Endoscopic transsphenoidal resection of craniopharyngioma

ABSTRACTBackground: Endoscopic surgery techniques had been advancing in this last two decades. Transsphenoidal approach endoscopic surgery to the skull base provides better visualization of the operation field compared to microscopic surgery, and also brought lower morbidity than other techniques. Purpose: To report a transsphenoidal endoscopic skull base surgery for craniopharyngioma resection. Case Report: A case of craniopharyngioma in a 47-year-old man. The tumor resection was performed with transsphenoidal endoscopic approach, in collaboration with a neurosurgeon. Clinical Question: Is transsphenoidal endoscopic skull base surgery approach, the appropriate surgical procedure for craniopharyngioma management? Review Method: Evidence based literature study of skull base surgery with transsphenoidal endoscopic approach in craniopharyngioma through database Cochrane library, Pubmed Medline, and hand searching. Result: Skull base surgery with transsphenoidal endoscopic approach was minimally invasive with maximally invasion compared to transcranial surgery, and also provided better view, and could reduce complication rate. Conclusion: Skull base surgery with transsphenoidal endoscopic approach offers more advantage in skull base lesion management compared to other techniques. Collaboration between neurosurgeon and otorhinolaryngologist using this technique could reduce complication and morbidity rate. ABSTRAKLatar belakang: Teknik operasi endoskopi mengalami perkembangan pesat dalam dua dekade terakhir. Bedah basis kranii dengan pendekatan endoskopi transfenoid memberikan kualitas visualisasi lapang pandang operasi lebih baik dibanding menggunakan mikroskop, dan juga mengakibatkan morbiditas lebih rendah dibanding teknik lainnya. Tujuan: Melaporkan keberhasilan bedah basis kranii dengan pendekatan endoskopi transfenoid pada kraniofaringioma. Laporan kasus: Seorang laki-laki 47 tahun dengan diagnosis kraniofaringioma yang dilakukan tindakan reseksi tumor dengan pendekatan endoskopi transfenoid berkolaborasi dengan ahli bedah saraf. Pertanyaan Klinis: Apakah bedah basis kranii dengan pendekatan endoskopi transfenoid merupakan teknik operasi yang tepat untuk tatalaksana kraniofaringioma? Telaah literatur: Telaah literatur berbasis bukti mengenai bedah basis kranii dengan pendekatan endoskopi transfenoid pada kraniofaringioma melalui database Cochrane library, Pubmed Medline, dan pencarian manual. Hasil: Bedah basis kranii dengan pendekatan endoskopi transfenoid memberikan akses minimal dengan invasi maksimal, visualisasi lebih baik, dan dapat menurunkan angka komplikasi. Kesimpulan: Bedah basis kranii dengan pendekatan endoskopi transfenoid merupakan teknik operasi lesi basis kranii yang lebih unggul dibandingkan teknik lainnya. Kolaborasi antara ahli bedah saraf dan THT dapat mengurangi angka komplikasi dan morbiditas tindakan ini.

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Long Term Sinusitis Outcomes of Endoscopic Skull Base Surgery: Comparison of Minimally Invasive Pituitary Surgery versus Expanded Endoscopic Surgery for Malignancy

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1579824 ◽

2016 ◽

Vol 77 (S 01) ◽

Author(s):

Lauren Fedore ◽

Adam Zanation

Keyword(s):

Minimally Invasive ◽

Skull Base ◽

Endoscopic Surgery ◽

Skull Base Surgery ◽

Pituitary Surgery ◽

Endoscopic Skull Base Surgery

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Gigant Transethmoidal Meningoencephalocele Operated by Full Endonasal Endoscopic Approach: Case Report

Case Reports in Medicine ◽

10.1155/2012/763259 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Omar Lopez Arbolay ◽

Jorge Rojas Manresa ◽

Justo Gonzalez Gonzalez ◽

Jose Luis Bretón Rosario

Keyword(s):

Case Report ◽

Skull Base ◽

Skull Base Surgery ◽

Clinical Manifestations ◽

Anterior Skull Base ◽

Endoscopic Approach ◽

Surgical Morbidity ◽

Endoscopic Skull Base Surgery ◽

Watertight Closure ◽

Skull Base Defect

Intranasal meningoencephaloceles have historically been managed by neurosurgeons, although their main clinical manifestations are rhinological. Recent advances in endoscopic skull base surgery has significantly improved the treatment of these lesions and consequently diminished appreciable surgical morbidity. We report an ethmoidal meningoencephalocele case operated on by endonasal endoscopic approach for removal of the lesion and reconstructing the associated skull base. From this experience, we conclude that removal of the lesion and watertight closure of the skull base irrespective of the size of the mass and anterior skull base defect are the operation’s most important aspects.

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Open Approaches to the Anterior Skull Base in Children: Review of the Literature

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1621739 ◽

2018 ◽

Vol 79 (01) ◽

pp. 042-046 ◽

Cited By ~ 9

Author(s):

Ari DeRowe ◽

Barak Ringel ◽

Gadi Fishman ◽

Dan Fliss ◽

Oshri Wasserzug

Keyword(s):

Skull Base ◽

Endoscopic Surgery ◽

Frontal Sinus ◽

Skull Base Surgery ◽

Pediatric Population ◽

Developed Countries ◽

Anterior Skull Base ◽

Surgical Approaches ◽

Endoscopic Skull Base Surgery ◽

Skull Base Lesions

Introduction Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the “gold standard” for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods Comprehensive literature review. Results Extensive intracranial–intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a specific lesion in regard to its nature, location, and extent is of utmost importance.

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