The use of the endoscopic endonasal approach (EEA) for resection of anterior skull base meningiomas has become increasingly popular. However, the orbital contents, especially the optic nerves, limit the lateral exposure of EEA.
For skull base tumors lateral to the optic nerve, a supraorbital craniotomy provides excellent exposure with minimal brain retraction. However, the angle of the orbital roof can make it difficult to access more medial regions of the anterior cranial base. In addition, the limited size of the pericranial flap that can be harvested makes reconstruction challenging for large anterior skull base defects.
For tumors that overlap the boundaries of a single approach, multiple minimally invasive surgical corridors may be combined for optimal resection instead of a larger traditional craniotomy and skin incision.
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