A medical team has developed a minimally invasive neurosurgical technique using an endoscope for removing skull base tumors. This approach outperforms traditional microscopic methods by offering shorter operation times, reduced blood loss, and smaller craniotomies.
Skull base tumors pose a significant challenge in neurosurgery due to their location. The current standard treatment involves microscopic surgery known as the anterior transpetrosal approach (ATPA). To minimize risks associated with potential damage and postoperative complications, a research team at Osaka Metropolitan University is pioneering a new method.
Led by Dr. Hiroki Morisako and Professor Takeo Goto from the Department of Neurosurgery at the Graduate School of Medicine, the team introduced a minimally invasive technique named purely endoscopic subtemporal keyhole ATPA. Their work, published in The Journal of Neurosurgery, represents a groundbreaking description of this procedure for removing petrous apex lesions in the skull base region.
Compared to the microscopic approach, the endoscopic technique requires a significantly smaller skull opening area, averaging only 11.2 cm² versus 33.9 cm². This reduction also lowers the risk of brain damage.
Between 2022 and 2023, the team performed 10 surgeries using their technique at Osaka Metropolitan University Hospital, comparing the outcomes with 13 surgeries conducted with the microscopic ATPA from 2014 to 2021. The endoscopic approach notably reduced average operation time from 410.9 minutes to 252.9 minutes and decreased blood loss from 193 ml to 90 ml. Tumor removal rates and preservation of neurological functions were on par with the conventional method or even better.
“When comparing the new endoscopic technique with the traditional microscopic one, we observed no significant differences in tumor removal rates or patients’ ability to perform daily activities post-surgery. The endoscopic method stands out for its shorter operation times and reduced blood loss,” Professor Goto explained. “Widespread adoption of this surgical innovation is poised to enhance brain tumor treatment outcomes globally.”
