Endoscopic Skull Base Surgery: Our Initial Experience

Abstract

Introduction
 Patients with lesions of the skull base form a minor but very important subgroup of patients presenting to the ENT surgeon or are referred from other departments with complaints such as headache, nasal discharge and nasal obstruction. This study was done to study the clinical presentation of the patients with lesions of the skull base, assess intra operative findings and complications, and to document post operative clinical course and histopathological reports.
 Materials and Methods
 A prospective study was conducted on 10 patients with skull base lesions, who were operated on at our institution between August 2014 and August 2015. Patients with clinically and radiologically documented skull base lesions operated by endoscopic methods were included, while those operated on with open methods or those having involvement of the cavernous sinuses and the internal carotid arteries were excluded.
 Results 
 All patients in the group were successfully operated on with no major intra operative or post operative complications encountered. Adequate tissue was obtained for biopsy with adequate sellar decompression and plugging of CSF leaks was done as required.
 Conclusion 
 Endoscopic interventions for the skull base lesions can be safely performed in tertiary care set ups with minimal intra operative and post operative morbidity and have a better prognosis than other open procedures.

Estudo dos canais etmoidais em peças anatômicas sob visão endoscópica e análise histológica

“…A base anterior do crânio, intracranianamente, é composta do osso frontal, das placas orbitais dos ossos frontal, etmoidal e esfenoidal 17 .…”

“…Os pontos de referência importantes incluem anterior e posterior, os seios frontais, o forame cego, a crista galli, a placa cribriforme com fossa olfatória, formando em ambos, os lados da crista galli, o plano esfenoidal, cobrindo os seios esfenoidais 17 .…”

“…A base anterior do crânio é delineada, posteriormente, pelas asas menores do esfenoide e pelos processos clinoides anteriores, que estão intimamente relacionados ao canal óptico e às artérias carótidas internas 17 .…”

“…Na porção extracraniana, a base anterior do crânio anterior está relacionada às órbitas, aos seios etmoidais, seios esfenoidais e às cavidades nasais. A órbita contém a fissura orbitária superior, comunicandose com a fossa craniana média, a fissura orbitária inferior comunicando-se com a fossa pterigopalatina e o canal óptico 17 .…”

“…Intracranianamente, a base média do crânio consiste na borda posterior da asa menor do esfenoide, das asas maiores do esfenoide, da parte escamosa do osso temporal e da parte petrosa do osso temporal 17 .…”