Critical Appraisal of Extent of Resection of Clival Lesions Using the Expanded Endoscopic Endonasal Approach

Cutler, Aaron; Mundi, Jagmeet; Solomon, Noriko; Suh, Jeffrey D.; Wang, Marilene B.; Bergsneider, Marvin

doi:10.1055/s-0033-1342915

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…A handful of retrospective reviews have also highlighted rates of CSF leak for transclival surgeries, particularly dealing with the resection of chordomas. These studies report rates of reconstructive failure of 32.7% (17/52), 15.7% (8/51), 19% (2/19), 6.7% (1/15), and 21% (3/14), respectively. Aggregating this data reveals a 19.1% rate of reconstructive failure for a total of 299 patients with clival defects.…”

Section: Complicationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Complicationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

279

View full text Add to dashboard Cite

show abstract

“…Posterior cranial fossa defects are considered to be the highest risk location for post-operative CSF leak given the high-flow nature of the prepontine cistern. Rates of CSF leak for clival defects are reported between 6.7% to 32.7% [ 9 , 13 , 22 , 27 , 33 , 34 , 35 ]. Limited data is available for craniocervical (odontoid) lesions, of which many are extradural (i.e., basilar invagination, rheumatoid pannus).…”

Section: Csf Leakmentioning

confidence: 99%

Endoscopic Endonasal Skull Base Surgery Complication Avoidance: A Contemporary Review

2022

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The endoscopic endonasal approach (EEA) provides a direct trajectory to ventral skull base lesions, avoidance of brain retraction, and clear visualization of cranial nerves as they exit skull base foramina. Despite these benefits, the EEA is not without complications. Here, we review published literature highlighting complications associated with the EEA including cerebrospinal fluid (CSF) leak, cranial nerve (CN) dysfunction, pituitary gland dysfunction, internal carotid artery (ICA) injury, infection, and others; we place special emphasis on discussing the prevention of these complications. As widespread adoption of the EEA continues, it becomes critical to educate surgeons regarding potential complications and their prevention while identifying gaps in the current literature to guide future research and advances in clinical care.

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“…To this end, CT and stereotactic image guidance are helpful and thus can remarkably reduce complications owing to accurate surgical procedure and targeted therapeutic effects. 7 …”

Section: Introdcutionmentioning

confidence: 99%

Short-term therapeutic effects of low-dose cytarabine plus surgical resection on elderly patients with trigeminal nerve tumor and safety observation

Yang

Shen

et al. 2014

Pak J Med Sci

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Objective:To evaluate the short-term therapeutic effects of low-dose cytarabine plus surgical resection on elderly patients with trigeminal nerve tumor and to observe the safety.Methods:A total of 120 elderly patients with trigeminal nerve tumor were divided into a treatment group and a control group by random draw (n=60), and both groups were subjected to resection by stereotactic image-guided endoscopic nasal surgery. Afterwards, the control group was administered with high-dose cytarabine while the treatment group was given low-dose cytarabine for 14 days.Results: Both groups completed treatment, but the effective rate of the treatment group (96.7%) was significantly higher than that of the control group (83.3%) (P < 0.05). The pain scores of the two groups were similar at T0, T1 and T2, but the score of the treatment group at T2 was significantly different from those at T0 and T1 (P < 0.05). During treatment, the treatment group was significantly less prone to complications such as headache, vomiting, vision impairment, nausea and local swelling than the control group (P < 0.05). During three months of follow-up, the appetite, sleep and daily living scores were significantly higher than those of the control group (P < 0.05).Conclusion:Stereotactic image-guided surgery was able to treat trigeminal nerve tumor well, and the effect was enhanced by low-dose cytarabine that improved postoperative outcomes and quality of life by dramatically decreasing complications.

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Critical Appraisal of Extent of Resection of Clival Lesions Using the Expanded Endoscopic Endonasal Approach

Cited by 8 publications

References 22 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Endoscopic Endonasal Skull Base Surgery Complication Avoidance: A Contemporary Review

Short-term therapeutic effects of low-dose cytarabine plus surgical resection on elderly patients with trigeminal nerve tumor and safety observation

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