Abstract：
OBJECTIVE: Tumors of the skull base can be accessed through different routes. Recent advantages in minimally invasive techniques have shown that very different routes can be applied for optimal tumor resection depending on the technical equipment, the surgeon\'s preference, and the individual anatomy of the pathology. Here, the authors present their technique for pure endoscopic transcranial tumor resection in meningiomas.
METHODS: Out of the cases of the Department of Neurosurgery, Homburg Saar Germany of the last 10 years, all endoscopic procedures for meningiomas were analyzed. Particular attention was given to evaluating the peculiarities of those meningiomas that were treated purely endoscopically.
RESULTS: While the endoscope was used in a large number of skull base meningiomas in endonasal approaches or for endoscopic inspection in transcranial skull base surgery, only a small number of meningiomas was selected for a purely endoscopically performed resection. The characteristics of these cases were rather a small lesion, straight access, and a keyhole position of the craniotomy. A complete resection of the tumor was achieved in all cases. Conversion to the microscope was not necessary in any case. There were no technical issues or complications associated with a fully endoscopic resection.
CONCLUSIONS: The endoscope is a valuable tool for visualization in meningioma surgery. In most cases, it is applied for an endonasal route or for endoscopic inspection in transcranial microsurgical cases. However, small to medium-sized meningiomas that can be accessed through the keyhole approach are good candidates for pure endoscopic resection. Because of the very high magnification and the minimally invasive nature of this approach, it should be considered more frequently in suitable lesions.
METHODS: Out of the cases of the Department of Neurosurgery, Homburg Saar Germany of the last 10 years, all endoscopic procedures for meningiomas were analyzed. Particular attention was given to evaluating the peculiarities of those meningiomas that were treated purely endoscopically.
RESULTS: While the endoscope was used in a large number of skull base meningiomas in endonasal approaches or for endoscopic inspection in transcranial skull base surgery, only a small number of meningiomas was selected for a purely endoscopically performed resection. The characteristics of these cases were rather a small lesion, straight access, and a keyhole position of the craniotomy. A complete resection of the tumor was achieved in all cases. Conversion to the microscope was not necessary in any case. There were no technical issues or complications associated with a fully endoscopic resection.
CONCLUSIONS: The endoscope is a valuable tool for visualization in meningioma surgery. In most cases, it is applied for an endonasal route or for endoscopic inspection in transcranial microsurgical cases. However, small to medium-sized meningiomas that can be accessed through the keyhole approach are good candidates for pure endoscopic resection. Because of the very high magnification and the minimally invasive nature of this approach, it should be considered more frequently in suitable lesions.
摘要：
目的：颅底肿瘤可以通过不同的途径进入。微创技术的最新优势表明，根据技术设备，可以采用非常不同的途径进行最佳的肿瘤切除。外科医生的偏好，和病理学的个体解剖学。这里,作者介绍了他们的技术用于脑膜瘤的纯内镜经颅肿瘤切除术。
方法：在神经外科的病例中，在过去的10年里，德国的萨尔州，对脑膜瘤的所有内镜手术进行了分析.特别注意评估纯内窥镜治疗的脑膜瘤的特殊性。
结果：虽然内窥镜用于经鼻入路的大量颅底脑膜瘤或用于经颅颅底手术的内窥镜检查，仅少数脑膜瘤被选择用于单纯内镜切除.这些病例的特征是相当小的病变，直通,和开颅手术的锁孔位置。在所有情况下都实现了肿瘤的完全切除。在任何情况下都不需要转换到显微镜。没有与完全内窥镜切除相关的技术问题或并发症。
结论：内窥镜是脑膜瘤手术可视化的有价值的工具。在大多数情况下,它适用于经鼻途径或经颅显微外科病例的内窥镜检查。然而,可以通过锁孔入路进入的中小型脑膜瘤是纯内窥镜切除的理想选择。由于这种方法具有很高的放大倍数和微创性，在合适的病变中应该更频繁地考虑。
方法：在神经外科的病例中，在过去的10年里，德国的萨尔州，对脑膜瘤的所有内镜手术进行了分析.特别注意评估纯内窥镜治疗的脑膜瘤的特殊性。
结果：虽然内窥镜用于经鼻入路的大量颅底脑膜瘤或用于经颅颅底手术的内窥镜检查，仅少数脑膜瘤被选择用于单纯内镜切除.这些病例的特征是相当小的病变，直通,和开颅手术的锁孔位置。在所有情况下都实现了肿瘤的完全切除。在任何情况下都不需要转换到显微镜。没有与完全内窥镜切除相关的技术问题或并发症。
结论：内窥镜是脑膜瘤手术可视化的有价值的工具。在大多数情况下,它适用于经鼻途径或经颅显微外科病例的内窥镜检查。然而,可以通过锁孔入路进入的中小型脑膜瘤是纯内窥镜切除的理想选择。由于这种方法具有很高的放大倍数和微创性，在合适的病变中应该更频繁地考虑。
