Abstract
Tumors of the skull base have historically posed a unique surgical challenge. The abundance of critical neurovascular structures in this region necessitates a distinct balance between the goals of maximal tumor removal and avoidance of neurological deficits. A number of these lesions do not have a set standard treatment paradigm, thus requiring a highly personalized plan of care based around the individual patient. Surgical resection of these lesions has the benefit of allowing direct decompression of the neurovascular elements, potentially leading to significant clinical improvement. Additionally, in a number of scenarios, surgery may be the only treatment option that offers a cure. On the other hand, the primary goal of stereotactic radiosurgery is tumor control, preventing further growth of an existing tumor or residual lesion. The desired therapeutic intervention should be determined based on various factors including the individual patient’s age, symptoms, comorbidities, tumor location, and extent of the involvement of surrounding neurovascular structures. This chapter discusses the surgical considerations for a variety of skull base tumors, including indications for surgery, surgical approaches, and patient outcomes. Due to the variability in location, natural history, and clinical presentation of skull base tumors, the discussion will illustrate the different surgical considerations for specific tumors, including trigeminal schwannomas, glomus jugulare tumors, chordomas, chondrosarcomas, esthesioneuroblastomas, craniopharyngiomas, and skull base meningiomas.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Nanda A, Jawahar A, Sathyanarayana S (2003) Microsurgery for potential radiosurgical skull base lesions: a retrospective analysis and comparison of results. Skull Base 13(3):131–138
Samii M, Migliori MM, Tatagiba M, Babu R (1995) Surgical treatment of trigeminal schwannomas. J Neurosurg 82(5):711–718
Zhang L, Yang Y, Xu S, Wang J, Liu Y, Zhu S (2009) Trigeminal schwannomas: a report of 42 cases and review of the relevant surgical approaches. Clin Neurol Neurosurg 111(3):261–269
Fukaya R, Yoshida K, Ohira T, Kawase T (2010) Trigeminal schwannomas: experience with 57 cases and a review of the literature. Neurosurg Rev 34(2):159–171
Guthikonda B, Theodosopoulos PV, van Loveren H, Tew JM Jr, Pensak ML (2008) Evolution in the assessment and management of trigeminal schwannoma. Laryngoscope 118(2):195–203
Sharma BS, Ahmad FU, Chandra PS, Mahapatra AK (2008) Trigeminal schwannomas: experience with 68 cases. J Clin Neurosci 15(7):738–743
Taha JM, Tew JM Jr, van Loveren HR, Keller JT, el-Kalliny M (1995) Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas. J Neurosurg 82(5):719–725
Yoshida K, Kawase T (1999) Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature. J Neurosurg 91(2):202–211
Al-Mefty O, Ayoubi S, Gaber E (2002) Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function. J Neurosurg 96(3):453–463
Goel A, Muzumdar D, Raman C (2003) Trigeminal neuroma: analysis of surgical experience with 73 cases. Neurosurgery 52(4):783–790; discussion 90
Jefferson G (1953) The trigeminal neurinomas with some remarks on malignant invasion of the gasserian ganglion. Clin Neurosurg 1:11–54
Kano H, Niranjan A, Kondziolka D, Flickinger JC, Dade LL (2009) Stereotactic radiosurgery for trigeminal schwannoma: tumor control and functional preservation Clinical article. J Neurosurg 110(3):553–558
Hasegawa T, Kida Y, Yoshimoto M, Koike J (2007) Trigeminal schwannomas: results of gamma knife surgery in 37 cases. J Neurosurg 106(1):18–23
Sheehan J, Yen CP, Arkha Y, Schlesinger D, Steiner L (2007) Gamma knife surgery for trigeminal schwannoma. J Neurosurg 106(5):839–845
Peker S, Bayrakli F, Kilic T, Pamir MN (2007) Gamma-knife radiosurgery in the treatment of trigeminal schwannomas. Acta Neurochir (Wien) 149(11):1133–1137; discussion 7
