Minim Invasive Neurosurg 2009; 52(3): 114-118
DOI: 10.1055/s-0028-1119414
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Extended Endoscopic Endonasal Approach to the Skull Base

O. L. Arbolay 1 , J. G. González 1 , R. H. González 2 , Y. H. Gálvez 3
  • 1Department of Neurosurgery, ldquo;Hermanos Ameijeiras” Hospital, La Habana City, Cuba
  • 2Department of Anesthesiology, “Hermanos Ameijeiras” Hospital, La Habana City, Cuba
  • 3Department of Maxillo-Facial Surgery, “Hermanos Ameijeiras” Hospital, La Habana City, Cuba
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Publikationsverlauf

Publikationsdatum:
31. Juli 2009 (online)

Abstract

Objective: Different approaches to the skull base have been developed through the sphenoidal sinus. Traditional boundaries of the trans-sphenoidal approach can be extended in antero-posterior and lateral planes. We review our experience with the extended endoscopic endonasal approach in the first 12 cases.

Methods: We used the extended endoscopic endonasal approach in 12 patients with different lesions of the skull base. This study specifically focuses on the type of lesions, surgical approach, outcome and surgical complications.

Results: The extended endoscopic endonasal approach was used in 12 patients with the following lesions: 4 nvasive adenomas to the cavernous sinus, 2 clival chordomas, 2 craniopharyngiomas, 1 hypothalamic astrocytoma and 3 pituitary adenomas extended upon the tuberculum. Gross total resection was achieved in 8 cases (66.7%) subtotal resection in 3 and just a biopsy could be accomplished in the case of astrocytoma. This last patient developed meningo-encephalitis and died two weeks later.

Conclusions: The extended endoscopic endonasal approach is a promising minimally invasive alternative for selected cases with sellar, parasellar or clivus lesions. As techniques and technology advance, this approach may become the procedure of choice for most lesions and should be considered an option in the management of the patients with these complex pathologies by skull base surgeons.

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Correspondence

O. L. ArbolayMD, PhD 

Department of Neurosurgery

“Hermanos Ameijeiras” Hospital

San Lazaro 701

La Habana City

Cuba

eMail: arbolay@infomed.sld.cu