Microvascular decompression is safe, effective, and micro-invasive. Due to these advantages, it has become the mainstream treatment for trigeminal neuralgia, glossopharyngeal neuralgia, and hemifacial spasm. Initially, microvascular decompression was performed under a microscope, which limited the light source and visualization capabilities. With the development of endoscopic technology, the endoscope has been used in microvascular decompression, which further improved the visualization range and light source properties. The purpose of the present study was to investigate the efficacy of fully endoscopic microvascular decompression for the treatment of trigeminal neuralgia. In total, three patients with trigeminal neuralgia who underwent fully endoscopic microvascular decompression were evaluated. After surgery, the facial pain of all patients was significantly relieved. In addition, there were no obvious postoperative complications and no recurrence after 6 months of follow-up. These excellent surgical outcomes indicate that fully endoscopic microvascular decompression is an effective and safe method for the treatment of trigeminal neuralgia. Furthermore, it also shows that the endoscope presents advantages for use in microvascular decompression.

With the advances in endoscopic technology, endoscopy is widely used in many neurosurgical procedures, such as microvascular decompression, which is an effective method to treat glossopharyngeal neuralgia, trigeminal neuralgia, and facial spasm. The purpose of this study was to determine the efficacy of fully endoscopic microvascular decompression in the treatment of glossopharyngeal neuralgia. We managed a patient with glossopharyngeal neuralgia in our department, whose main clinical manifestation was recurrent left ear and facial pain for 3 years. The patient underwent a fully endoscopic microvascular decompression. The pain in the left ear and face was significantly relieved postoperatively, and there was no recurrence at the 6-month follow-up evaluation. We describe a case of glossopharyngeal neuralgia that was successfully treated by fully endoscopic microvascular decompression, which showed that endoscopy has advantages in microvascular decompression, and fully endoscopic microvascular decompression is an effective method for glossopharyngeal neuralgia.

The endoscope-assisted supraorbital keyhole approach and extended transsphenoidal approach have been widely used in the treatment of tuberculum sellae meningiomas (TSMs). The purpose of the present study was to retrospectively analyze and compare the characteristics and efficacy of the two surgical approaches under the endoscope in the resection of TSMs. In the present study, 36 patients with TSMs who underwent surgical resection are presented, including one group of 17 cases with an endoscopic supraorbital keyhole approach and the other group of 19 cases with an endoscopic extended transsphenoidal approach. The clinical characteristics, diagnosis, treatment process and treatment effect of the two groups were analyzed retrospectively, and the two surgical approaches were also compared. The gross total resection rates of the two groups were similar, reaching 94.5 and 94.7%, respectively. The postoperative visual acuity recovery showed that in the endoscopic supraorbital keyhole approach group, 23 eyes were improved, 8 eyes were maintained and 3 eyes deteriorated, and the visual recovery was 67.6%. In the endoscopic extended transsphenoidal approach group, 32 eyes were improved, 4 eyes were maintained and 2 eyes deteriorated, and the visual recovery was 84.2%. In the supraorbital keyhole approach group, there was no cerebrospinal fluid leakage, while in the extended transsphenoidal approach group, cerebrospinal fluid leakage occurred in 3 cases (15.8%). In these two groups, no tumor recurrence was revealed during the follow-up of ~5 years. Both the endoscope-assisted supraorbital keyhole approach and the extended transsphenoidal approach were effective and safe. The endoscopic supraorbital keyhole approach treated TSMs with lateral extension, but it was not enough to protect the optic nerve. The endoscopic extended transsphenoidal approach protected the optic nerve, but the risk of cerebrospinal fluid leakage was increased. In conclusion, these two surgical methods have their own advantages and limitations.

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Thanks to the rapid development and progress of endoscopic technology, the endoscopic endonasal transsphenoidal approach has become one of the best surgical methods for resection of sellar and suprasellar tumors. The craniopharyngioma is usually located in the sellar region or suprasellar region, which is suitable for resection through the endoscopic endonasal transsphenoidal approach. The present report describes 21 cases of craniopharyngioma treated by endoscopic endonasal transsphenoidal approach in the Department of Neurosurgery at the Chongqing General Hospital from February 2014 to September 2019. The characteristics of patients and tumors, including clinical symptoms, preoperative magnetic resonance imaging, intraoperative conditions, as well as postoperative and follow-up outcomes were evaluated. The main clinical symptoms were headache in 15 cases, visual deficiency in 13 cases and growth retardation in two cases. All 21 patients with craniopharyngioma underwent endoscopic endonasal transsphenoidal surgery. Of these, 20 patients achieved gross total resection and one case achieved subtotal resection. After surgery, headache symptoms improved in 11 patients without deterioration and the vision of 11 patients improved without deterioration. The primary postoperative complications were pituitary deficiency in eight cases and permanent diabetes insipidus in five cases. The patients were followed up from one to 52 months post-operation. There was no recurrence in all patients during the follow-up period. The endoscopic endonasal transsphenoidal approach is a safe and effective resection for craniopharyngioma. Moreover, the endoscopic endonasal trans-sphenoidal approach is one of the preferred surgical methods for treatment of sellar or suprasellar tumor.