Al-Mefty O, Fox JL, Rifai A, Smith RR (1987) A combined infratemporal and posterior fossa approach for the removal of giant glomus tumors and chondrosarcomas. Surg Neurol 28(6):423–431
Gottfried ON, Liu JK, Couldwell WT (2004) Comparison of radiosurgery and conventional surgery for the treatment of glomus jugulare tumors. Neurosurg Focus 17(2):E4
Fayad JN, Keles B, Brackmann DE (2010) Jugular foramen tumors: clinical characteristics and treatment outcomes. Otol Neurotol 31(2):299–305
Semaan MT, Megerian CA (2008) Current assessment and management of glomus tumors. Curr Opin Otolaryngol Head Neck Surg 16(5):420–426
Green JD Jr, Brackmann DE, Nguyen CD, Arriaga MA, Telischi FF, De la Cruz A (1994) Surgical management of previously untreated glomus jugulare tumors. Laryngoscope 104(8 Pt 1):917–921
Gstoettner W, Matula C, Hamzavi J, Kornfehl J, Czerny C (1999) Long-term results of different treatment modalities in 37 patients with glomus jugulare tumors. Eur Arch Otorhinolaryngol 256(7):351–355
Gjuric M, Rudiger Wolf S, Wigand ME, Weidenbecher M (1996) Cranial nerve and hearing function after combined-approach surgery for glomus jugulare tumors. Ann Otol Rhinol Laryngol 105(12):949–954
Anand VK, Leonetti JP, al-Mefty O (1993) Neurovascular considerations in surgery of glomus tumors with intracranial extensions. Laryngoscope 103(7):722–728
Huy PT, Kania R, Duet M, Dessard-Diana B, Mazeron JJ, Benhamed R (2009) Evolving concepts in the management of jugular paraganglioma: a comparison of radiotherapy and surgery in 88 cases. Skull Base 19(1):83–91
Patel SJ, Sekhar LN, Cass SP, Hirsch BE (1994) Combined approaches for resection of extensive glomus jugulare tumors. A review of 12 cases. J Neurosurg 80(6):1026–1038
Sanna M, Jain Y, De Donato G, Rohit, Lauda L, Taibah A (2004) Management of jugular paragangliomas: the Gruppo Otologico experience. Otol Neurotol 25(5):797–804
Whitfield PC, Grey P, Hardy DG, Moffat DA (1996) The surgical management of patients with glomus tumours of the skull base. Br J Neurosurg 10(4):343–350
Watkins LD, Mendoza N, Cheesman AD, Symon L (1994) Glomus jugulare tumours: a review of 61 cases. Acta Neurochir (Wien) 130(1–4):66–70
Al-Mefty O, Teixeira A (2002) Complex tumors of the glomus jugulare: criteria, treatment, and outcome. J Neurosurg 97(6):1356–1366 [Case Reports]
Pareschi R, Righini S, Destito D, Raucci AF, Colombo S (2003) Surgery of Glomus Jugulare Tumors. Skull Base 13(3):149–157
Liu JK, Sameshima T, Gottfried ON, Couldwell WT, Fukushima T (2006) The combined transmastoid retro- and infralabyrinthine transjugular transcondylar transtubercular high cervical approach for resection of glomus jugulare tumors. Neurosurgery 59(1 Suppl 1):ONS115–ONS125; discussion ONS-25
Borba LAB, Araujo JC, de Oliveira JG, Filho MG, Moro MS, Tirapelli LF et al (2010) Surgical management of glomus jugulare tumors: a proposal for approach selection based on tumor relationships with the facial nerve. J Neurosurg 112(1):88–98
Suarez C, Rodrigo JP, Bodeker CC, Llorente JL, Silver CE, Jansen JC et al (2013) Jugular and vagal paragangliomas: systematic study of management with surgery and radiotherapy. Head Neck 35(8):1195–1204
Ivan ME, Sughrue ME, Clark AJ, Kane AJ, Aranda D, Barani IJ et al (2011) A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors. J Neurosurg 114(5):1299–1305
Jackson CG, McGrew BM, Forest JA, Netterville JL, Hampf CF, Glasscock ME 3rd (2001) Lateral skull base surgery for glomus tumors: long-term control. Otol Neurotol 22(3):377–382
Karaman E, Yilmaz M, Isildak H, Hacizade Y, Korkut N, Devranoglu I et al (2010) Management of jugular paragangliomas in otolaryngology practice. J Craniofac Surg 21(1):117–120
Saringer W, Khayal H, Ertl A, Schoeggl A, Kitz K (2001) Efficiency of gamma knife radiosurgery in the treatment of glomus jugulare tumors. Minim Invasive Neurosurg 44(3):141–146
