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JOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia


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Journal of Neurosurgical Sciences 2018 Feb 13

DOI: 10.23736/S0390-5616.18.04348-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Limitations of the endoscopic endonasal transcribriform approach

Neil MAJMUNDAR 1, Naveed KAMAL 1, Renuka REDDY 2, Jean A. ELOY 1, 4, James K. LIU 1, 3

1 Department of Neurological Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; 2 Department of Otolaryngology, Head & Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; 3 Center for Skull Base and Pituitary Surgery, Rutgers Neurological Institute of New Jersey, Newark, NJ, USA; 4 Department of Ophthalmology and Visual Sciences, Rutgers-New Jersey Medical School, Newark, NJ, USA


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The endoscopic endonasal transcribriform approach (EETA) has become a useful strategy in the treatment of various anterior skull base pathology, including meningoencephaloceles, olfactory groove meningiomas, schwannomas, esthesioneuroblastomas, and other sinonasal malignancies. However, not all pathologies are optimally treated through this approach due to tumor size, extent of the lesion, vascular involvement, and the presence of intact olfaction. One must be prepared to use a transcranial approach if the EETA is not favorable. In some patients, a combined approach (transcranial-EETA) may be needed in appropriate cases. Therefore, patient selection is paramount for achieving a successful result with avoidance of complications. For certain tumors, the limitations of the EETA may result in lower rates of gross-total resection, higher rates of cerebrospinal fluid leakage, postoperative impairment of olfaction, and higher complication rates. In this paper, we discuss the limitations of the EETA when considering approach selection to treat anterior skull base lesions.


KEY WORDS: Endoscopic endonasal transcribriform approach - Endoscopic skull base surgery - Limitations - Anterior skull base - Olfactory groove meningiomas - Sinonasal malignancies

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Publication History

Article first published online: February 13, 2018
Manuscript accepted: January 25, 2018
Manuscript received: January 18, 2018

Per citare questo articolo

Majmundar N, Kamal N, Reddy R, Eloy JA, Liu JK. Limitations of the endoscopic endonasal transcribriform approach. J Neurosurg Sci 2018 Feb 13. DOI: 10.23736/S0390-5616.18.04348-5

Corresponding author e-mail

james.liu.md@rutgers.edu