The advantages of endoscopic approach to skull base are many. They include:
- It is the most direct route to anterior skull base. This approach provides access to the following areas Sella, Cribriform plate, Planum sphenoidale, suprasellar cistern, Clivus, Pterygopalatine fossa and adjacent parasellar areas.
- In this approach there is decreased retraction of brain and cranial nerves when compared to that of conventional neurosurgical apporaches.
- Endoscope offers excellent visualization of the tumor and the surrounding neurovascular structures
- Post operative recovery time is short when compared to that of conventional neurosurgical approaches
As with any other procedure this method also has its flip side, which includes a steep learning curve, and need to collaborate with neurosurgeon. A cohesive collaboration with neurosurgeon is a must for successful endoscopic skull base surgical procedures.The complicated anatomy of skull base has managed to bridge these two specialities. In a nut shell an otolaryngologist navigates the pathway to the intracranial lesion while the neurosurgeon removes the tumor.
Dangers of endoscopic skull base surgery:
Since the skull base has many vital structures it should be performed with the highest degree of deligence and skill. The potential complications of any endoscopic skull base surgery include:
- CSF rhinorrhoea
- Injury to great vessels (internal carotid artery and its branches inside the skull)
- Injury to optic nerve
- Injury to other cranial nerves
- Bleeding from cavernous sinus
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