Endoscopic endonasal approach for resection of ventral skull base keratinaceous cysts

2011 ◽  
Vol 2 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Edward D. McCoul ◽  
Samuel Chow ◽  
Dennis L.Y. Lee ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Skull Base ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Ventral Skull Base

Extended endoscopic endonasal approach to the ventral skull base lesions

2018 ◽  
Vol 167 ◽  
pp. 129-140 ◽  
Author(s):  
Murat Kutlay ◽  
Abdullah Durmaz ◽  
İlker Özer ◽  
Cahit Kural ◽  
Çağlar Temiz ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Skull Base Lesions ◽  
Ventral Skull Base

Endoscopic Endonasal Approach for Nonvestibular Schwannomas

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. 1046-1057 ◽  
Author(s):  
Samuel S. Shin ◽  
Paul A. Gardner ◽  
S. Tonya Stefko ◽  
Ricky Madhok ◽  
Juan C. Fernandez-Miranda ◽  
...  
Keyword(s):  
Skull Base ◽  
Trigeminal Nerve ◽  
Medical Center ◽  
Motor Deficit ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
University Of Pittsburgh ◽  
Sensory Deficits ◽  
Ventral Skull Base

Abstract BACKGROUND Nonvestibular schwannomas of the skull base often represent a challenge owing to their anatomic location. With improved techniques in endoscopic endonasal skull base surgery, resection of various ventral skull base tumors, including schwannomas, has become possible. OBJECTIVE To assess the outcomes of using endoscopic endonasal approach (EEA) for nonvestibular schwannomas of the skull base. METHODS Seventeen patients operated on for skull base schwannomas by EEA at the University of Pittsburgh Medical Center from 2003 to 2009 were reviewed. RESULTS Three patients underwent combined approaches with retromastoid craniectomy (n = 2) and orbitopterional craniotomy (n = 1). Three patients underwent multistage EEA. The rest received a single EEA operation. Data on degree of resection were found for 15 patients. Gross total resection (n = 9) and near-total (>90%) resection (n = 3) were achieved in 12 patients (80%). There were no tumor recurrences or postoperative cerebrospinal fluid leaks. In 3 of 7 patients with preoperative sensory deficits of trigeminal nerve distribution, there were partial improvements. Patients with preoperative reduced vision (n = 1) and cranial nerve VI or III palsies (n = 3) also showed improvement. Five patients had new postoperative trigeminal nerve deficits: 2 had sensory deficits only, 1 had motor deficit only, and 2 had both motor and sensory deficits. Three of these patients had partial improvement, but 3 developed corneal neurotrophic keratopathy. CONCLUSION An EEA provides adequate access for nonvestibular schwannomas invading the skull base, allowing a high degree of resection with a low rate of complications.

scholarly journals Endoscopic endonasal resection of a large tuberculum sella meningioma

2020 ◽  
Vol 2 (2) ◽  
pp. V3
Author(s):  
Ahmed Mohyeldin ◽  
Jayakar V. Nayak ◽  
Juan C. Fernandez-Miranda
Keyword(s):  
Skull Base ◽  
Wide Spectrum ◽  
Direct Access ◽  
Csf Leak ◽  
Anterior Communicating Artery ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Tuberculum Sella ◽  
Ventral Skull Base

Over the past three decades, endoscopic endonasal surgery has unlocked new corridors to treat a wide spectrum of ventral skull base lesions. Tuberculum sella meningiomas represent one of the most ideal pathologies for ventral skull base access. Traditionally, these lesions were approached primarily through various subfrontal and frontal-lateral transcranial approaches that have unfortunately been shown to be associated with worsening visual decline postoperatively. The endoscopic endonasal approach is now being attempted by more surgeons and leverages an infrachiasmatic trajectory that provides direct access to the tuberculum sella where most of the vascular supply for these lesions can be taken early, facilitating more efficient surgical resection and mitigating the risk of optic nerve injury. Here we review a challenging case of a large (∼3 cm) tuberculum sella meningioma, encasing critical vessels off the circle of Willis and resected via an endoscopic endonasal approach. We discuss the technical nuances and relevant surgical anatomy of this approach and highlight important considerations in the safe and successful removal of these meningiomas. We show that certain tumors that appear to encase the supraclinoidal carotid artery can be fully resected via an endonasal approach with precise surgical technique and adequate exposure. Furthermore, this case illustrates the risk of injuring a key perforating vessel from the anterior communicating artery complex, called the subcallosal artery. Injury to this vessel is highly associated with tumors like the one presented here that extend into the suprachiasmatic space between the optic chiasm and the anterior communicating complex. Meticulous surgical dissection is required to preserve this perforating vessel as well as branches from the superior hypophyseal artery. Finally, we review our current closure techniques for these challenging approaches and discuss the use of a lumbar drain for 3 days to lower CSF leak rates.The video can be found here: https://youtu.be/mafyXi5B0MA.

Could Endoscopic Endonasal Approach Contribute to Improve Skull Base Chondrosarcoma Prognosis?

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Anne Laure Bernat ◽  
Damien Bresson ◽  
Marc Polivka ◽  
Homa Adle-Biassette ◽  
Patricia De Cremoux ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal

Endoscopic Endonasal Approach for Clival Chordomas: 12 Years of Experience from a Large Skull Base Referral Center

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Georgios Zenonos ◽  
Kenan Alkhalili ◽  
Maria Koutourousiou ◽  
Nathan Zwagerman ◽  
David Panczykowski ◽  
...  
Keyword(s):  
Skull Base ◽  
Years Of Experience ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Referral Center

Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Endoscopic Endonasal Approach to the Orbit

2021 ◽  
Author(s):  
Laura Salgado-Lopez ◽  
Luciano C. Leonel ◽  
Michael Obrien ◽  
Adedamola Adepoju ◽  
Michael J. Link ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Anatomy ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal
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