Guss ZD, Batra S, Limb CJ, Li G, Sughrue ME, Redmond K et al (2011) Radiosurgery of glomus jugulare tumors: a meta-analysis. Int J Radiat Oncol Biol Phys 81(4):e497–e502
Healey JH, Lane JM (1989) Chordoma: a critical review of diagnosis and treatment. Orthop Clin North Am 20(3):417–426
Watkins L, Khudados ES, Kaleoglu M, Revesz T, Sacares P, Crockard HA (1993) Skull base chordomas: a review of 38 patients, 1958–88. Br J Neurosurg 7(3):241–248
McMaster ML, Goldstein AM, Bromley CM, Ishibe N, Parry DM (2001) Chordoma: incidence and survival patterns in the United States, 1973–1995. Cancer Causes Control 12(1):1–11
Sen C, Triana AI, Berglind N, Godbold J, Shrivastava RK (2010) Clival chordomas: clinical management, results, and complications in 71 patients. J Neurosurg 113(5):1059–1071
Crockard HA (1985) The transoral approach to the base of the brain and upper cervical cord. Ann R Coll Surg Engl 67(5):321–325
Walcott BP, Nahed BV, Mohyeldin A, Coumans JV, Kahle KT, Ferreira MJ (2012) Chordoma: current concepts, management, and future directions. Lancet Oncol 13(2):e69–e76
Cummings BJ, Hodson DI, Bush RS (1983) Chordoma: the results of megavoltage radiation therapy. Int J Radiat Oncol Biol Phys 9(5):633–642
Stark AM, Mehdorn HM (2003) Images in clinical medicine. Chondroid clival chordoma. N Engl J Med 349(10):e10
Kitai R, Yoshida K, Kubota T, Sato K, Handa Y, Kasahara K et al (2005) Clival chordoma manifesting as nasal bleeding. A case report. Neuroradiology 47(5):368–371
Levi AD, Kucharczyk W, Lang AP, Schutz H (1991) Clival chordoma presenting with acute brain stem hemorrhage. Can J Neurol Sci 18(4):515–518
Di Maio S, Temkin N, Ramanathan D, Sekhar LN (2011) Current comprehensive management of cranial base chordomas: 10-year meta-analysis of observational studies. J Neurosurg 115(6):1094–1105
Lanzino G, Dumont AS, Lopes MB, Laws ER Jr (2001) Skull base chordomas: overview of disease, management options, and outcome. Neurosurg Focus 10(3):E12
al-Mefty O, Borba LA (1997) Skull base chordomas: a management challenge. J Neurosurg 86(2):182–189
Tzortzidis F, Elahi F, Wright D, Natarajan SK, Sekhar LN (2006) Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chordomas. Neurosurgery 59(2):230–237; discussion 7
Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2011) The endoscope-assisted ventral approach compared with open microscope-assisted surgery for clival chordomas. World Neurosurg 76(3–4):318–327; discussion 259–262
Jian BJ, Bloch OG, Yang I, Han SJ, Aranda D, Tihan T et al (2010) Adjuvant radiation therapy and chondroid chordoma subtype are associated with a lower tumor recurrence rate of cranial chordoma. J Neurooncol 98(1):101–108
Amichetti M, Cianchetti M, Amelio D, Enrici RM, Minniti G (2009) Proton therapy in chordoma of the base of the skull: a systematic review. Neurosurg Rev 32(4):403–416
Brada M, Pijls-Johannesma M, De Ruysscher D (2007) Proton therapy in clinical practice: current clinical evidence. J Clin Oncol 25(8):965–970
Cianfriglia F, Pompili A, Occhipinti E (1978) Intracranial malignant cartilaginous tumours. Report of two cases and review of literature. Acta Neurochir (Wien) 45(1–2):163–175
Bloch OG, Jian BJ, Yang I, Han SJ, Aranda D, Ahn BJ et al (2009) A systematic review of intracranial chondrosarcoma and survival. J Clin Neurosci 16(12):1547–1551
Lau DP, Wharton SB, Antoun NM, Bottrill ID, Moffat DA (1997) Chondrosarcoma of the petrous apex. Dilemmas in diagnosis and treatment. J Laryngol Otol 111(4):368–371
Coltrera MD, Googe PB, Harrist TJ, Hyams VJ, Schiller AL, Goodman ML (1986) Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature. Cancer 58(12):2689–2696
Seidman MD, Nichols RD, Raju UB, Mehta B, Levy HG. Extracranial skull base chondrosarcoma. Ear Nose Throat J. 1989;68(8):626–32, 35.
