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01-11-2016 | Topic Review

Endoscopic transnasal skull base surgery: pushing the boundaries

Authors: Nathan T. Zwagerman, Georgios Zenonos, Stefan Lieber, Wei-Hsin Wang, Eric W. Wang, Juan C. Fernandez-Miranda, Carl H. Snyderman, Paul A. Gardner

Published in: Journal of Neuro-Oncology | Issue 2/2016

Abstract

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.

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Title: Endoscopic transnasal skull base surgery: pushing the boundaries
Authors: Nathan T. Zwagerman
Georgios Zenonos
Stefan Lieber
Wei-Hsin Wang
Eric W. Wang
Juan C. Fernandez-Miranda
Carl H. Snyderman
Paul A. Gardner
Publication date: 01-11-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-016-2274-y

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Springer Medicine

Endoscopic transnasal skull base surgery: pushing the boundaries

Abstract

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Abstract

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