Background: Skull base tumors presented great challenge for neurosurgeons\nsince decades due to their deep location, associated morbidity and limitation\nof operative field; however modern neurosurgery using the endoscope and/or\nthe microscope served in minimizing peri-operative morbidities and improving\nthe clinical outcome. Objective: To demonstrate the value of endoscope-\nassisted microsurgical technique for resection of skull base tumors. Patients\nand Methods: 30 patients divided into 3 groups (10 patients had medial\nsphenoid wing meningioma constituted group 1, 10 patients had suprasellar\nmeningioma constituted group 2 and 10 patients had Cerbello-Pontine\nAngle (CPA) epidermoids constituted group 3) were operated through Endoscope\nAssisted Microscopic Skull Base Surgery technique at Al-Azhar University\nHospitals during the period starting from January 2016 till the end of\nSeptember 2017 using a rigid endoscope for inspection of tumor boundaries\nand neighboring vascularity in addition to confirm the extent of resection.\nTumor resection was tried in all cases. Intra-operative resection rate and\npost-operative radiological outcomes were assessed. Results: Total gross resection\nwas possible in 27 patients (90%). Subtotal resection was done in the\nother 3 cases (recurrent medial sphenoid wing meningiomas) due to excessive\nbleeding and adhesions of the tumors with vascular structures. Total resection\nof the tumor in post operative radiology was obtained in 24 patients (80%)\nand post-operative residual tumor was noticed in 6 patients in early post\noperative radiology and in only 3 cases at 3 months follow up radiology. Conclusion:\nEndoscopic-assisted microsurgical approach is a reliable, safe and effective\noption for adequate surgical resection of skull base tumors. The technique\nallowed proper inspection of the tumor relations and vascularity, detection\nof any residual portions, providing better chance for gross total resection\nwith minimal tissue damage or vascular injury as well as convenient clinical\noutcome.
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