Bloch OG, Jian BJ, Yang I, Han SJ, Aranda D, Ahn BJ et al (2010) Cranial chondrosarcoma and recurrence. Skull Base 20(3):149–156
Neff B, Sataloff RT, Storey L, Hawkshaw M, Spiegel JR (2002) Chondrosarcoma of the skull base. Laryngoscope 112(1):134–139
Gay E, Sekhar LN, Rubinstein E, Wright DC, Sen C, Janecka IP et al (1995) Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients. Neurosurgery 36(5):887–896; discussion 96–97
Radner H, Katenkamp D, Reifenberger G, Dekert M, Pietsch T, Wiestler OD (2001) New developments in the pathology of skull base tumors. Virchows Arch 438(4):321–335
Wanebo JE, Bristol RE, Porter RR, Coons SW, Spetzler RF (2006) Management of cranial base chondrosarcomas. Neurosurgery 58(2):249–255; discussion 55
Gonzalez LF, Crawford NR, Horgan MA, Deshmukh P, Zabramski JM, Spetzler RF (2002) Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach. Neurosurgery 50(3):550–555; discussion 5–7
Honeybul S, Neil-Dwyer G, Lees PD, Evans BT, Lang DA (1996) The orbitozygomatic infratemporal fossa approach: a quantitative anatomical study. Acta Neurochir (Wien) 138(3):255–264
Qiu QH, Liang MZ, Liu H, Chen SH, Zhang HB, Zhang QH (2010) [Nasal endoscopic surgical treatment for chondrosarcoma of paranasal sinus and the skull base]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 45(7):551–554
Zanation AM, Snyderman CH, Carrau RL, Gardner PA, Prevedello DM, Kassam AB (2009) Endoscopic endonasal surgery for petrous apex lesions. Laryngoscope 119(1):19–25
Zhang Q, Kong F, Yan B, Ni Z, Liu H (2008) Endoscopic endonasal surgery for clival chordoma and chondrosarcoma. ORL J Otorhinolaryngol Relat Spec 70(2):124–129
Munzenrider JE, Liebsch NJ (1999) Proton therapy for tumors of the skull base. Strahlenther Onkol 175(Suppl 2):57–63
Iyer A, Kano H, Kondziolka D, Liu X, Niranjan A, Flickinger JC et al (2012) Stereotactic radiosurgery for intracranial chondrosarcoma. J Neurooncol 108(3):535–542
Dulguerov P, Allal AS, Calcaterra TC (2001) Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2(11):683–690
Smee RI, Broadley K, Williams JR, Meagher NS, Bridger GP (2011) Retained role of surgery for olfactory neuroblastoma. Head Neck 33(10):1486–1492
Lund VJ, Howard D, Wei W, Spittle M (2003) Olfactory neuroblastoma: past, present, and future? Laryngoscope 113(3):502–507
Theilgaard SA, Buchwald C, Ingeholm P, Kornum Larsen S, Eriksen JG, Sand HH (2003) Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol 123(3):433–439
Thompson LD (2009) Olfactory neuroblastoma. Head Neck Pathol 3(3):252–259
Levine PA, Gallagher R, Cantrell RW (1999) Esthesioneuroblastoma: reflections of a 21-year experience. Laryngoscope 109(10):1539–1543
Oskouian RJ Jr, Jane JA Sr, Dumont AS, Sheehan JM, Laurent JJ, Levine PA (2002) Esthesioneuroblastoma: clinical presentation, radiological, and pathological features, treatment, review of the literature, and the University of Virginia experience. Neurosurg Focus 12(5):e4
Cantrell RW, Ghorayeb BY, Fitz-Hugh GS (1977) Esthesioneuroblastoma: diagnosis and treatment. Ann Otol Rhinol Laryngol 86(6 Pt 1):760–765
Shah JP, Kraus DH, Bilsky MH, Gutin PH, Harrison LH, Strong EW (1997) Craniofacial resection for malignant tumors involving the anterior skull base. Arch Otolaryngol Head Neck Surg 123(12):1312–1317
Bilsky MH, Kraus DH, Strong EW, Harrison LB, Gutin PH, Shah JP (1997) Extended anterior craniofacial resection for intracranial extension of malignant tumors. Am J Surg 174(5):565–568
Eden BV, Debo RF, Larner JM, Kelly MD, Levine PA, Stewart FM et al (1994) Esthesioneuroblastoma. Long-term outcome and patterns of failure—the University of Virginia experience. Cancer 73(10):2556–2562
Aboziada MA, Eisbruch A (2010) Esthesioneuroblastoma: the role of post-operative irradiation after complete surgical resection. J Egypt Natl Canc Inst 22(2):143–148
Ward PD, Heth JA, Thompson BG, Thompson BG, Marentette LJ (2009) Esthesioneuroblastoma: results and outcomes of a single institution’s experience. Skull Base 19(2):133–140
