scholarly journals Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica

2005 ◽  
Vol 19 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Amin Kassam ◽  
Carl H. Snyderman ◽  
Arlan Mintz ◽  
Paul Gardner ◽  
Ricardo L. Carrau
Keyword(s):  
Skull Base ◽  
Sella Turcica ◽  
Surgical Techniques ◽  
Case Series ◽  
Anterior Skull Base ◽  
Anatomical Landmarks ◽  
Endonasal Approach ◽  
Appropriate Use ◽  
Expanded Endonasal Approach ◽  
Skull Base Lesions

Object Transsphenoidal approaches have been used for a century for the resection of pituitary and other sellar tumors. More recently, the standard endonasal approach has been expanded to provide access to other, parasellar lesions. With the addition of the endoscope, this expansion carries significant potential for the resection of skull base lesions. Methods The anatomical landmarks and surgical techniques used in expanded (extended) endoscopic approaches to the rostral, anterior skull base are reviewed and presented, accompanied by case illustrations of each segment (or module) of approach. The rostral half of the anterior skull base is divided into modules of approach: sellar/parasellar, transplanum/transtuberculum, and transcribriform. Case illustrations of successful resections of lesions with each module are presented and discussed. Conclusions Endoscopic, expanded endonasal approaches to rostral anterior skull base lesions are feasible and hold great potential for decreased morbidity. The effectiveness and appropriate use of these techniques must be evaluated by close examination of outcomes as case series expand.

scholarly journals Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum

2005 ◽  
Vol 19 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Amin Kassam ◽  
Carl H. Snyderman ◽  
Arlan Mintz ◽  
Paul Gardner ◽  
Ricardo L. Carrau
Keyword(s):  
Skull Base ◽  
Surgical Techniques ◽  
Case Series ◽  
Foramen Magnum ◽  
Anterior Skull Base ◽  
Anatomical Landmarks ◽  
Endonasal Approach ◽  
Cervicomedullary Junction ◽  
Caudal Portion ◽  
Expanded Endonasal Approach

Object Transsphenoidal approaches have been used for a century for the resection of pituitary and other sellar tumors. Recently, however, the standard endonasal approach has been expanded to provide access to other parasellar lesions. With the addition of the endoscope, this expansion has significant potential for the resection of skull base lesions. Methods The anatomical landmarks and surgical techniques used in expanded (extended) endoscopic approaches to the clivus and cervicomedullary junction are reviewed and presented, accompanied by case illustrations of each segment (or module) of approach. The caudal portion of the midline anterior skull base and the cervicomedullary junction is divided into modules of approach: the middle third of the clivus, its lower third, and the cervicomedullary junction. Case illustrations of successful resections of lesions via each module of the approach are presented and discussed. Conclusions Endoscopic expanded endonasal approaches to caudally located midline anterior skull base and cervicomedullary lesions are feasible and hold great potential for decreased morbidity. The effectiveness and appropriate use of these techniques must be evaluated by close examination of outcomes as case series expand.

Endoscopic Expanded Endonasal Approach for Anterior Skull Base Lesions

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
Amin Kassam ◽  
Ajith Thomas ◽  
Paul Gardner ◽  
Carl Snyderman ◽  
Ricardo Carrau ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Endonasal Approach ◽  
Expanded Endonasal Approach ◽  
Skull Base Lesions

In-hospital Costs Associated with an Expanded Endonasal Approach to Anterior Skull Base Tumors

2019 ◽  
Author(s):  
Arjun Parasher ◽  
David Lerner ◽  
Jordan Glicksman ◽  
James Palmer ◽  
Nithin Adappa
Keyword(s):  
Skull Base ◽  
Hospital Costs ◽  
Anterior Skull Base ◽  
Endonasal Approach ◽  
Skull Base Tumors ◽  
Expanded Endonasal Approach

The expanded endonasal approach for the treatment of anterior skull base tumors

2010 ◽  
Vol 21 (1) ◽  
pp. 66-73 ◽  
Author(s):  
Amol M. Bhatki ◽  
Harshita Pant ◽  
Carl H. Snyderman ◽  
Ricardo L. Carrau ◽  
Paul Gardner ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Endonasal Approach ◽  
Skull Base Tumors ◽  
Expanded Endonasal Approach

3D-FIESTA MR images are useful in the evaluation of the endoscopic expanded endonasal approach for midline skull-base lesions

2010 ◽  
Vol 153 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Tao Xie ◽  
Xiao-Biao Zhang ◽  
Hong Yun ◽  
Fan Hu ◽  
Yong Yu ◽  
...  
Keyword(s):  
Skull Base ◽  
Endonasal Approach ◽  
Mr Images ◽  
Expanded Endonasal Approach ◽  
Skull Base Lesions

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

2013 ◽  
Vol 51 (1) ◽  
pp. 37-46
Author(s):  
J. Ensenat ◽  
M. de Notaris ◽  
M. Sanchez ◽  
C. Fernandez ◽  
E. Ferrer ◽  
...  
Keyword(s):  
Skull Base ◽  
Case Series ◽  
Cerebrospinal Fluid Leak ◽  
Endonasal Approach ◽  
Partial Removal ◽  
Endoscopic Endonasal ◽  
Case Series Report ◽  
Skull Base Lesions ◽  
Fluid Leak ◽  
Series Report

Background: The introduction of the endoscope in transsphenoidal surgery has allowed access to lesions located in complex regions of the skull base under direct visual control. With the application of this technique, our group started treating pituitary tumours and from 2009 onwards began treating skull base lesions through extended endoscopic endonasal approaches. The AIM OF THE PRESENT STUDY is to report our experience with extended endoscopic approaches. Indications, results, limitations and complications of this new technique are also discussed. Material and methods: From January 2007 to January 2012, the endonasal approach was used in 40 patients with different cancerous lesions. Results: Total tumour removal, as assessed by postoperative magnetic resonance imaging, occurred in 30/ 40 patients (75%), but in 10 patients only partial removal was possible. Major complications, including cerebrospinal fluid leak, were observed in 5/40 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.

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series

2014 ◽  
Vol 37 (4) ◽  
pp. E2 ◽  
Author(s):  
Satyan B. Sreenath ◽  
Rounak B. Rawal ◽  
Adam M. Zanation
Keyword(s):  
Skull Base ◽  
Case Series ◽  
Feasibility Studies ◽  
Transoral Approach ◽  
Endonasal Approach ◽  
Minimally Invasive Surgical ◽  
Expanded Endonasal Approach ◽  
Head And Neck Pathology ◽  
Surgical Options ◽  
Surgical Option

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

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