REVIEW  THE LIMITS OF ENDOSCOPIC ENDONASAL APPROACHES 

Journal of Neurosurgical Sciences 2018 June;62(3):322-31

DOI: 10.23736/S0390-5616.18.04411-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

The limits of the endoscopic endonasal transclival approach for posterior fossa tumors

Alexandre BOSSI TODESCHINI ¹, Alaa S. MONTASER ^{1, 2}, Douglas A. HARDESTY ^{1, 3}, Ricardo L. CARRAU ^{1, 4}, Daniel M. PREVEDELLO ^{1, 4} ✉

¹ Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA; ² Department of Neurosurgery, Ain Shams University, Cairo, Egypt; ³ Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA; ⁴ Department of Otolaryngology, Head and Neck Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA

Endoscopic endonasal approaches (EEA) have gained popularity and acceptance in skull base surgery over the last two decades. So-called expanded EEA allow access in the sagittal plane from the frontal sinus to the odontoid process. The endoscopic endonasal transclival approach allows a unique trajectory into the midline clivus and skull base that is unachievable from traditional craniotomy approaches to lesions such as chondrosarcomas, chordomas, and posterior fossa meningiomas. In this review, we will assess the benefits and drawbacks to using an endoscopic endonasal approach versus transcranial approach to these challenging lesions, assess the anatomical limits of endoscopic endonasal transclival surgery, and discuss the published literature on the topic.

KEY WORDS: Skull base - Neurosurgical procedures - Endoscopy