Download PDF
Minim Invasive Neurosurg 2002; 45(3): 185-188
DOI: 10.1055/s-2002-34338
Technical Note
Georg Thieme Verlag Stuttgart · New York

Endoscopic Glabellar Approach to the Anterior Skull Base: A Technical Note

H.-D.  Jho1 , A.  Alfieri1
  • 1Center for Minimally Invasive Endoscopic Neurosurgery, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Further Information

Publication History

Publication Date:
26 September 2002 (online)

    Permissions and Reprints

Abstract

Object: An endoscopic glabellar transethmoidal approach via a small nasional incision to the anterior skull base is reported as a minimally invasive neurosurgical technique.

Surgical Technique: A frontonasal craniotomy (2 × 2 cm in size) between the medial orbits is made via a nasional skin incision approximately 3-cm in length. An ethmoidectomy is performed in order to expose the skull base at the anterior cranial fossa. Anterior and posterior ethmoidal arteries, which provide blood-supply to the tumor, are interrupted during the ethmoidectomy. The tumor located at the anterior cranial fossa is removed under an endoscope. A rod-lens endoscope, which is 4-mm in diameter and 18-cm in length, is used. The dura mater is reconstructed with dural graft placement. The skull-base bone at the anterior cranial fossa is reconstructed with autogenous bone or a piece of titanium mesh. The ethmoidectomy site is filled with abdominal fat graft material. The craniotomy bone flap is secured with titanium microplates and screws. Two demonstrative patients are reported. The benefits of the minimally invasiveness of this surgical technique have been observed in patient recovery.

Conclusion: An endoscopic glabellar transethmoidal approach to the anterior cranial fossa via a small nasional incision is reported with two patients with olfactory groove meningiomas.

Key words

Brain Tumors - Craniotomy - Endoscope - Ethmoid - Meningioma - Nasal Bone - Skull Base Surgery

References

  • 1 Jho H-D, Ko Y. Glabellar approach: Simplified midline anterior skull base approach.  Minim Invasive Neurosurg. 1997;  40 62-67
    PubMedGoogle Scholar
  • 2 Apuzzo M LJ, Heifetz M D, Weiss M H, Kurze T. Neurosurgical endoscopy using the side-viewing telescope.  J Neurosurg. 1977;  46 398-400
    CrossrefPubMedGoogle Scholar
  • 3 Perneczky A, Fries G. Endoscope-assisted brain surgery: Part 1 - evolution, basic concept, and current technique.  Neurosurgery. 1998;  42 219-225
    CrossrefPubMedGoogle Scholar
  • 4 Jho H-D, Carrau R L. Endoscopic endonasal transsphenoidal surgery: Experience with 50 patients.  J Neurosurg. 1997;  87 44-51
    CrossrefPubMedGoogle Scholar

H.-D. Jho,M. D., Ph.D. 

Professor of Neurological Surgery · Director, Jho Institute for Minimally Invasive Neurosurgery · Department of Neurological Surgery · Allegheny General Hospital

Suite 312, East Wing, 420 East North Avenue

Pittsburgh, Pennsylvania 15212-4746, USA ·

Phone: +1-412-359-6110

Fax: +1-412-359-4811

Email: hdjho@DrJho.com

      >