scholarly journals Endoscopic Endonasal Partial Middle Turbinectomy Approach: Adaptability of the Procedure in a Cadaveric Study and in Surgery for Different Sphenoid Sinus and Skull Base Lesions

Skull Base ◽  
2006 ◽  
Vol 16 (01) ◽  
pp. 001-013 ◽  
Author(s):  
Omar A El-Banhawy ◽  
Abd El-Hafiz Shehab El-Dien ◽  
Ahmed Said Zolfakar ◽  
Ahmed N Halaka ◽  
Heshmat Ayad
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Cadaveric Study ◽  
Endoscopic Endonasal ◽  
Skull Base Lesions

scholarly journals ENDOSCOPIC ENDONASAL PARTIAL MIDDLE TURBINECTOMY APPROACH: ADAPTABILITY OF THE PROCEDURE IN A CADAVERIC STUDY AND IN SURGERY FOR DIFFERENT SPHENOID SINUS AND SKULL BASE LESIONS

2003 ◽  
Vol 32 (2) ◽  
pp. 409-427
Author(s):  
Omar El-Banhawy ◽  
Abdel-Hafiz Shehab EI-Dien ◽  
Ahmed Zolfakar ◽  
Ahmed Halaka ◽  
Heshmat Ayad
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Cadaveric Study ◽  
Endoscopic Endonasal ◽  
Skull Base Lesions

Endoscopic Endonasal Surgery for Sinonasal and Skull Base Lesions in the Pediatric Population

2015 ◽  
Vol 48 (1) ◽  
pp. 79-99 ◽  
Author(s):  
Jeffrey C. Rastatter ◽  
Carl H. Snyderman ◽  
Paul A. Gardner ◽  
Tord D. Alden ◽  
Elizabeth Tyler-Kabara
Keyword(s):  
Skull Base ◽  
Pediatric Population ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Skull Base Lesions

Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles

2012 ◽  
Vol 32 (6) ◽  
pp. E5 ◽  
Author(s):  
Richard F. Schmidt ◽  
Osamah J. Choudhry ◽  
Joseph Raviv ◽  
Soly Baredes ◽  
Roy R. Casiano ◽  
...  
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Skull Base Surgery ◽  
Surgical Anatomy ◽  
Endoscopic Endonasal ◽  
Csf Rhinorrhea ◽  
Lateral Recess ◽  
Sternberg Canal ◽  
Deep Location ◽  
Repair Techniques

Lateral sphenoid encephaloceles of the Sternberg canal are rare entities and usually present with spontaneous CSF rhinorrhea. Traditionally, these were treated via transcranial approaches, which can be challenging given the deep location of these lesions. However, with advancements in endoscopic skull base surgery, including improved surgical exposures, angled endoscopes and instruments, and novel repair techniques, these encephaloceles can be resected and successfully repaired with purely endoscopic endonasal approaches. In this report, the authors review the endoscopic endonasal transpterygoid approach to the lateral recess of the sphenoid sinus for repair of temporal lobe encephaloceles, including an overview of the surgical anatomy from an endoscopic perspective, and describe the technical operative nuances and surgical pearls for these cases. The authors also present 4 new cases of lateral sphenoid recess encephaloceles that were successfully treated using this approach.

Calvian Endo-pen: New Coagulation Forceps for Endoscopic Endonasal Transsphenoidal Surgery

2018 ◽  
Vol 79 (06) ◽  
pp. 524-527
Author(s):  
Steffen Rosahl ◽  
Geralf Kellner ◽  
Rüdiger Gerlach
Keyword(s):  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal ◽  
Small Vessels ◽  
The Past ◽  
Bipolar Electrocoagulation ◽  
New Type ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Lesions ◽  
Anatomical Area

Objective Over the past few years bipolar electrocoagulation techniques in neurosurgery have been continually improving. However, limited access during endoscopic endonasal transsphenoidal surgery (EETS) for central skull base pathologies and the requirement of very precise coagulation in that dedicated anatomical area requires further refinement of bipolar coagulation instruments. We describe our experience (effectiveness of coagulation, intraoperative handling, and the use as a dissecting tool) with a new type of coagulation forceps, the Calvian endo-pen (Sutter Medizintechnik, Freiburg, Germany) during EETS. Method From June to August 2015, 12 patients with central skull base lesions (9 with a pituitary adenoma and 1 each with epidermoid, hemangioma, and juvenile angiofibroma) were operated on with the Calvian endo-pen. Results The application of the Calvian endo-pen was feasible in all cases. The angled thin tips proved to be very effective and precise for soft tissue coagulation to achieve hemostasis. Even very small vessels could be occluded selectively. It was also helpful for outward dissection in separating normal from tumor tissue. Conclusion The use of the Calvian endo-pen is safe and effective during EETS for central skull base pathologies. Its ease in intraoperative handling (maneuverability, cleaning) and precise coagulation makes it a promising instrument for EETS.

scholarly journals Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study

2019 ◽  
Vol 133 (12) ◽  
pp. 1059-1063
Author(s):  
B H K Ng ◽  
I P Tang ◽  
P Narayanan ◽  
R Raman ◽  
R L Carrau
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Controlled Trial ◽  
Nasal Lavage ◽  
Nasal Endoscopy ◽  
Controlled Study ◽  
Endoscopic Endonasal ◽  
Randomised Controlled Study ◽  
Skull Base Lesions ◽  
Randomised Controlled

AbstractBackgroundNasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery.ObjectiveTo evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery.MethodsA pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy.ResultsPatients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin.ConclusionNasal lavage with mupirocin seems to yield better outcomes regarding patients’ symptoms and endoscopic findings.