Nichols AC, Chan AW, Curry WT, Barker FG, Deschler DG, Lin DT (2008) Esthesioneuroblastoma: the Massachusetts eye and ear infirmary and Massachusetts general hospital experience with craniofacial resection, proton beam radiation, and chemotherapy. Skull Base 18(5):327–337
Porter AB, Bernold DM, Giannini C, Foote RL, Link MJ, Olsen KD et al (2008) Retrospective review of adjuvant chemotherapy for esthesioneuroblastoma. J Neurooncol 90(2):201–204
McLean JN, Nunley SR, Klass C, Moore C, Muller S, Johnstone PA (2007) Combined modality therapy of esthesioneuroblastoma. Otolaryngol Head Neck Surg 136(6):998–1002
Soler ZM, Smith TL (2012) Endoscopic versus open craniofacial resection of esthesioneuroblastoma: what is the evidence? Laryngoscope 122(2):244–245
Monteiro EM, Lopes MG, Santos ER, Diniz CV, Albuquerque AS, Monteiro AP et al (2011) Endoscopic treatment of esthesioneuroblastoma. Braz J Otorhinolaryngol 77(2):171–177
Kodama S, Kawano T, Suzuki M (2009) Endoscopic transnasal resection of ectopic esthesioneuroblastoma in the pterygopalatine fossa: technical case report. Neurosurgery 65(6 Suppl):E112–E113; discussion E3
Folbe A, Herzallah I, Duvvuri U, Bublik M, Sargi Z, Snyderman CH et al (2009) Endoscopic endonasal resection of esthesioneuroblastoma: a multicenter study. Am J Rhinol Allergy 23(1):91–94
Gallia GL, Reh DD, Salmasi V, Blitz AM, Koch W, Ishii M (2011) Endonasal endoscopic resection of esthesioneuroblastoma: the Johns Hopkins Hospital experience and review of the literature. Neurosurg Rev 34(4):465–475
Casiano RR, Numa WA, Falquez AM (2001) Endoscopic resection of esthesioneuroblastoma. Am J Rhinol 15(4):271–279
Unger F, Haselsberger K, Walch C, Stammberger H, Papaefthymiou G (2005) Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma (esthesioneuroblastoma). Acta Neurochir (Wien) 147(6):595–601; discussion 2
Unger F, Walch C, Stammberger H, Papaefthymiou G, Haselsberger K, Pendl G (2001) Olfactory neuroblastoma (esthesioneuroblastoma): report of six cases treated by a novel combination of endoscopic surgery and radiosurgery. Minim Invasive Neurosurg 44(2):79–84
Walch C, Stammberger H, Unger F, Anderhuber W (2000) A new therapy concept in esthesioneuroblastoma. Laryngorhinootologie 79(12):743–748
Prabhu VC, Brown HG (2005) The pathogenesis of craniopharyngiomas. Childs Nerv Syst 21(8–9):622–627
Stamm AC, Vellutini E, Balsalobre L. Craniopharyngioma. Otolaryngol Clin North Am. 2011;44(4):937–52, viii.
Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89(4):547–551
Caldarelli M, Massimi L, Tamburrini G, Cappa M, Di Rocco C (2005) Long-term results of the surgical treatment of craniopharyngioma: the experience at the Policlinico Gemelli, Catholic University, Rome. Childs Nerv Syst 21(8–9):747–757
Laws ER Jr (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52(5):661–666
Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90(2):237–250
Nielsen EH, Feldt-Rasmussen U, Poulsgaard L, Kristensen LO, Astrup J, Jorgensen JO et al (2011) Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults. J Neurooncol 104(3):755–763
Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D et al (1994) Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 35(6):1001–1010; discussion 10–11
Adamson TE, Wiestler OD, Kleihues P, Yasargil MG (1990) Correlation of clinical and pathological features in surgically treated craniopharyngiomas. J Neurosurg 73(1):12–17
Muller HL, Bruhnken G, Emser A, Faldum A, Etavard-Gorris N, Gebhardt U et al (2005) Longitudinal study on quality of life in 102 survivors of childhood craniopharyngioma. Childs Nerv Syst 21(11):975–980
Puget S, Garnett M, Wray A, Grill J, Habrand JL, Bodaert N et al (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106(1 Suppl):3–12
Merchant TE, Kiehna EN, Sanford RA, Mulhern RK, Thompson SJ, Wilson MW et al (2002) Craniopharyngioma: the St. Jude Children’s Research Hospital experience 1984–2001. Int J Radiat Oncol Biol Phys 53(3):533–542
Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76(1):47–52
Baskin DS, Wilson CB (1986) Surgical management of craniopharyngiomas. A review of 74 cases. J Neurosurg 65(1):22–27
Karavitaki N, Wass JA. Craniopharyngiomas. Endocrinol Metab Clin North Am. 2008;37(1):173–93, ix-x.
