Modified Trans-Sinusal Transglabellar Approach for Anterior Cranial Fossa Meningiomas: Technical Note and Literature Review

Abstract

Abstract Introduction Currently, skull base surgery faces the dilemma of achieving the maximum possible tumor resection through less aggressive approaches and with minimal retraction of brain tissue. The objective of this work is to report a minimally invasive step-by-step approach to anterior cranial fossa tumors and to perform a literature review. Methods In our work, we describe a step-by-step approach, with images, which is a variation of the transglabellar approach. Results In all cases, we achieved maximum total resection of the lesion. There were no postoperative complications related to the surgery. In one case, we used the access to remove a foreign body in the frontal lobe. Conclusion The frontal trans-sinusal transglabellar access allows direct access to anterior cranial fossa tumors and other frontal lobe lesions close to the floor of the anterior fossa, without the need for brain retraction, allowing early devascularization of the tumor. However, this access is not recommended for all types of tumors, and is being improved for more anteriorly located lesions.