Endoscopic Endonasal Transethmoidal Transcribriform Transfovea Ethmoidalis Approach to the Anterior Cranial Fossa and Skull Base

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 883-892 ◽  
Author(s):  
Jeffrey P. Greenfield ◽  
Vijay K. Anand ◽  
Ashutosh Kacker ◽  
Michael J. Seibert ◽  
Ameet Singh ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Sphenoid Sinus ◽  
Malignant Tumors ◽  
Anterior Skull Base ◽  
Anterior Cranial Fossa ◽  
Csf Leak ◽  
Endoscopic Endonasal ◽  
Lumbar Drainage ◽  
Cranial Fossa

Abstract OBJECTIVE The anterior skull base, in front of the sphenoid sinus, can be approached using a variety of techniques including extended subfrontal, transfacial, and craniofacial approaches. These methods include risks of brain retraction, contusion, cerebrospinal fluid leak, meningitis, and cosmetic deformity. An alternate and more direct approach is the endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach. METHODS An endoscopic, endonasal approach was used to treat a variety of conditions of the anterior skull base arising in front of the sphenoid sinus and between the orbits in a series of 44 patients. A prospective database was used to detail the corridor of approach, closure technique, use of intraoperative lumbar drainage, operative time, and postoperative complications. Extent of resection was determined by a radiologist using volumetric analysis. RESULTS Pathology included meningo/encephaloceles (19), benign tumors (14), malignant tumors (9), and infectious lesions (2). Lumbar drains were placed intraoperatively in 20 patients. The CSF leak rate was 6.8% for the whole series and 9% for intradural cases. Leaks were effectively managed with lumbar drainage. Early reoperation for cerebrospinal fluid (CSF) leak occurred in 1 patient (2.2%). There were no intracranial infections. Greater than 98% resection was achieved in 12 of 14 benign and 5 of 9 malignant tumors. CONCLUSION The endoscopic, endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach is versatile and suitable for managing a variety of pathological entities. This minimal access surgery is a feasible alternative to transcranial, transfacial, or combined craniofacial approaches to the anterior skull base and anterior cranial fossa in front of the sphenoid sinus. The risk of CSF leak and infection are reasonably low and decrease with experience. Longer follow-up and larger series of patients will be required to validate the long-term efficacy of this minimally invasive approach.

scholarly journals Surgical Outcomes of the Endoscopic Endonasal Transsphenoidal Approach for Anterior Skull Base Lesions: Experience in Combined Military Hospital, Dhaka

2019 ◽  
Vol 14 (1) ◽  
pp. 66-68
Author(s):  
Md Al Amin Salek ◽  
Md Hasnayen Faisal ◽  
Md Abdul Hye Manik ◽  
Ahmed Ul Mursalin Choudhury ◽  
Rukun Uddin Chowdhury ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Outcomes ◽  
Cerebrospinal Fluid Leak ◽  
Armed Forces ◽  
Anterior Skull Base ◽  
Military Hospital ◽  
Cushing Disease ◽  
Endoscopic Endonasal ◽  
Cross Sectional ◽  
Skull Base Lesions

Introduction:The endoscopic endonasal approach is a minimally invasive surgical technique for removal of skull base lesions by using nose and sinuses as natural corridors. This study represents our institutional experience with endoscopic endonasal trans-sphenoidal approach for anterior skull base lesions. Objective: To find out surgical outcomes of endoscopic endonasal trans-sphenoidal approach for treatment of anterior skull base lesions. Materials and Methods: Cross-sectional observational study of 38 consecutive patients who underwent endoscopic endonasal trans-sphenoidal surgery for anterior skull base lesions in Combined Military Hospital, Dhaka from July 2013 to June 2017. Results:This study included 16 men and 22 women, ranging from 24 to 68 years of age where median was 38 years. Common presentations were visual disorder (60%), headache (30%), features of pituitary apoplexy (5%), Cushing disease (0.35%), acromegaly (0.7 %), galactorrhoea (0.35%). Radiological evaluation revealed intrasellar (12), sellar and suprasellar (22), sellar and parasellar (1), tuberculum sella and planum sphenoidale (3), clival (1) lesions. Recurrent cases (3/38) were nonfunctioning pituitary macroadenoma, prolactinoma, and growth hormone secreting macroadenoma. The surgical resection in relation to post op imaging were 45% as gross total resection, near-total in 35%, subtotal in 15%, and partial in 5%. We found fifteen patients experienced improvement in visual acuity, while one patient worsened. Common complications were transient diabetes insipidus (53%), new pituitary deficit (35%), endonasal adhesions (20%), and cerebrospinal fluid leak (5%). Surgical mortality was (0.35%). The histological diagnoses included twenty-eight pituitary adenomas, five craniopharyngioma, three meningioma, one Rathke’s cleft cyst and one clival chordoma. Conclusion: Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for an anterior skull base lesion. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 66-68

Endoscopic Endonasal Surgery for Pediatric Skull Base Lesions

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
M. Koutourousiou ◽  
S. Chivukula ◽  
C. Snyderman ◽  
P. Gardner ◽  
E. Tyler-Kabara
Keyword(s):  
Skull Base ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Skull Base Lesions
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