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Skull base surgery

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.
Expanded endoscopic skull base vs. Open skull base approach: decision analysis
In this key lecture, Dr. Dehdashti compares two approaches, namely the expanded endoscopic skull base vs. the open skull base approach in order to make a therapeutic decision.
1. Skull base approach and endoscopic approach
2. Indication and limitation
3. Comparison of skull base cranial approaches with endoscopic approaches
4. Olfactory groove meningioma
5. Example of endoscopic transnasal approach for planum sphenoidal meningioma
6. Which approach we can choose for meningiomas
7. Suprasellar meningioma via transnasal endoscopic approach
8. Suprasellar meningioma via interhemispheric frontobasal approach
9. Tuberculum sellae meningioma via transnasal endoscopic approach
10. Endoscopic endonasal resection of meningioma
A Dehdashti
Lecture
2 years ago
246 views
10 likes
1 comment
28:23
Expanded endoscopic skull base vs. Open skull base approach: decision analysis
In this key lecture, Dr. Dehdashti compares two approaches, namely the expanded endoscopic skull base vs. the open skull base approach in order to make a therapeutic decision.
1. Skull base approach and endoscopic approach
2. Indication and limitation
3. Comparison of skull base cranial approaches with endoscopic approaches
4. Olfactory groove meningioma
5. Example of endoscopic transnasal approach for planum sphenoidal meningioma
6. Which approach we can choose for meningiomas
7. Suprasellar meningioma via transnasal endoscopic approach
8. Suprasellar meningioma via interhemispheric frontobasal approach
9. Tuberculum sellae meningioma via transnasal endoscopic approach
10. Endoscopic endonasal resection of meningioma
Endoscopic endonasal approach to the cranio-cervical junction
There exists a variety of pathological processes involving the craniocervical junction (CCJ): tumors (e.g. primary bone tumors, chordomas, metastases), infections (e.g. tuberculoma), malformations and rheumatoid arthritis. Instability—either induced by the pathology itself or after surgery— is often associated with these diseases and has to be addressed. For a long time, the transoral approach (TOA) has been the gold standard for anterior surgical decompression at the CCJ. Over the last years, the endoscopic endonasal approach (EEA) has become a valuable alternative. In order to work efficiently and safely via the EEA, there are some prerequisites: a thorough knowledge of the endoscopic anatomy, careful preoperative planning based on radiology, adequate endoscopic technique (ideally a team of neurosurgeons and ENT specialists), dedicated endoscopic instrumentation and intraoperative navigation and the ability to perform occipitocervical stabilization. Finally, for successful patient management, it is crucial to learn about the possibilities and limits of this approach - or when to choose it and when not.
JF Cornelius
Lecture
7 years ago
482 views
1 like
0 comments
11:02
Endoscopic endonasal approach to the cranio-cervical junction
There exists a variety of pathological processes involving the craniocervical junction (CCJ): tumors (e.g. primary bone tumors, chordomas, metastases), infections (e.g. tuberculoma), malformations and rheumatoid arthritis. Instability—either induced by the pathology itself or after surgery— is often associated with these diseases and has to be addressed. For a long time, the transoral approach (TOA) has been the gold standard for anterior surgical decompression at the CCJ. Over the last years, the endoscopic endonasal approach (EEA) has become a valuable alternative. In order to work efficiently and safely via the EEA, there are some prerequisites: a thorough knowledge of the endoscopic anatomy, careful preoperative planning based on radiology, adequate endoscopic technique (ideally a team of neurosurgeons and ENT specialists), dedicated endoscopic instrumentation and intraoperative navigation and the ability to perform occipitocervical stabilization. Finally, for successful patient management, it is crucial to learn about the possibilities and limits of this approach - or when to choose it and when not.
Endoscopic endonasal approach to pituitary adenomas
The endoscopic endonasal approach is a continuously evolving speciality of modern neurosurgery, which requires precise anatomical knowledge, technical skills and integrated appreciation of the pathology to be treated.
This technique is a minimally invasive approach that allows the surgeon to deal with several diseases, especially entire skull base obviating brain retraction. The endoscopic endonasal approach offers some advantages arising from the use of the endoscope itself: a superior close-up view of the relevant anatomy and an enlarged working angle with an increased panoramic vision within the surgical area. Indeed, it offers the opportunity to safely and effectively visualize the surgical field, which as a result provides a corridor through the nasal cavity to reach the brain with its neurovascular structures.
Most pituitary adenomas can be managed and removed through a standard transsphenoidal approach either microscopically or endoscopically. More recently, the introduction of the endoscope in the extended endoscopic endonasal approach has made this technique more popular, and today this technique can be considered suitable for the removal of lesions extending beyond the sellar area such as parasellar, suprasellar and/or retrosellar spaces.
We have been using the endoscopic endonasal technique since 1997 on more than 1000 patients, aiming to remove first sellar lesions and more recently skull base lesions applying the so-called extended endonasal approach.
We report our experience through a step-by-step depiction of the surgical techniques to access the different compartments, detailing the anatomy as seen from the endonasal perspective, focusing on dangerous landmarks, describing possible complications and techniques used to manage this kind of lesions.
D Solari
Lecture
7 years ago
667 views
6 likes
0 comments
19:31
Endoscopic endonasal approach to pituitary adenomas
The endoscopic endonasal approach is a continuously evolving speciality of modern neurosurgery, which requires precise anatomical knowledge, technical skills and integrated appreciation of the pathology to be treated.
This technique is a minimally invasive approach that allows the surgeon to deal with several diseases, especially entire skull base obviating brain retraction. The endoscopic endonasal approach offers some advantages arising from the use of the endoscope itself: a superior close-up view of the relevant anatomy and an enlarged working angle with an increased panoramic vision within the surgical area. Indeed, it offers the opportunity to safely and effectively visualize the surgical field, which as a result provides a corridor through the nasal cavity to reach the brain with its neurovascular structures.
Most pituitary adenomas can be managed and removed through a standard transsphenoidal approach either microscopically or endoscopically. More recently, the introduction of the endoscope in the extended endoscopic endonasal approach has made this technique more popular, and today this technique can be considered suitable for the removal of lesions extending beyond the sellar area such as parasellar, suprasellar and/or retrosellar spaces.
We have been using the endoscopic endonasal technique since 1997 on more than 1000 patients, aiming to remove first sellar lesions and more recently skull base lesions applying the so-called extended endonasal approach.
We report our experience through a step-by-step depiction of the surgical techniques to access the different compartments, detailing the anatomy as seen from the endonasal perspective, focusing on dangerous landmarks, describing possible complications and techniques used to manage this kind of lesions.