Expanded Endonasal Approach for Anterior Skull Base and Central Skull Base Lesions: Outstretched Hands of Otorhinolaryngologists

The diagnosis and treatment of the skull base lesions have dramatically changed in the past two decades. Neurosurgeons are not quite familiar to the uses of endoscope during sinus surgeries. There is a vast field for Otorhinolaryngologist to deal with the diseases of skull base but as it is the anatomy of skull base and vital structures related to it that makes skull base surgeries difficult to them. Another interesting fact is that an ENT surgeon deals with it during sinus surgeries, most of the times unknowingly. This prospective study was performed at a tertiary care center associated with a medical college. In the study we discuss about the various common anterior and central skull base lesions and their total endoscopic management. It includes 42 cases of a variety of lesions and their management. . All patients were thoroughly examined, investigated for mapping of the lesion and subjected to total endonasal endoscopic surgery with recording of preoperative and post operative findings. Surgery was performed mainly by transseptal route (80.9%). Complete removal of disease was seen in 33 patients (78.5%) till the last follow up. 9 patients with extensive lesions developed recurrence in an average period of 6–12 months. An interesting fact was that all surgeries were done by an ENT surgeon but with the help of a neurosurgeon.

Keywords

skull base surgery - endoscopic skull base surgery - anterior skull base - central skull base - pituitary surgery