AI Article Synopsis
- Expanded endonasal approaches allow surgeons to access the midline skull base easily, enhancing the removal of tumors located in the suprasellar region.
- Surgical methods involving bone drilling and dissection techniques are crucial in determining how safe and effective the surgical exposure will be.
- This article outlines a detailed approach, including step-by-step dissections, to improve safety and success in surgeries targeting suprasellar lesions.
Article Abstract
Background: Expanded endonasal approaches can provide direct access to the midline skull base from the anterior cranial fossa to the ventral foramen magnum. Surgical strategies of bone drilling, dural opening, and intradural dissection can determine the area of surgical exposure and instrument handling, affecting the safety of devascularizing/debulking suprasellar tumors.
Methods: We describe an expanded endoscopic endonasal approach for suprasellar lesions, with stepwise image-guided dissections highlighting surgical pearls and pitfalls to enhance surgical safety. This article presents transnasal intra-third-ventricular anatomy from trans-tuber cinereum, and trans-lamina terminalis approaches, comparing subchiasmatic and suprachiasmatic trajectories.
Conclusion: The rostral extension via endoscopic endonasal transsellar-transtubercular-transplanum approaches can provide a safe and feasible route for suprasellar lesions, in subchiasmatic, suprachiasmatic, and intraventricular regions.
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| http://dx.doi.org/10.1007/s00701-020-04368-9 | DOI Listing |
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