Anterior Skull Base Tumors: comparative Analysis of Endoscopic and Open Approaches, Tumors Classification, Prevalence and Associated Surgical Complications. A Systematic Review

Abstract

Abstract Objective: To conduct a review on different types of anterior skull base tumors, their prevalence, approaches toward them, and pre, intra, and postoperative complications. Introduction Anterior skull base tumors present unique challenges due to their proximity to vital structures. Surgical management has evolved with the advent of endoscopic and open techniques. Endoscopic procedures, involving small incisions and specialized tools, reduce morbidity and hasten recovery. Open techniques offer direct tumor access, enabling complete removal. Meningiomas are the most common tumor type, with esthesioneuroblastoma and other rare variants also occurring. Incidence varies by histology and demographics. Surgery carries inherent risks, such as structural damage, visual impairment, fluid leaks, bleeding, infection, and brain injury, influenced by tumor characteristics and surgical approach. Advances in techniques and monitoring have improved patient outcomes. Understanding these approaches, tumor types, prevalence, and complications is vital for effective management of anterior skull base tumors. Materials and Methods To conduct a review on different types of anterior skull base tumors, their prevalence, approaches toward them, and pre, intra, and postoperative complications, I searched almost all articles related to topic or its key words such as endoscopic approach, anterior skull base tumors, surgical complications on PubMed MEDLINE, JSTOR, Science Direct, cochrane and Google scholardatabase. After going through 2000 articles I selected all those articles from 1981 through 2022 which contain review articles, case studies and retrospective studies related to topic. The PRISMA (preferred reporting items for systematic review and metanalysis) flow sheet for the search is given in FIG 1. Detail of the information extracted from each selected article, mentioned in references. Data was categorized on basis of, surgical approach, tumor type, prevalence rates, and complications. A cumulative total of 2000 prospective studies were identified after compiling search results. Following the elimination of duplicate entries, a total of 1180 potential investigations were discovered. The remaining articles were screened to determine their relevancy based on their title and abstract. After conducting a manual search of titles and abstracts, a total of 58 references were identified and included in the study. Conclusion The present study provides an overview of the surgical techniques used in resecting anterior skull base tumors, specifically focusing on endoscopic and open procedures. The article examines the frequency and classifications of tumors, including pituitary adenomas, meningiomas, esthesioneuroblastomas, chordomas, and craniopharyngiomas. The endoscopic method is associated with less morbidity and expedited recovery, but the open approach gives a broader field of view for managing bigger or more intricate malignancies. The management of surgical complications such as cerebrospinal fluid leaks, meningitis, vascular damage, and vision abnormalities is discussed. The study underscores the significance of interdisciplinary teamwork, thorough planning, and improved methodologies in enhancing results