Müller HL (2013) Childhood craniopharyngioma. Pituitary 16(1):56–67
Van Effenterre R, Boch AL (2002) Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg 97(1):3–11
Minamida Y, Mikami T, Hashi K, Houkin K (2005) Surgical management of the recurrence and regrowth of craniopharyngiomas. J Neurosurg 103(2):224–232
Leng LZ, Greenfield JP, Souweidane MM, Anand VK, Schwartz TH (2012) Endoscopic, endonasal resection of craniopharyngiomas: analysis of outcome including extent of resection, cerebrospinal fluid leak, return to preoperative productivity, and body mass index. Neurosurgery 70(1):110–123; discussion 23–24
Lin LL, El Naqa I, Leonard JR, Park TS, Hollander AS, Michalski JM et al (2008) Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1(2):126–130
De Vile CJ, Grant DB, Kendall BE, Neville BG, Stanhope R, Watkins KE et al (1996) Management of childhood craniopharyngioma: can the morbidity of radical surgery be predicted? J Neurosurg 85(1):73–81
Matson DD, Crigler JF Jr (1969) Management of craniopharyngioma in childhood. J Neurosurg 30(4):377–390
Liu JK, Christiano LD, Gupta G, Carmel PW (2010) Surgical nuances for removal of retrochiasmatic craniopharyngiomas via the transbasal subfrontal translamina terminalis approach. Neurosurg Focus 28(4):E6
Maira G, Anile C, Albanese A, Cabezas D, Pardi F, Vignati A (2004) The role of transsphenoidal surgery in the treatment of craniopharyngiomas. J Neurosurg 100(3):445–451
Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T (2004) Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery 55(3):539–547; discussion 47–50
Liu JK, Eloy JA. Endoscopic endonasal transplanum transtuberculum approach for resection of retrochiasmatic craniopharyngioma. J Neurosurg. 2012;32 Suppl:E2.
Pemberton LS, Dougal M, Magee B, Gattamaneni HR (2005) Experience of external beam radiotherapy given adjuvantly or at relapse following surgery for craniopharyngioma. Radiother Oncol 77(1):99–104
Yang I, Sughrue ME, Rutkowski MJ, Kaur R, Ivan ME, Aranda D et al (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28(4):E5
Veeravagu A, Lee M, Jiang B, Chang SD (2010) The role of radiosurgery in the treatment of craniopharyngiomas. Neurosurg Focus 28(4):E11
Lee M, Kalani MY, Cheshier S, Gibbs IC, Adler JR, Chang SD (2008) Radiation therapy and CyberKnife radiosurgery in the management of craniopharyngiomas. Neurosurg Focus 24(5):E4
Di Maio S, Ramanathan D, Garcia-Lopez R, Rocha MH, Guerrero FP, Ferreira M Jr et al (2012) Evolution and future of skull base surgery: the paradigm of skull base meningiomas. World Neurosurg 78(3–4):260–275
Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 77(5–6):713–724
Ichinose T, Goto T, Ishibashi K, Takami T, Ohata K (2010) The role of radical microsurgical resection in multimodal treatment for skull base meningioma. J Neurosurg 113(5):1072–1078
Couldwell WT, Fukushima T, Giannotta SL, Weiss MH (1996) Petroclival meningiomas: surgical experience in 109 cases. J Neurosurg 84(1):20–28
Jung HW, Yoo H, Paek SH, Choi KS (2000) Long-term outcome and growth rate of subtotally resected petroclival meningiomas: experience with 38 cases. Neurosurgery 46(3):567–574; discussion 74–75
Kano T, Kawase T, Horiguchi T, Yoshida K (2010) Meningiomas of the ventral foramen magnum and lower clivus: factors influencing surgical morbidity, the extent of tumour resection, and tumour recurrence. Acta Neurochir (Wien) 152(1):79–86; discussion 86
Natarajan SK, Sekhar LN, Schessel D, Morita A (2007) Petroclival meningiomas: multimodality treatment and outcomes at long-term follow-up. Neurosurgery 60(6):965–979; discussion 79–81
Obeid F, Al-Mefty O (2003) Recurrence of olfactory groove meningiomas. Neurosurgery 53(3):534–542; discussion 42–43
Fisch U (1978) Infratemporal fossa approach to tumours of the temporal bone and base of the skull. J Laryngol Otol 92(11):949–967
Samii M, Tatagiba M, Carvalho GA (1999) Resection of large petroclival meningiomas by the simple retrosigmoid route. J Clin Neurosci 6(1):27–30
