What is the best approach to resect an anterior midline skull base meningioma in 2011? Microsurgical transcranial, endonasal endoscopic, or minimal access cranial?

摘要

Neurosurgery in general, and skull base surgery in particular, has advanced during the last 3 decades by the adoption of new technologies and new techniques. These new technologies and techniques include the widespread adoption of the surgical microscope with progressive improvements, improvements in anesthetic techniques, improvements in intraoperative instrumentation and equipment (e.g., ultrasonic aspirators, microinstruments, neuronavigation), neurophysiologic monitoring, the innovation of skull base approaches and reconstruction methods, multidisciplinary team approaches, radiosur-gery, and endoscopically assisted surgery. Many of the new techniques have resulted in changes in the surgical paradigm, and although they have met with initial resistance or increased complications, they have gone on to widespread adoption by neurosurgeons throughout the world.