Extended endoscopic approaches for midline skull-base lesions.

Abstract:

:The endoscopic transsphenoidal approach has been reported in the literature as a useful tool to treat sellar and parasellar lesions. The endoscope permits a panoramic view instead of the narrow microscopic view, and it allows the inspection and removal of the lesions of sellar, parasellar, and suprasellar compartments by angled-lens endoscopes. On the basis of the experience gained with the use of the endoscope, we have performed extended endoscopic endonasal transsphenoidal approach in 13 of 200 (total endoscopic transphenoidal approaches since September 1997) patients for the last 5 years. Extended endoscopic transsphenoidal approach was performed for three patients with pituitary adenoma, two patients with craniopharyngioma, one patient with metastatic lesion, one patient with anaplastic germinoma, two patients with chordoma, one patient with chondrosarcoma, one plasmocytoma, and two patients with tuberculum sella meningioma. Total removal of the tumor was achieved in nine patients and subtotal removal was achieved in four patients. Extended approaches are essential for reaching the area from lamina cribrosa to the cranio-cervical junction. Endoscopic approach permits reaching the lesion without brain retraction and with minimal neurovascular manipulation. The main problems are related to the hemorrhage control of intracranial vessels and to the closure of the dural and bony defects, with subsequent increased risk of postoperative cerebrospinal fluid leak, tensive pneumocephalus, and/or meningitis.

journal_name

Neurosurg Rev

journal_title

Neurosurgical review

authors

Ceylan S,Koc K,Anik I

doi

10.1007/s10143-009-0201-9

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

309-19; discussion 318-9

issue

3

eissn

0344-5607

issn

1437-2320

journal_volume

32

pub_type

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