SPECIAL ARTICLE  ENDOSCOPIC ENDONASAL APPROACHES TO THE ANTERIOR FOSSA 

Journal of Neurosurgical Sciences 2021 April;65(2):169-80

DOI: 10.23736/S0390-5616.21.05170-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Endoscopic approaches to skull base malignancies affecting the anterior fossa

Giuliano SILVEIRA-BERTAZZO ^{1, 2}, Ruichun LI ¹, Thaïs C. REJANE-HEIM ^{1, 2}, Rafael MARTINEZ-PEREZ ¹, Thiago ALBONETTE-FELICIO ¹, Ahmed G. SHOLKAMY DIAB ^{3, 4}, Mohammad S. MAHMOUD MADY ^{3, 5}, Douglas A. HARDESTY ^{1, 3},
Ricardo L. CARRAU ^{1, 3}, Daniel M. PREVEDELLO ^{1, 3} ✉

¹ Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA; ² Department of Pediatric Neuroendocrinology and Pediatric Endocrinology, Jeser Amarante Faria Children’s Hospital, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil; ³ Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, USA; ⁴ Department of Otolaryngology-Head and Neck Surgery, University of Assiut, Assiut, Egypt; ⁵ Department of Otolaryngology-Head and Neck Surgery, Ain Shams University, El Cairo, Egypt

Anterior skull base malignancies are rare and comprise distinct histological entities. Surgery encompasses the traditional craniofacial resections (CFR), and more recently, endoscopic endonasal approaches (EEA) or a hybrid cranioendoscopic (CEA) technique. Although the CFR is still considered the “gold-standard;” there is growing evidence supporting that EEA yield equivalent oncologic outcomes with less morbidity in well-selected cases. Therefore, this article aims to review the current state-of-art in addressing anterior cranial base malignancies using expanded endoscopic endonasal approaches (EEA) with particular references to surgical anatomy and nuances of hybrid cranioendoscopic techniques. Cadaveric dissections and illustrative cases are presented to detail our current surgical technique allied with tailored adjuvant therapies, and treatment strategies are further discussed based on tumor histology.

KEY WORDS: Skull Base; Endoscopy; Neoplasms; Surgical procedures, operative