Endoscopic skull base surgery: A comprehensive comparison with open transcranial approaches

Ricardo J Komotar, Robert M. Starke, Daniel M S Raper, Vijay K. Anand, Theodore H. Schwartz

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Little data exists comparing endoscopic endonasal approaches to pathology of the anterior skull base with more traditional transcranial and transsphenoidal microscopic approaches. In order to more fully characterize the role of endoscopy in the management of pathology of the anterior cranial base, we conducted a systematic review of case series and case reports documenting surgical and clinical outcomes. We found that for craniopharyngiomas, clival chordomas, esthesioneuroblastomas and giant pituitary adenomas, the endonasal endoscopic approach can result in equivalent or higher rates of gross total resection than open approaches. For meningiomas, however, open transcranial approaches are still able to achieve higher rates of total resection. CSF leak rates are higher for patients undergoing endoscopic surgery for meningiomas and craniopharyngiomas, but not for chordomas, esthesioneuroblastomas or giant pituitary adenomas. In certain patients, the endonasal endoscopic approach may be a safe and effective alternative for the treatment of a wide variety of skull base pathology, particularly those with small midline tumours.

Original languageEnglish
Pages (from-to)637-648
Number of pages12
JournalBritish Journal of Neurosurgery
Volume26
Issue number5
DOIs
StatePublished - Oct 1 2012

Fingerprint

Skull Base
Olfactory Esthesioneuroblastoma
Chordoma
Craniopharyngioma
Pituitary Neoplasms
Meningioma
Pathology
Endoscopy
Neoplasms
Therapeutics

Keywords

  • Endoscopy
  • Minimally invasive surgery
  • Outcome
  • Skull base tumours
  • Surgical approach

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Endoscopic skull base surgery : A comprehensive comparison with open transcranial approaches. / Komotar, Ricardo J; Starke, Robert M.; Raper, Daniel M S; Anand, Vijay K.; Schwartz, Theodore H.

In: British Journal of Neurosurgery, Vol. 26, No. 5, 01.10.2012, p. 637-648.

Research output: Contribution to journalArticle

Komotar, Ricardo J ; Starke, Robert M. ; Raper, Daniel M S ; Anand, Vijay K. ; Schwartz, Theodore H. / Endoscopic skull base surgery : A comprehensive comparison with open transcranial approaches. In: British Journal of Neurosurgery. 2012 ; Vol. 26, No. 5. pp. 637-648.
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