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Nuances of Endoscopic Surgery

Last Updated: September 28, 2018

Figure 1: Endoscopic transnasal surgery has revolutionized skull base surgery. The pathoanatomy of a tuberculum sella meningioma is illustrated.

Endoscopic Transnasal Transtuberculum Resection of Craniopharyngioma

The endoscopic transnasal approach provides a panoramic view of the paraventral skull base from the cribriform plate to the foramen magnum through the existing corridors of the paranasal sinuses. This is in contrast to transcranial surgery that creates new anatomical corridors (the transfacial/craniofacial routes) to access deep-seated lesions through an osteotomy and brain mobilization or transgression.

The transnasal operative corridor has vastly advanced the minimally disruptive reach of the skull base surgeon. Although the exposure of the expanded endonasal trajectory...