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JOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


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Journal of Neurosurgical Sciences 2018 Feb 13

DOI: 10.23736/S0390-5616.18.04347-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Limits of the endoscopic transnasal trans-tubercular approach

Verena GELLNER , Peter V. TOMAZIC

Department of Neurosurgery, Medical University of Graz, Graz, Austria


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INTRODUCTION: The endoscopic transnasal transsphenoidal transtubercular approach has become a standard alternative approach to neurosurgical transcranial routes for lesions of the anterior skull base in particular pathologies of the anterior tubercle, sphenoid plane, and midline lesions up to the interpeduncular cistern. For both the endoscopic and the transcranial approach indications must strictly be evaluated and tailored to the patients’ morphology and condition. The purpose of this review is to evaluate the evidence in literature of the limitations of the endoscopic transtubercular approach.
METHODS: A PubMed/Medline search was conducted in January 2018 entering following keywords. Upon initial screening 7 papers were included in this review. There are several other papers describing the endoscopic transtubercular approach (ETTA). We tried to list the limitation factors according to the actual existing literature as cited.
RESULTS: The main limiting factors are laterally extending lesions in relation to the optic canal and vascular encasement and/or unfavourable tumor tissue consistency.
CONCLUSIONS: The ETTA is considered as a high level transnasal endoscopic extended skull base approach and requires excellent training, skills and experience.


KEY WORDS: Transtubercular approach - Limitations - Endoscopic skull base surgery - Extended endonasal endoscopic approach

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Publication History

Article first published online: February 13, 2018
Manuscript accepted: January 25, 2018
Manuscript received: January 17, 2018

Cite this article as

Gellner V, Tomazic PV. Limits of the endoscopic transnasal trans-tubercular approach. J Neurosurg Sci 2018 Feb 13. DOI: 10.23736/S0390-5616.18.04347-3

Corresponding author e-mail

verena.gellner@medunigraz.at