Extended endoscopic endonasal approach to the ventral skull base lesions
| Autor: | Serdar Kaya, Abdullah Durmaz, İlker Solmaz, Yusuf Izci, Çağlar Temiz, Murat Kutlay, Mehmet Daneyemez, Cahit Kural, İlker Özer |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Endoscope Skull Base Neoplasms Neurosurgical Procedures 03 medical and health sciences Craniopharyngioma 0302 clinical medicine Cerebrospinal fluid medicine Humans Pituitary Neoplasms Aged Skull Base Cerebrospinal Fluid Leak business.industry Mortality rate Endoscopy General Medicine Middle Aged Gross Total Resection Intracerebral hematoma Tension pneumocephalus Skull medicine.anatomical_structure Case selection 030220 oncology & carcinogenesis Pneumocephalus Surgery Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Clinical neurology and neurosurgery. 167 |
| ISSN: | 1872-6968 |
| Popis: | Objective With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. Patients and Methods The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions. Four different approaches were used including transtuberculum-transplanum, transethmoidal-transcribriform, transclival, and transmaxillary-transpterygoidal. Results The overall gross total resection (GTR) rate for these diverse pathologies was 75.0% in 88 patients (excluding the operations performed for non-neoplastic pathologies). GTR was achieved in 100%, 77.8%, 75%, 75%, 72.2%, 62.5%, 60% of fibro-osseous lesions, giant/large pitutary adenomas, meningiomas, esthesioneuroblastomas, sinonasal malignancies, craniopharyngiomas, and chordomas, respectively. The overall rate of improvement in visual fields was 86%. The overall rate of CSF leak was 8.4%. Other surgical complications included intracerebral hematoma and tension pneumocephalus. The mortality rate was 0.9%. Conclusion EEEA is a safe, well-tolerated and effective surgical treatment modality in the management of ventral skull base lesions. It should be performed with close interdisciplinary collaboration. Appropriate case selection is mandatory. However, despite improved reconstruction techniques, postoperative CSF leakage still remains a challenge. |
| Databáze: | OpenAIRE |
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