Skull base defects and injuries are rare, but may occur during endoscopic sinus surgery, as a result of facial trauma, or as a result of tumors in the anterior cranial fossa. Injury to the skull base can lead to catastrophic outcomes such as meningitis, brain abscess, neurological deficits, brain hemorrhage, and death. The content presents ways in which a surgeon may work to prevent or minimize injury to the skull base and describes management of skull base injuries when they do occur, reviews the current literature, and describes various reconstruction techniques used in free tissue grafts and pedicled grafts.
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National Clinical Research Center for Metabolic Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Medical Faculty of Heidelberg University, Heidelberg, Germany.
Introduction: Tumorous growths in the sellar region pose significant clinical challenges due to their proximity to critical visual structures such as the optic chiasm and optic nerves. Given their proximity to the optic system, these tumors are often diagnosed due to a progressive decrease in visual acuity. Thus, surgical intervention is crucial to prevent irreversible damage, as timely decompression can halt the progression of edema and subsequent optic atrophy.
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Department of Neurosurgery, Dokkyo Medical University School of Medicine, Tochigi, Japan.
In endoscopic endonasal surgery for anterior skull base lesions, maximizing the anterior sphenoidotomy in the superior part is crucial for direct visualization and creating a wide working corridor. Here, we describe a technique we devised that maximizes upper anterior sphenoidotomy while preserving the olfactory mucosa. Laryngoscope, 2024.
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