Acta Neurochir (2014) 156:2283–2287 DOI 10.1007/s00701-014-2223-5
TECHNICAL NOTE - NEUROSURGICAL TECHNIQUES
Transglabellar approach for resection of anterior midline skull base meningiomas: technical note Jean-Charles Kleiber & Segolene Roemer & Julien Duntze & Christophe Eap & Etienne Theret & Pascal Rousseaux & Fabien Litre
Received: 11 July 2014 / Accepted: 1 September 2014 / Published online: 21 September 2014 # Springer-Verlag Wien 2014
Abstract Background We describe our experience of minimally invasive approach of the anterior skull base through the transglabellar approach. Method The technical details of the transglabellar approach are described in this article as we have been using it for the past 3 years. After an inter-eyebrow skin incision, the scalp is elevated allowing the creation of a 3-cm bone flap in the frontal sinus, which gives direct access to the anterior midline skull base. Removal of the tumour is carried out without brain retraction. The closure requires obstruction of nasofrontal ducts and sinus mucosa removal. Results We operated on 24 patients using this approach. The tumour was completely removed in every case. We reported one case of meningitis and three cerebrospinal fluid leaks. Every patient was satisfied with the aesthetic results. Conclusions The transglabellar approach is a reasonably easy and efficient way to resect anterior midline skull base meningiomas.
base. This provides close access to the tumour despite the existence of a long and potentially haemorrhagic bicoronal flap. In this paper, we describe a minimally invasive approach to the anterior skull base, the so-called “transglabellar approach”, characterised by an inter-eyebrow skin incision, a transfrontal sinus craniotomy and an endoscope-assisted tumour removal for resection of anterior skull base meningiomas.
Material and methods Ethical standards All patients gave oral consent to their inclusion in the study. Surgical technique Patient positioning
Keywords Meningioma . Skull base . Surgical procedures . Minimally invasive . Transglabellar approach
Introduction Modern skull base surgery faces the dilemma of obtaining complete tumour removal through the least aggressive approach possible in order to protect the frontal cortex from retraction [1–4]. Hallacq et al. [5, 6] and Ducic and Coimbra  described a transfrontal sinus approach to the anterior skull J.