Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Abstract

patients (8%). One patient died 3 months after surgery due to a severe systemic sepsis. Conclusion:The extended endoscopic endonasal approach could be used as a minimally invasive and innovative technique for the removal of selected skull base lesions.

Endoscopic transsphenoidal approach to skull base lesions

“…13 Macro-adenoma was noted in 67% of cases in our study, which is comparable to studies in which 70% of their cases were macroadenomas. 11,12 Visual function improvement was achieved in 82% of patients in this study, and this improvement was nearly the same as in other studies in which 90% of cases showed visual improvement after surgery. 12,13 In both studies, the majority of cases that developed better visual results complained of pituitary macroadenomas.…”

Endoscopic sinus surgery and musculoskeletal symptoms

“…This pan-European survey provides further evidence of the high prevalence of musculoskeletal problems attributed to ESS among rhinologists. Endoscopic skull base procedures are longer and physically more demanding than standard ESS cases, and are becoming more common (28) . This will only serve to…”

Minimally Invasive but Maximally Effective Treatment of Anterior Skull Based Tumors — The Combination of Advanced Neuroendoscopy and Intraoperative Imaging with iMRI and O-Arm

“…This technique requires a team approach with an ENT and neurosurgeon who both must be experienced in endoscopic principles, skull base anatomy and have a vast understanding of all potential treatment options [1,2,[4][5][6]. An enormous learning curve exists not only for performing the surgical approach but also for dissection and removal of the lesion and subsequent reconstruction of the surgical defect and complication avoidance.…”

“…They are typically related to either damage to major vascular structures or perforating vessels, optic nerve and chiasm or cranial nerves [1,2,[4][5][6][7][8]. New or worsening visual symptoms are rare and their occurrence varies considerably based on pathology.…”

“…During the early experience with this exposure the concern for operating through a contaminated nasal corridor and the associated risk of meningitis or intracranial abscess was an enormous concern; however, experience has shown that this risk is minimal and usually limited to the setting of postoperative CSF leakage. In fact most authors recommend standard perioperative gram positive antibiotic coverage (cefazolin, clindamycin, vancomycin) for 24-48 hours [1,2,4,7]. In addition, because the pathological process is approached from the ventral bone interface, brain retraction and manipulation is minimal in these procedures.…”