Endoscopic transnasal skull base surgery: pushing the boundaries. J Neurooncol 2016 Nov;130(2):319-330
Date
11/03/2016Pubmed ID
27766473DOI
10.1007/s11060-016-2274-yScopus ID
2-s2.0-84991753310 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
The endoscopic endonasal approach (EEA) has significantly evolved since its initial uses in pituitary and sinonasal surgery. The literature is filled with reports and case series demonstrating efficacy and advantages for the entire ventral skull base. With competence in 'minimally invasive' parasellar approaches, larger and more complex approaches were developed to utilize the endonasal corridor to create maximally invasive endoscopic skull base procedures. The challenges of these more complex endoscopic procedures include a long learning curve and navigating in a narrow corridor; reconstruction of defects presented new challenges and early experience revealed a significantly higher risk of cerebrospinal fluid leak. Despite these challenges, there are many benefits to the EEA including avoidance of brain and neurovascular retraction, improved visualization, a direct corridor onto many tumors and the two-surgeon approach. Most importantly, the EEA provides a midline corridor to directly access tumors, which displace critical neurovascular structures laterally, giving it an inherent advantage of minimizing any manipulation of these structures and thus decreasing their potential injury.
Author List
Zwagerman NT, Zenonos G, Lieber S, Wang WH, Wang EW, Fernandez-Miranda JC, Snyderman CH, Gardner PAAuthor
Nathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
HumansNatural Orifice Endoscopic Surgery
Neuronavigation
Neurosurgical Procedures
Skull Base
Skull Base Neoplasms
