Evaluation of Complications and Outcome of the Extended Endoscopic Endonasal Approach for Anterior, Middle and Posterior Skull Base Lesions

Document Type : Original Articles

Authors

1 Neurosurgery Department, Suez Canal University

2 Neurosurgery Department, Ninewells Hospital and Dundee medical school, University of Dundee - United Kingdom

3 Department of Neurological Surgery Faculty of Medicine, Suez Canal University, Ismailia – Egypt

4 Neurosurgery Department, Suez Canal University, Ismailia, Egypt

Abstract

Background: The endoscope in neurosurgery has started since the beginning of the 20th century. Its usage started in the ventricular system. Later, the pituitary was added as an indication for the endoscopy followed by skull base lesions.
Objective: The study aimed to improve the care of skull base lesion patients and assess the safety and effectiveness of using the endoscopic endonasal approach for resecting skull base tumors.

Methods: A Prospective clinical study of thirty patients with various types of anterior and middle skull base lesions managed with the endoscope. Thirty patients were performed at Suez Canal University Hospitals (Ismailia, Egypt) between 2020 and 2022. The study included 30 subjects including 11 males (36.7%) and 19 females (63.3%). Their mean age was 51.2 ± 12.5 years with a median of 50 years with a range from 19 - 73 years.



Results: Regarding the intra-operative complications 1 patient with excessive bleeding. Regarding CSF leakage, 13.3% of the patients (4 patients) experienced CSF leakage, however, only 1 patient (3.3%) had persistent CSF leakage which mandated management with a lumbar drain.
Conclusion: Using the endoscope in the extended endonasal transsphenoidal surgery speeds up the recovery time due to its minimally invasive characteristics. Its main target is midline sellar and parasellar lesions. The endoscope gives a panoramic view instead of a narrow microscopic view with very well-concentrated illumination which allows inspection and removal of lesions of the sellar, parasellar, and suprasellar compartments.

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