The combined supraorbital keyhole-endoscopic endonasal transsphenoidal approach to sellar, perisellar and frontal skull base tumors: surgical technique
| Autor: | E. J. van Lindert, J.A. Grotenhuis |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adenoma
medicine.medical_specialty Surgical strategy Adolescent Skull Base Neoplasms Neurosurgical Procedures Transsphenoidal approach medicine Perception and Action [DCN 1] Humans Minimally Invasive Surgical Procedures business.industry Endoscopy General Medicine Middle Aged Surgical training Combined approach Surgery Skull medicine.anatomical_structure Neuroendoscopy Treatment Outcome Female Neurology (clinical) business Meningioma Keyhole |
| Zdroj: | Minimally Invasive Neurosurgery, 52, 5-6, pp. 281-6 Minimally Invasive Neurosurgery, 52, 281-6 |
| ISSN: | 0946-7211 |
| DOI: | 10.1055/s-0029-1242776 |
| Popis: | Introduction: Extended endoscopic endonasal transsphenoidal approaches (extended EETA) are increasingly being explored for lesions around the sella and the frontal skull base. These approaches, however, require significant surgical expertise and training that can only be obtained in high-volume centers and therefore these approaches are not generalizable to the whole neurosurgical community. Also, these approaches require significant skull base destruction and reconstruction, which comes with a high risk of CSF fistulas. The aim of this article is to describe a combined supraorbital keyhole-endoscopic endonasal transsphenoidal approach as an alternative surgical strategy to the extended EETA that is easier to perform and that leaves the skull base anatomy more intact. Technique: Two fairly common neurosurgical approaches, the supraorbital keyhole approach and the endoscopic endonasal transsphenoidal approach, are combined into a single-stage or two-stage surgical procedure. The procedure can be performed as a single neurosurgeon-serial approach and as a two neurosurgeon-parallel simultaneous approach. The philosophy and technique of this combined approach will be described. Conclusion: The combined supraorbital keyhole-EETA approach can be used without extra surgical training or expertise and with preservation of skull base anatomy for sellar, perisellar and frontal skull base tumors. |
| Databáze: | OpenAIRE |
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