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Cappabianca et al. Mini-invasive Surg 2020;4:83 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.67

Review Open Access

Meningiomas: criteria for modern surgical
indications

Paolo Cappabianca, Elena d’Avella, Luigi Maria Cavallo, Domenico Solari

Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of
Napoli “Federico II”, Naples 80131, Italy.
Correspondence to: Dr. Elena d’Avella, Department of Neurosciences and Reproductive and Odontostomatological Sciences,
Division of Neurosurgery, University of Napoli “Federico II”, Via Pansini, 5, Naples 80131, Italy. E-mail: elenadavella@gmail.com
How to cite this article: Cappabianca P, d’Avella E, Cavallo LM, Solari D. Meningiomas: criteria for modern surgical indications.
Mini-invasive Surg 2020;4:83. http://dx.doi.org/10.20517/2574-1225.2020.67
Received: 30 Jun 2020 First Decision: 4 Aug 2020 Revised: 4 Aug 2020 Accepted: 5 Aug 2020 Published: 13 Nov 2020

Academic Editor: Oreste de Divitiis Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
The contemporary management of meningiomas is the result of the continuous evolution of neurosurgical
techniques, along with the refinement of dedicated instrumentations. Above all, it is the magnification of
the surgical view, thanks to the microscope and the endoscope, and their advancements, which allowed the
improvement of surgical outcomes, in terms of both extent of resection and morbidity rates. Because of the
benign nature of the vast majority of meningiomas, complete tumor resection is curative, and it is the gold-
standard treatment. However, in the case of high risk of surgical morbidity, a less aggressive surgical treatment
may be justified, also upon tailored analysis of the meningiomas’ biological behavior and the improvements in
postoperative strategies. The endoscopic technique plays a role, as a unique visualization tool or in combination
with the microscope, in granting so-called maximum allowed resection. Considering the above, the most
challenging task confronting modern meningioma surgery remains the selection of the most appropriate surgical
approach, the latter greatly depending on location, anatomic tumor features, and relationships with critical
neurovascular structures. Herein, we present a cogent analysis of the modern multifaceted indications for the
endoscopic treatment of meningiomas, with a glimpse into the adjacent fields.

Keywords: Meningiomas, endoscopic-assistance, endoscopic endonasal, postoperative treatments

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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