Limitations of the endoscopic endonasal transcribriform approach

Authors

Neil Majmundar, Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.Follow
Naveed H. Kamal, Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Renuka K. Reddy, Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Jean A. Eloy, Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
James K. Liu, Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA - james.liu.md@rutgers.edu.

Document Type

Article

Abstract

The endoscopic endonasal transcribriform approach (EETA) has become a useful strategy in the treatment of various anterior skull base pathologies, including meningoencephaloceles, olfactory groove meningiomas, schwannomas, esthesioneuroblastomas, and other sinonasal malignancies. However, not all pathologies are optimally treated through this approach due to tumor size, extent of the lesion, vascular involvement, and the presence of intact olfaction. One must be prepared to use a transcranial approach if the EETA is not favorable. In some patients, a combined approach (transcranial-EETA) may be needed in appropriate cases. Therefore, patient selection is paramount for achieving a successful result with avoidance of complications. For certain tumors, the limitations of the EETA may result in lower rates of gross-total resection, higher rates of cerebrospinal fluid leakage, postoperative impairment of olfaction, and higher complication rates. In this paper, we discuss the limitations of the EETA when considering approach selection to treat anterior skull base lesions.

Medical Subject Headings

Cranial Fossa, Anterior (surgery); Humans; Maxillary Sinus Neoplasms (surgery); Meningeal Neoplasms (surgery); Meningioma (surgery); Natural Orifice Endoscopic Surgery (methods); Neuroendoscopy (methods); Skull Base (surgery); Skull Base Neoplasms (surgery)

Publication Date

6-1-2018

Publication Title

Journal of neurosurgical sciences

E-ISSN

1827-1855

Volume

62

Issue

3

First Page

287

Last Page

296

PubMed ID

29444558

Digital Object Identifier (DOI)

10.23736/S0390-5616.18.04348-5

Recommended Citation

Majmundar, Neil; Kamal, Naveed H.; Reddy, Renuka K.; Eloy, Jean A.; and Liu, James K., "Limitations of the endoscopic endonasal transcribriform approach" (2018). Neurosurgery. 2210.
https://scholar.barrowneuro.org/neurosurgery/2210