ICAR: endoscopic skull-base surgery

Eric W. Wang, Adam M. Zanation, Paul A. Gardner, Theodore H. Schwartz, Jean Anderson Eloy, Nithin D. Adappa, Martin Bettag, Benjamin S. Bleier, Paolo Cappabianca, Ricardo L. Carrau, Roy R. Casiano, Luigi M. Cavallo, Charles S. Ebert, Ivan H. El-Sayed, James J. Evans, Juan C. Fernandez-Miranda, Adam J. Folbe, Sebastien Froelich, Fred Gentili, Richard J. HarveyPeter H. Hwang, John A. Jane, Daniel F. Kelly, David Kennedy, Engelbert Knosp, Devyani Lal, John Y.K. Lee, James K. Liu, Valerie J. Lund, James N. Palmer, Daniel M. Prevedello, Rodney J. Schlosser, Raj Sindwani, C. Arturo Solares, Abtin Tabaee, Charles Teo, Parthasarathy D. Thirumala, Brian D. Thorp, Eduardo de Arnaldo Silva Vellutini, Ian Witterick, Bradford A. Woodworth, Peter John Wormald, Carl H. Snyderman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). Methods: Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results: The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion: A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.

Original languageEnglish (US)
Pages (from-to)S145-S365
JournalInternational Forum of Allergy and Rhinology
Volume9
Issue numberS3
DOIs
StatePublished - Jul 2019
Externally publishedYes

Fingerprint

Skull Base
Cerebrospinal Fluid Rhinorrhea
Pathology
Consensus
Learning Curve
Otolaryngology
Neurosurgery
Pituitary Neoplasms

Keywords

  • angiofibroma
  • clival chordoma
  • craniopharyngioma
  • CSF rhinorrhea
  • endoscopic endonasal approach
  • endoscopic endonasal skull-base surgery
  • esthesioneuroblastoma
  • evidence-based medicine
  • meningioma
  • nasoseptal flap reconstruction
  • olfactory neuroblastoma
  • pituitary adenoma
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Wang, E. W., Zanation, A. M., Gardner, P. A., Schwartz, T. H., Eloy, J. A., Adappa, N. D., ... Snyderman, C. H. (2019). ICAR: endoscopic skull-base surgery. International Forum of Allergy and Rhinology, 9(S3), S145-S365. https://doi.org/10.1002/alr.22326

ICAR : endoscopic skull-base surgery. / Wang, Eric W.; Zanation, Adam M.; Gardner, Paul A.; Schwartz, Theodore H.; Eloy, Jean Anderson; Adappa, Nithin D.; Bettag, Martin; Bleier, Benjamin S.; Cappabianca, Paolo; Carrau, Ricardo L.; Casiano, Roy R.; Cavallo, Luigi M.; Ebert, Charles S.; El-Sayed, Ivan H.; Evans, James J.; Fernandez-Miranda, Juan C.; Folbe, Adam J.; Froelich, Sebastien; Gentili, Fred; Harvey, Richard J.; Hwang, Peter H.; Jane, John A.; Kelly, Daniel F.; Kennedy, David; Knosp, Engelbert; Lal, Devyani; Lee, John Y.K.; Liu, James K.; Lund, Valerie J.; Palmer, James N.; Prevedello, Daniel M.; Schlosser, Rodney J.; Sindwani, Raj; Solares, C. Arturo; Tabaee, Abtin; Teo, Charles; Thirumala, Parthasarathy D.; Thorp, Brian D.; de Arnaldo Silva Vellutini, Eduardo; Witterick, Ian; Woodworth, Bradford A.; Wormald, Peter John; Snyderman, Carl H.

In: International Forum of Allergy and Rhinology, Vol. 9, No. S3, 07.2019, p. S145-S365.

