Introduction: With the introduction into the neurosurgical practice of minimally invasive methods using endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa.
Objective: To analyze the results of surgical treatment of patients with various centrally located tumors of the base of the skull that extend into the anterior region of the posterior cranial fossa using the endoscopic endonasal transclival approach.
Methods: The personal surgical experience of the first author is 136 patients with various tumors (e.g., chordomas, meningiomas, pituitary adenomas, and fibrous dysplasia).
Results: Radicality of tumor removal was total 61.03%; subtotal 25%; partial 13.23%; and insufficient removal 0.74%. Postoperative cerebrospinal fluid leaks occurred in 9 cases (6.62%) and meningitis in 13 cases (9.56%). In 2 cases, surgical treatment had a lethal outcome (1.47%).
Conclusions: The endoscopic endonasal transclival approach can be used to obtain access to centrally located skull base tumors. This approach allows for a radical and low-risk removal of various skull base tumors of central localization that, until recently, were considered to be almost inoperable.
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http://dx.doi.org/10.1016/j.wneu.2018.09.090 | DOI Listing |
Surg Neurol Int
December 2024
Department of Neurosurgery Westchester Medical Center, Valhalla, New York, United States.
Background: Pituitary apoplexy (PA) is a rare, life-threatening clinical syndrome that occurs in response to acute ischemic infarction or hemorrhage of a pituitary adenoma. We report two cases of sudden neurologic and visual decline in patients with pituitary region masses in coronavirus disease (COVID)-positive patients with a focus on potential pathophysiological mechanisms and a safe approach to treatment.
Case Description: Case one is a 58-year-old male presenting with sudden-onset headache and visual disturbance.
Surg Neurol Int
December 2024
Center for Skull Base and Minimally Invasive Neurosurgery, Hospital Angeles Pedregal, Centro de Especialidades Quirúrgicas, Mexico City, Mexico.
Background: Collision sellar tumors are rare disease entities. Less than 30 cases have been reported in the literature in the last 20 years. We present the case of one patient diagnosed with a collision sellar tumor and describe the use of Enhanced Contact Endoscopy for pituitary gland and tumoral identification not previously described in the literature.
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.
Background: Intracranial chondrosarcomas are malignant tumors that most commonly affect the clivus region. For tumors in this location, the extended endoscopic endonasal approach could offer an alternative route. We present a case of pons herniation after this technique.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Objective: The endoscopic endonasal approach (EEA), has become the preferred alternative to traditional open and transoral approaches to the ventral craniovertebral junction (CVJ) region. However, preoperative prediction of the limitations of caudal reach remains challenging. This cadaveric study aimed to quantify the CVJ area of exposure and access afforded by the EEA, evaluate the accuracy of previously described radiographic anthropometric lines, and identify the lowest limit of the EEA corridor.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Otolaryngology, Head and Neck Surgery, Helios HSK Wiesbaden, 65199 Wiesbaden, Germany.
: Sinonasal malignancies are rare and highly diverse cancers that pose significant diagnostic challenges due to their variable histological features and complex anatomical locations. Accurate diagnosis is critical for guiding treatment, yet conventional methods often require multiple biopsies. This study aimed to evaluate the potential of confocal laser endomicroscopy (CLE) for real-time imaging of sinonasal tumors to characterize specific features of different entities and improve diagnostic precision.
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