Burks, Joshua D.Conner, Andrew K.Bonney, Phillip A.Archer, Jacob B.Christensen, BlakeSmith, JacquelineSafavi-Abbasi, SamSughrue, Michael2017-04-102017-04-102016-04-27Burks, J. D., Conner, A. K., Bonney, P. A., Archer, J. B., Christensen, B., Smith, J., … Sughrue, M. (2016). Management of Intracranial Meningiomas Using Keyhole Techniques. Cureus, 8(4), e588. http://doi.org/10.7759/cureus.588https://hdl.handle.net/1805/12221BACKGROUND: Keyhole craniotomies are increasingly being used for lesions of the skull base. Here we review our recent experience with these approaches for resection of intracranial meningiomas. METHODS: Clinical and operative data were gathered on all patients treated with keyhole approaches by the senior author from January 2012 to June 2013. Thirty-one meningiomas were resected in 27 patients, including 9 supratentorial, 5 anterior fossa, 7 middle fossa, 6 posterior fossa, and 4 complex skull base tumors. Twenty-nine tumors were WHO Grade I, and 2 were Grade II. RESULTS: The mean operative time was 8 hours, 22 minutes (range, 2:55-16:14) for skull-base tumors, and 4 hours, 27 minutes (range, 1:45-7:13) for supratentorial tumors. Simpson Resection grades were as follows: Grade I = 8, II = 8, III = 1, IV = 15, V = 0. The median postoperative hospital stay was 4 days (range, 1-20 days). In the 9 patients presenting with some degree of visual loss, 7 saw improvement or complete resolution. In the 6 patients presenting with cranial nerve palsies, 4 experienced improvement or resolution of the deficit postoperatively. Four patients experienced new neurologic deficits, all of which were improved or resolved at the time of the last follow-up. Technical aspects and surgical nuances of these approaches for management of intracranial meningiomas are discussed. CONCLUSIONS: With careful preoperative evaluation, keyhole approaches can be utilized singly or in combination to manage meningiomas in a wide variety of locations with satisfactory results.en-USAttribution 3.0 United Statescraniotomyeyebrowkeyholemeningiomapterionalretrosigmoidsupraorbitaltumor resectionArticle