LASER-Assisted Microsurgery of the Skull-Base Meningiomas

It is more than a century since the first operations were carried out both for a tumor presenting as a hyperostosing meningioma (PECCHIOLI 1838, MACEWAN 1879).11,15 This was the beginning of neurosurgery and the development of the art was for a long time based largely upon the treatment of tumors. This aspect of work still occupies the centre of the neurosurgical stage with regard to the introduction of new techniques of diagnosis, surgery and other therapy. However, recurrences are common. There are numerous tumors, especially in the skull base or parasagittal, whose recurrences appear more likely to be related to arachnoid residues included in the dura or in the bone and independent of the previous tumor proliferation. In order to reduce the recurrence rate of these meningiomas we performed the Additional Laser Irradiation (ALI) of the bone with the Nd-YAG-LASER (1064 mm) after the “complete” removal of the tumor along with its dural attachment.