Save
The Effect of Preoperative Ligation of Ethmoidal Arteries on the Perioperative Outcomes of Large Anterior Skull Base Meningiomas: A Clinical Study
Author(s):
A.S. Youssef
Affiliations:
University of Colorado, Denver, United States
EANS Academy. Youssef A. Oct 21, 2018; 225991; EP4088
A Samy Youssef
A Samy Youssef
Login now to access Regular content available to all registered users.

Access to Privileged content is currently a membership benefit.

Click here to join EANS or renew your membership.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Abstract

Objective
Anterior skull base meningiomas often grow to a large size (≥4cm) prior to detection owing to their subtle clinical impact. Their blood supply is mostly provided by the anterior and posterior ethmoidal arteries. Because of their vascularity, intraoperative bleeding can be a limiting factor that adds to the length of procedure and increase the risk of perioperative complications. Preoperative ethmoidal arteries ligation has been employed to aid in limiting blood loss. However, endovascular techniques cannot be safely applied in anterior skull base due to the risk of blindness.The objective of this study is to assess the effect of preoperative direct arterial ligation on the perioperative course of large ((≥4cm) to giant (≥6cm) anterior skull base meningiomas.
Methods
We retrospectively searched our database for large anterior skull base meningiomas (≥4cm) resected by the senior author using the same technique. Ligation was performed either via an endoscopic endonasal approach or via a trancaruncular approach.
Results
Twelve patients with large anterior skull base meningiomas were studied. Seven underwent surgery without preoperative ethmoidal arteries ligation and five underwent preoperative ligation. There was no significant difference in baseline demographics or postoperative outcomes between the two groups. Average blood loss was less in the patients that underwent ligation group overall and when corrected by tumor volume.

Conclusion
In our small series, the results indicate a decrease in EBL with preoperative direct arterial ligation. Arterial blood supply beyond the ethmoidal arteries limits the benefits of ethmoidal arteries ligation in large anterior skull base meningiomas.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings