We describe the development of transnasal endoscopic approaches to the cranial base in an interdisciplinary series of 103 patients, including 13 in the pediatric age group. Our aim was to define, with the aid of different case reports, the possibilities of endoscopic techniques in tumor resection, fistula repair, the treatment of mucoceles and meningoceles, and of combined intracranial and endoscopic approaches. The advantages of these minimally invasive approaches are panoramic visualization, rapidity and reduction of the cosmetic and functional disabilities in comparison with other conventional approaches, and a better capacity for identifying and developing key landmarks for surgery. On the other hand, endoscopic surgery requires an exsanguine operation field, technical improvements in instruments, and specific skills. Interdisciplinary collaboration in endoscopic approaches has proved useful in integrating experiences without overlap between fields, and in broadening possibilities: in our opinion endoscopic approaches will certainly be important in the future of cranial base surgery.
Haemangiopericytomas are vascular tumours derived from Zimmerman's pericytes; they account for about 1% of all vascular tumours. About 5% of the cases occur in the nasal cavity and usually show well-differentiated tumours with low potential for local recurrence or metastasis. The treatment of choice is surgical resection. We present a case of nasal haemangiopericytoma treated by endoscopic resection, and we emphasise the advantages of this minimally invasive method compared with traditional methods.
The systematic use of fiberoptic techniques in the sinonasal region has made it possible to assess the nasal septum with more precision. The presence of limited septal deviation or isolated septal spurs can cause airway obstruction in the sinuses or impede the execution of endoscopic sinonasal procedures for a disorder not related to the morphology of the nasal septum. This study assesses the indications, surgical technique, and results in 170 patients who underwent endoscopic limited septoplasty performed concomitantly with endoscopic sinonasal surgery.
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