Extended Transnasal Endoscopic Approach for Skull Base Tumors and Tumors of the Orbit

Czech version

Authors: R. Lipina ¹; P. Matoušekihash2 ^{2,3 2,3}
Authors‘ workplace: Neurochirurgická klinika FN Ostrava ¹; ORL klinika FN Ostrava ²; LF Ostravské univerzity ³
Published in: Cesk Slov Neurol N 2012; 75/108(3): 326-332
Category: Original Paper

Overview

Aim:
The aim of the paper was to evaluate our experience with the extended endoscopic transnasal approach in resection of tumors of the skull base and orbit, as an alternative to the transcranial microscopic approach.

Material and methods:
Between April 2009 and September 2011, 13 patients underwent surgery using the extended transnasal endoscopic approach. The surgery was to treat meningioma in two patients, craniopharyngioma in five patients, epidermoid cyst in one patient, lymphoma of the pterygopalatine fossa in one patient and tumors of the orbit in four patients (histologically these were neurofibroma, leiomyoma, metasthasis and optic glioma).

Results:
Radical excision was achieved in eight patients in total. Of these, two patients had meningioma, three patients had craniopharyngioma, one patient had epidermoid cyst and two patients had orbital tumors. Partial resection, biopsy or decompression of the orbit and optic canal was performed in the remaining patients. Postoperative cerebrospinal fluid leak requiring transnasal endoscopic reoperation occurred in three patients and three patients experienced transient diabetes insipidus.

Conclusion:
The extended endoscopic transnasal approach is an alternative method for resection of tumors of the skull base and orbit. At present, this technique should be indicated as the first-choice method for resections of medial orbital tumors. Long-term results are required before a conclusion on the advantage of endoscopic approach over the transcranial microscopic approach of the skull base tumors can be made.

Key words:
skull base – orbit – endoscopy – transnasal surgery – craniopharyngioma – meningioma

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