Exo- and endoscopic two-step approach for anterior foramen magnum meningiomas: How I do it

Acta Neurochir (Wien). 2025 Apr 14;167(1):104. doi: 10.1007/s00701-025-06512-9.

Abstract

Anterior foramen magnum (AFM) meningiomas are difficult to treat because they are situated in anatomically complex regions. One of the most common approaches for AFM meningiomas is the far lateral approach. We describe our exo- and endoscopic two-step approach (EETA) through suboccipital craniotomy. An exoscope is used to remove the tumour's lateral part, whereas an endoscope is used to remove the residual tumour in the exoscope's blind spots, including the brainstem's ventral side. EETA is a viable option for treating AFM meningiomas because it provides an adequate surgical field of view and is minimally invasive.

Keywords: Anterior foramen magnum; Endoscope; Exoscope; Meningioma.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Craniotomy* / instrumentation
  • Craniotomy* / methods
  • Endoscopy* / instrumentation
  • Endoscopy* / methods
  • Foramen Magnum* / pathology
  • Foramen Magnum* / surgery
  • Humans
  • Meningeal Neoplasms* / pathology
  • Meningeal Neoplasms* / surgery
  • Meningioma* / pathology
  • Meningioma* / surgery
  • Neuroendoscopy* / instrumentation
  • Neuroendoscopy* / methods
  • Neurosurgical Procedures* / instrumentation
  • Neurosurgical Procedures* / methods
  • Skull Base Neoplasms* / pathology
  • Skull Base Neoplasms* / surgery
  • Treatment Outcome