Introduction: The evolution of skull base surgery over the past decade has been significantly influenced by advancement in visualization technology. As a result of such improvements in optical imaging and surgical instrumentation, endoscopic endonasal approaches has been widely used to expose and work in the different areas inside and around the sella. In the present study we describe the use of the newly developed 3D stereoscopic endoscope for the treatment of a series of patients with sellar and suprasellar lesions.
Methods: From January 2010 to January 2014, a pure 3D endoscopic endonasal approach was used in 30 patients with the following lesions: 3 tuberculum sellae meningiomas, 6 suprasellar and 2 cavernous sinus macroadenomas; 1 Rathke cleft cyst and 18 pituitary adenomas. A 4.0 mm, 0°, and 30° rigid 3D endoscopes were used as the sole method of visualization.
Results: Total tumour removal, as assessed by postoperative magnetic resonance imaging, was possible in 24 patients (80%), in 6 patients only partial removal was possible. Major complications , including cerebrospinal ?uid leak were observed in 2 patients (6%).
Conclusions: The use of three-dimensional endoscope for extended endoscopic endonasal approach could be used as a minimally invasive and innovative technique for the removal of selected skull base lesions. In our experience, three-dimensional endoscopy represents an important development in visualization, mainly in the understanding of the depth relations of complex intradural anatomical neurovascular structures.
Patient Care: Minimize approach, reduce hospidalitation and morbidity. Better aestethic results.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of endoscopy for skullbase surgery, 2) Discuss, in small groups,about extended transsphenoidal approach for sellar and suprasellar region, 3) Identify an effective treatment for anterior skullbase lesions.