Skull Base 2011; 21(2): 079-082
DOI: 10.1055/s-0030-1261258
ORIGINAL ARTICLE

© Thieme Medical Publishers

Feasibility of a Robotic Surgical Approach to Reconstruct the Skull Base

Michael E. Kupferman1 , Franco DeMonte2 , Nicholas Levine2 , Ehab Hanna1
  • 1Department of Head and Neck Surgery, M.D. Anderson Cancer Center, Houston, Texas
  • 2Department of Neurosurgery, M.D. Anderson Cancer Center, Houston, Texas
Further Information

Publication History

Publication Date:
25 June 2010 (online)

ABSTRACT

The role of robotic surgery in the skull base is evolving and represents the natural progression toward maximizing surgical resections in confined spaces without compromising oncological principles. In this study, we describe the novel application of robotic surgery to the repair of dural defects in the skull base. A transmaxillary-transantral approach to the nasal cavity was performed bilaterally in a cadaveric model. Repair of the skull base defect was undertaken robotically. In this technical report, we demonstrate the feasibility of a suture-based technique for surgical reconstruction of the skull base with robotic assistance in a cadaveric model. In all cases, suture repair of dural defects was successfully performed with robotic-assisted technique. Although preliminary in nature, this study suggests that traditional suture techniques can be implemented in a confined surgical site with the use of robotic technology.

REFERENCES

  • 1 Hanna E, DeMonte F, Ibrahim S, Roberts D, Levine N, Kupferman M. Endoscopic resection of sinonasal cancers with and without craniotomy: oncologic results.  Arch Otolaryngol Head Neck Surg. 2009;  135 1219-1224
  • 2 Banks C A, Palmer J N, Chiu A G, O'Malley Jr B W, Woodworth B A, Kennedy D W. Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years.  Otolaryngol Head Neck Surg. 2009;  140 826-833
  • 3 Kassam A B, Thomas A, Carrau R L, Snyderman C H et al.. Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap.  Neurosurgery. 2008;  63 ONS44-ONS52 discussion ONS52-ONS3
  • 4 Hanna E Y, Holsinger C, DeMonte F, Kupferman M. Robotic endoscopic surgery of the skull base: a novel surgical approach.  Arch Otolaryngol Head Neck Surg. 2007;  133 1209-1214
  • 5 Kupferman M, Demonte F, Holsinger F C, Hanna E. Transantral robotic access to the pituitary gland.  Otolaryngol Head Neck Surg. 2009;  141 413-415
  • 6 Diaz Jr E M, Johnigan III R H, Pero C et al.. Olfactory neuroblastoma: the 22-year experience at one comprehensive cancer center.  Head Neck. 2005;  27 138-149
  • 7 Hoppe B S, Stegman L D, Zelefsky M J et al.. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting—the MSKCC experience.  Int J Radiat Oncol Biol Phys. 2007;  67 691-702
  • 8 Nishioka H, Haraoka J, Ikeda Y. Risk factors of cerebrospinal fluid rhinorrhea following transsphenoidal surgery.  Acta Neurochir (Wien). 2005;  147 1163-1166 discussion 1166
  • 9 Eloy J A, Carai A, Patel A B, Genden E M, Bederson J B. Combined endoscope-assisted transclival clipping and endovascular stenting of a basilar trunk aneurysm: case report.  Neurosurgery. 2008;  62 (3 Suppl 1) 142-143 discussion 143-144
  • 10 Gardner P, Kassam A, Snyderman C, Mintz A, Carrau R, Moossy J J. Endoscopic endonasal suturing of dural reconstruction grafts: a novel application of the U-Clip technology. Technical note.  J Neurosurg. 2008;  108 395-400

Michael E KupfermanM.D. 

Department of Head & Neck Surgery, M.D. Anderson Cancer Center

1515 Holcombe Blvd, Unit 1445, Houston, TX 77030

Email: mekupfer@mdanderson.org

    >