neurovascular structures. (B) Schematic drawing of the intracanalicular tumor parts within the right optic canal after partial decompression. The surrounding neurovascular structures, such as the optic nerve, ophthalmic artery, and the anterior clionid process, are visible in relation to the tumor. (C) Intraoperative image through the operating microscope. Through the subfrontal approach, the supraoptic tumor parts are visible. (D) Endoscopic image through a 30-degree optic directed to the frontal base after decompression of the right optic nerve and complete tumor removal. ACP, anterior clinoid process; FB, frontal base; ICA, internal carotid artery; M1, middle cerebral artery; NI, olfactory nerve; NII, optic nerve; OC, optic canal; Tu, tumour.

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Quality:

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Conflict of Interest

None.

Address for correspondence

Peter Kurucz, MD
Neurochirurgische Klinik, Katharinenhospital
Kriegsbergstrasse 60, 70174
Deutschland   

   Permissions and Reprints
Zoom Image
Fig. 1 (A, B) Preoperative contrast agent-enhanced MRI scans of the head revealed a small lesion of the right optic foramen just medially to the anterior clinoid process (red arrows). (C, D) Postoperative contrast agent-enhanced MRI scans of the head show complete tumor removal (red arrows). MRI, magnetic resonance imaging.
Zoom Image
Fig. 2 (A) Schematic representation of the supraoptic tumor parts and their relations to the surrounding neurovascular structures. (B) Schematic drawing of the intracanalicular tumor parts within the right optic canal after partial decompression. The surrounding neurovascular structures, such as the optic nerve, ophthalmic artery, and the anterior clionid process, are visible in relation to the tumor. (C) Intraoperative image through the operating microscope. Through the subfrontal approach, the supraoptic tumor parts are visible. (D) Endoscopic image through a 30-degree optic directed to the frontal base after decompression of the right optic nerve and complete tumor removal. ACP, anterior clinoid process; FB, frontal base; ICA, internal carotid artery; M1, middle cerebral artery; NI, olfactory nerve; NII, optic nerve; OC, optic canal; Tu, tumour.