Totally Endoscopic Resection of Recurrent Convexity Meningioma Following Multiple Surgeries: Oblique Trajectory to Avoid Manipulation of a Vascularized Free Flap: A Technical Note.

Abstract

Endoscopic surgery is widely used for intraventricular and skull base tumor resections; however, its utility is not limited to deep parts of the brain. A 73-year-old female presented with left-side hemiparesis and seizures due to a relapsed atypical meningioma of convexity. The tumor was located just under a synthetic bone substitute and was covered by a delicate myocutaneous free flap, preventing the usual skin incision route to approach the lesion. The tumor was successfully removed using an endoscope without damaging the flap. With the aid of an endoscope, a superficial meningioma could be removed with the affected dura through a small craniotomy.