Jane JA, Park TS, Pobereskin LH, Winn HR, Butler AB (1982) The supraorbital approach: technical note. Neurosurgery 11(4):537–542
Yasargil MG, Reichman MV, Kubik S (1987) Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy. Technical article. J Neurosurg 67(3):463–466
Hakuba A, Liu S, Nishimura S (1986) The orbitozygomatic infratemporal approach: a new surgical technique. Surg Neurol 26(3):271–276
Sekhar LN, Schramm VL Jr, Jones NF (1987) Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg 67(4):488–499
Al-Mefty O, Smith RR (1988) Surgery of tumors invading the cavernous sinus. Surg Neurol 30(5):370–381
Kawase T, Shiobara R, Toya S (1991) Anterior transpetrosal-transtentorial approach for sphenopetroclival meningiomas: surgical method and results in 10 patients. Neurosurgery 28(6):869–875; discussion 75–76
Samii M, Gerganov V, Giordano M, Samii A (2010) Two step approach for surgical removal of petroclival meningiomas with large supratentorial extension. Neurosurg Rev 34(2):173–179
Cho CW, Al-Mefty O (2002) Combined petrosal approach to petroclival meningiomas. Neurosurgery 51(3):708–716; discussion 16–18
Babu RP, Sekhar LN, Wright DC (1994) Extreme lateral transcondylar approach: technical improvements and lessons learned. J Neurosurg 81(1):49–59
Sekhar LN, Babu RP, Wright DC (1994) Surgical resection of cranial base meningiomas. Neurosurg Clin N Am 5(2):299–330
Sen CN, Sekhar LN (1990) An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery 27(2):197–204
Laufer I, Anand VK, Schwartz TH (2007) Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions. J Neurosurg 106(3):400–406
Schwartz TH, Anand VK (2007) The endoscopic endonasal transsphenoidal approach to the suprasellar cistern. Clin Neurosurg 54:226–235
Gardner PA, Kassam AB, Thomas A, Snyderman CH, Carrau RL, Mintz AH et al (2008) Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery 63(1):36–52; discussion 4
Liu JK, Christiano LD, Patel SK, Tubbs RS, Eloy JA (2011) Surgical nuances for removal of olfactory groove meningiomas using the endoscopic endonasal transcribriform approach. Neurosurg Focus 30(5):E3
Liu JK, Christiano LD, Patel SK, Tubbs RS, Eloy JA (2011) Surgical nuances for removal of tuberculum sellae meningiomas with optic canal involvement using the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach. Neurosurg Focus 30(5):E2
Aydin S, Cavallo LM, Messina A, Dal Fabbro M, Cappabianca P, Barlas O et al (2007) The endoscopic endonasal trans-sphenoidal approach to the sellar and suprasellar area. Anatomic study. J Neurosurg Sci 51(3):129–138
Cavallo LM, de Divitiis O, Aydin S, Messina A, Esposito F, Iaconetta G et al (2007) Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations—part 1. Neurosurgery 61(3 Suppl):24–33; discussion 4
de Divitiis E, Cavallo LM, Cappabianca P, Esposito F (2007) Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors: Part 2. Neurosurgery 60(1):46–58; discussion 9
Heth JA, Al-Mefty O (2003) Cavernous sinus meningiomas. Neurosurg Focus 14(6):e3
Walsh MT, Couldwell WT (2009) Management options for cavernous sinus meningiomas. J Neurooncol 92(3):307–316
Long DM (2001) The treatment of meningiomas in the region of the cavernous sinus. Childs Nerv Syst 17(3):168–172
Pichierri A, Santoro A, Raco A, Paolini S, Cantore G, Delfini R (2009) Cavernous sinus meningiomas: retrospective analysis and proposal of a treatment algorithm. Neurosurgery 64(6):1090–1099; discussion 9–101
De Jesus O, Sekhar LN, Parikh HK, Wright DC, Wagner DP (1996) Long-term follow-up of patients with meningiomas involving the cavernous sinus: recurrence, progression, and quality of life. Neurosurgery 39(5):915–919; discussion 9–20
Sekhar LN, Patel S, Cusimano M, Wright DC, Sen CN, Bank WO (1996) Surgical treatment of meningiomas involving the cavernous sinus: evolving ideas based on a ten year experience. Acta Neurochir Suppl 65:58–62
