Skull Base 2010; 20(4): 223-228
DOI: 10.1055/s-0030-1247630
ORIGINAL ARTICLE

© Thieme Medical Publishers

Utility of a Three-Dimensional Endoscopic System in Skull Base Surgery

Oshri Wasserzug1 , Nevo Margalit2 , 3 , Noam Weizman1 , Dan M. Fliss1 , Ziv Gil1 , 2
  • 1Department of Otolaryngology–Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  • 2The Skull Base Surgery Service, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  • 3Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Further Information

Publication History

Publication Date:
29 January 2010 (online)

ABSTRACT

We evaluated the utility of a three-dimensional (3-D) endoscopic system for skull base surgery. We performed a retrospective case series in a tertiary care medical center. Thirty-six patients underwent skull base (nonpituitary) resections via 3-D endoscopic system. Fifteen patients (42%) were operated for excision of malignant tumors, 19 (53%) for excision of benign lesions, and 3 (8.3%) for skull base reconstruction. The tumors involved the cribriform plate (n = 13), sphenoid sinus and planum (n = 17), clivus (n = 7), and sella (n = 7). Complete tumor resection was achieved in 31 patients and subtotal resection in two. Five patients (14%) had postoperative complications. There was one case of meningitis, and there were no cases of cerebrospinal fluid leak. The surgeon's ability to recognize anatomic structures at the skull base was evaluated using the 3-D and two-dimensional systems. The 3-D technique was superior to the conventional technique for identification of the sella, carotid prominence, optic prominence, cribriform plate, sphenoid, and fovea ethmoidalis. The two systems were equal for detection of the turbinates, clivus, maxillary, ethmoids, and frontal sinuses. Endoscopic skull base surgery with stereoscopic viewing is feasible and safe. Further studies are required to evaluate the advantage of binocular vision in skull base surgery.

REFERENCES

Ziv Gil, M.D. , Ph.D. 

The Skull Base Surgery Service, Department of Otolaryngology–Head and Neck Surgery

Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 64239, Tel-Aviv, Israel

Email: ziv@baseofskull.org