Research output: Contribution to journalArticle

Wang, EW, Zanation, AM, Gardner, PA, Schwartz, TH, Eloy, JA, Adappa, ND, Bettag, M, Bleier, BS, Cappabianca, P, Carrau, RL, Casiano, RR, Cavallo, LM, Ebert, CS, El-Sayed, IH, Evans, JJ, Fernandez-Miranda, JC, Folbe, AJ, Froelich, S, Gentili, F, Harvey, RJ, Hwang, PH, Jane, JA, Kelly, DF, Kennedy, D, Knosp, E, Lal, D, Lee, JYK, Liu, JK, Lund, VJ, Palmer, JN, Prevedello, DM, Schlosser, RJ, Sindwani, R, Solares, CA, Tabaee, A, Teo, C, Thirumala, PD, Thorp, BD, de Arnaldo Silva Vellutini, E, Witterick, I, Woodworth, BA, Wormald, PJ & Snyderman, CH 2019, 'ICAR: endoscopic skull-base surgery', International Forum of Allergy and Rhinology, vol. 9, no. S3, pp. S145-S365. https://doi.org/10.1002/alr.22326
Wang EW, Zanation AM, Gardner PA, Schwartz TH, Eloy JA, Adappa ND et al. ICAR: endoscopic skull-base surgery. International Forum of Allergy and Rhinology. 2019 Jul;9(S3):S145-S365. https://doi.org/10.1002/alr.22326
Wang, Eric W. ; Zanation, Adam M. ; Gardner, Paul A. ; Schwartz, Theodore H. ; Eloy, Jean Anderson ; Adappa, Nithin D. ; Bettag, Martin ; Bleier, Benjamin S. ; Cappabianca, Paolo ; Carrau, Ricardo L. ; Casiano, Roy R. ; Cavallo, Luigi M. ; Ebert, Charles S. ; El-Sayed, Ivan H. ; Evans, James J. ; Fernandez-Miranda, Juan C. ; Folbe, Adam J. ; Froelich, Sebastien ; Gentili, Fred ; Harvey, Richard J. ; Hwang, Peter H. ; Jane, John A. ; Kelly, Daniel F. ; Kennedy, David ; Knosp, Engelbert ; Lal, Devyani ; Lee, John Y.K. ; Liu, James K. ; Lund, Valerie J. ; Palmer, James N. ; Prevedello, Daniel M. ; Schlosser, Rodney J. ; Sindwani, Raj ; Solares, C. Arturo ; Tabaee, Abtin ; Teo, Charles ; Thirumala, Parthasarathy D. ; Thorp, Brian D. ; de Arnaldo Silva Vellutini, Eduardo ; Witterick, Ian ; Woodworth, Bradford A. ; Wormald, Peter John ; Snyderman, Carl H. / ICAR : endoscopic skull-base surgery. In: International Forum of Allergy and Rhinology. 2019 ; Vol. 9, No. S3. pp. S145-S365.
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title = "ICAR: endoscopic skull-base surgery",
abstract = "Background: Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). Methods: Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results: The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion: A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.",
keywords = "angiofibroma, clival chordoma, craniopharyngioma, CSF rhinorrhea, endoscopic endonasal approach, endoscopic endonasal skull-base surgery, esthesioneuroblastoma, evidence-based medicine, meningioma, nasoseptal flap reconstruction, olfactory neuroblastoma, pituitary adenoma, squamous cell carcinoma",
author = "Wang, {Eric W.} and Zanation, {Adam M.} and Gardner, {Paul A.} and Schwartz, {Theodore H.} and Eloy, {Jean Anderson} and Adappa, {Nithin D.} and Martin Bettag and Bleier, {Benjamin S.} and Paolo Cappabianca and Carrau, {Ricardo L.} and Casiano, {Roy R.} and Cavallo, {Luigi M.} and Ebert, {Charles S.} and El-Sayed, {Ivan H.} and Evans, {James J.} and Fernandez-Miranda, {Juan C.} and Folbe, {Adam J.} and Sebastien Froelich and Fred Gentili and Harvey, {Richard J.} and Hwang, {Peter H.} and Jane, {John A.} and Kelly, {Daniel F.} and David Kennedy and Engelbert Knosp and Devyani Lal and Lee, {John Y.K.} and Liu, {James K.} and Lund, {Valerie J.} and Palmer, {James N.} and Prevedello, {Daniel M.} and Schlosser, {Rodney J.} and Raj Sindwani and Solares, {C. Arturo} and Abtin Tabaee and Charles Teo and Thirumala, {Parthasarathy D.} and Thorp, {Brian D.} and {de Arnaldo Silva Vellutini}, Eduardo and Ian Witterick and Woodworth, {Bradford A.} and Wormald, {Peter John} and Snyderman, {Carl H.}",
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month = "7",
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TY - JOUR

T1 - ICAR

T2 - endoscopic skull-base surgery

AU - Wang, Eric W.

AU - Zanation, Adam M.

AU - Gardner, Paul A.

AU - Schwartz, Theodore H.

AU - Eloy, Jean Anderson

AU - Adappa, Nithin D.

AU - Bettag, Martin

AU - Bleier, Benjamin S.

AU - Cappabianca, Paolo

AU - Carrau, Ricardo L.

AU - Casiano, Roy R.

AU - Cavallo, Luigi M.

AU - Ebert, Charles S.

AU - El-Sayed, Ivan H.

AU - Evans, James J.

AU - Fernandez-Miranda, Juan C.

AU - Folbe, Adam J.

AU - Froelich, Sebastien

AU - Gentili, Fred

AU - Harvey, Richard J.

AU - Hwang, Peter H.

AU - Jane, John A.

AU - Kelly, Daniel F.

AU - Kennedy, David

AU - Knosp, Engelbert

AU - Lal, Devyani

AU - Lee, John Y.K.

AU - Liu, James K.

AU - Lund, Valerie J.

AU - Palmer, James N.

AU - Prevedello, Daniel M.

AU - Schlosser, Rodney J.

AU - Sindwani, Raj

AU - Solares, C. Arturo

AU - Tabaee, Abtin

AU - Teo, Charles

AU - Thirumala, Parthasarathy D.

AU - Thorp, Brian D.

AU - de Arnaldo Silva Vellutini, Eduardo

AU - Witterick, Ian

AU - Woodworth, Bradford A.

AU - Wormald, Peter John

AU - Snyderman, Carl H.

PY - 2019/7

Y1 - 2019/7

N2 - Background: Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). Methods: Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results: The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion: A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.

AB - Background: Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). Methods: Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results: The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion: A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.

KW - angiofibroma

KW - clival chordoma

KW - craniopharyngioma

KW - CSF rhinorrhea

KW - endoscopic endonasal approach

KW - endoscopic endonasal skull-base surgery

KW - esthesioneuroblastoma

KW - evidence-based medicine

KW - meningioma

KW - nasoseptal flap reconstruction

KW - olfactory neuroblastoma

KW - pituitary adenoma

KW - squamous cell carcinoma

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