Hasegawa T, Kida Y, Yoshimoto M, Koike J, Iizuka H, Ishii D (2007) Long-term outcomes of Gamma Knife surgery for cavernous sinus meningioma. J Neurosurg 107(4):745–751
Ware ML, Pravdenkova S, Erkmen K, Al-Mefty O (2009) Petroclival and upper clival meningiomas I: an overview of surgical approaches. In: Lee JH (ed) Meningiomas: diagnosis, treatment, and outcome. Springer, London
Nanda A, Javalkar V, Banerjee AD (2011) Petroclival meningiomas: study on outcomes, complications and recurrence rates. J Neurosurg 114(5):1268–1277
Van Havenbergh T, Carvalho G, Tatagiba M, Plets C, Samii M (2003) Natural history of petroclival meningiomas. Neurosurgery 52(1):55–62; discussion 4
Al-Mefty O, Sekhar LN, Sen C, van Loveren HR (2001) Petroclival meningioma: case history and responses. Skull Base 11(2):143–148
Tatagiba M, Samii M, Matthies C, Vorkapic P (1996) Management of petroclival meningiomas: a critical analysis of surgical treatment. Acta Neurochir Suppl 65:92–94
Ammirati M, Samii M (1992) Presigmoid sinus approach to petroclival meningiomas. Skull Base Surg 2(3):124–128
Samii M, Gerganov VM (2011) Petroclival meningiomas: quo vadis? World Neurosurg 75(3–4):424
Al-Mefty O (1991) Meningiomas. Raven Press, New York
Mahmoud M, Nader R, Al-Mefty O. Optic canal involvement in tuberculum sellae meningiomas: influence on approach, recurrence, and visual recovery. Neurosurgery. 2010;67(3 Suppl Operative):ons108–18; discussion ons18–19.
Nozaki K, Kikuta K, Takagi Y, Mineharu Y, Takahashi JA, Hashimoto N (2008) Effect of early optic canal unroofing on the outcome of visual functions in surgery for meningiomas of the tuberculum sellae and planum sphenoidale. Neurosurgery 62(4):839–844; discussion 44–46
Attia M, Kandasamy J, Jakimovski D, Bedrosian J, Alimi M, Lee DL, et al. The importance and timing of optic canal exploration and decompression during endoscopic endonasal resection of tuberculum sella and planum sphenoidale meningiomas. Neurosurgery. 2012;71(1 Suppl Operative):ons58–67.
Schick U, Hassler W (2005) Surgical management of tuberculum sellae meningiomas: involvement of the optic canal and visual outcome. J Neurol Neurosurg Psychiatry 76(7):977–983
Otani N, Muroi C, Yano H, Khan N, Pangalu A, Yonekawa Y (2006) Surgical management of tuberculum sellae meningioma: role of selective extradural anterior clinoidectomy. Br J Neurosurg 20(3):129–138
Sade B, Lee JH (2009) High incidence of optic canal involvement in tuberculum sellae meningiomas: rationale for aggressive skull base approach. Surg Neurol 72(2):118–123; discussion 23
Chai Y, Yamazaki H, Kondo A, Oshitari T, Yamamoto S (2012) Case of acute optic nerve compression caused by tuberculum sellae meningioma with optic canal involvement. Clin Ophthalmol 6:661–666
de Divitiis E, Esposito F, Cappabianca P, Cavallo LM, de Divitiis O (2008) Tuberculum sellae meningiomas: high route or low route? A series of 51 consecutive cases. Neurosurgery 62(3):556–563; discussion 63
Bowers CA, Altay T, Couldwell WT (2011) Surgical decision-making strategies in tuberculum sellae meningioma resection. Neurosurg Focus 30(5):E1
Kassam AB, Thomas A, Carrau RL, Snyderman CH, Vescan A, Prevedello D et al (2008) Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery 63(1 Suppl 1):ONS44–ONS52; discussion ONS3
Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH et al (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116(10):1882–1886
Starke RM, Williams BJ, Hiles C, Nguyen JH, Elsharkawy MY, Sheehan JP (2012) Gamma knife surgery for skull base meningiomas. J Neurosurg 116(3):588–597
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Schmidt, R.F., Patel, S.K., Jyung, R.W., Eloy, J.A., Liu, J.K. (2015). Skull Base Tumors: Viewpoint—Surgery. In: Chin, L., Regine, W. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8363-2_39
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8363-2_39
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8362-5
Online ISBN: 978-1-4614-8363-2
eBook Packages: MedicineMedicine (R0)