Clinical analysis of microscopical craniotomy combined with neuroendoscopy for resection of intracranial invastive olfactory neuroblastoma

Abstract

Objective To investigate the clinical characteristics, neurosurgical strategy and curative effect of intracranial invastive olfactory neuroblastoma. Methods A total of 24 patients with intracranial invasive olfactory neuroblastoma diagnosed and treated in Beijing Tongren Hospital, Capital Medical University from January 2005 to December 2020 were included. All patients underwent bilateral extended transbasal approach combined with endoscopic transnasal approach and skull base reconstruction. Results Among the 24 patients, total resection was performed in 22 cases (91.67%) and nearly total resection in 2 cases (8.33%), all of which were confirmed as olfactory neuroblastoma by postoperative pathological examination. Transient cerebrospinal fluid leakage occurred in 2 cases (8.33%) and intracranial infection occurred in 2 cases (8.33%), which were cured by symptomatic treatment. Visual acuity was aggravated in one case and eye movement disorder in 2 cases. Twenty patients were followed up for an average of 54.60 months, and no long⁃term operation related complications occurred. During the follow⁃up period, 12 patients (60%) had tumor recurrence, and the 5⁃year survival rate was 45% (9/20). Conclusions Surgical resection of intracranial invasive olfactory neuroblastoma via extended transbasal approach combined with endoscopic transnasal approach is safe and effective. The operative surgeon should have both microneurosurgery and neuroendoscopy techniques, which is worthy of clinical promotion.

Keywords

• neuroblastoma
• olfactory nerve
• microsurgery
• neuroendoscopes