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Endoscopic Skull Base Surgery: Anatomical Basis of Skull Base Approaches

  • M. Kürşat GökcanEmail author
  • Süha Beton
  • Babur Küçük
Chapter

Abstract

One of the most exciting and challenging fields in otorhinolaryngology is the rapidly evolving multidisciplinary skull base surgery. The discipline of endoscopic skull base surgery has progressed profoundly in the past several decades due to developments in imaging, instrumentation, and endoscopic techniques. Today, endoscopy was adopted largely for endonasal surgery by the assistance of cameras and high-technology video systems. Neurosurgeons also began to use these new endoscopes as an adjunct to microscope particularly for the resection of pituitary and parasellar lesions. However, when the microscope is on the field, the speculum limits the working space and the maneuverability of the endoscope and instruments. Understanding the inside-out endoscopic anatomy of anterior skull base, development of imaging and navigation technologies, and refinement of surgical instruments enabled four-hands, two-team approach for endoscopic skull base surgery. Both of these developments finally came together in the 1990s when the first multidisciplinary endoscopic skull base teams were formed. Endoscopic endonasal surgery has now become an invaluable surgical modality by which several pathologies of the skull base can be approached and treated. It offers a direct route for accessing the anterior, middle, and posterior cranial fossa. It has been shown to be safe and effective; however, it requires a detailed understanding of the intricate anatomy to be successful.

Keywords

Endoscopic skull base surgery Anatomy Multidisciplinary Imaging Instrumentation 

References

  1. 1.
    Bleier BS. Comprehensive techniques in CSF leak repair and skull base reconstruction. Stereotact Funct Neurosurg. 2013;91(2):69–140.CrossRefGoogle Scholar
  2. 2.
    Heerman J, Heerman R. Development and use of microscopic and endoscopic surgery of the nose and sinuses. In: Stamm AC, Draf W, editors. Micro-endoscopic surgery of the paranasal sinuses and the skull base. Berlin, Heidelberg: Springer-Verlag; 2000. p. 1–16.Google Scholar
  3. 3.
    Messerklinger W. Technik und möglichkeiten der Nasenendoskopie. HNO. 1972;20(5):133–5.PubMedGoogle Scholar
  4. 4.
    Prevedello DM, Kassam AB, Gardner PA, Carrau RL, Snyderman CH. Expanded endoscopic endonasal approaches to the skull base. In: Cappabianca P, Califano L, Iaconetta G, editors. Cranial, craniofacial and skull base surgery. Italia: Springer- Verlag; 2010. p. 239–51.CrossRefGoogle Scholar
  5. 5.
    Patel CR, Fernandez-Miranda JC, Wang WH, Wang EW. Skull base anatomy. Otolaryngol Clin North Am. 2016;49(1):9–20.  https://doi.org/10.1016/j.otc.2015.09.001.CrossRefPubMedGoogle Scholar
  6. 6.
    Martins C, Rhoton AL. J. Anatomy of the cranial base. In: Hanna EY, editor. Comprehensive management of skull base tumors. New York: Informa Healthcare USA Inc.; 2009. p. 3–42.Google Scholar
  7. 7.
    Martins C, Campero A, Yasuda A, de Alencastro L, Osawa S, Rhoton A. Anatomical basis of skull base surgery: skull osteology. In: Stamm AC, editor. Transnasal endoscopic skull base and brain surgery: tips and pearls. New York: Thieme Medical Publisher; 2011. p. 3–15.Google Scholar
  8. 8.
    Yorulmaz I, Kucuk B, Elhan A, Tekdemir I. Surgical anatomy for endoscopic sphenoethmoidectomy. Tuttlingen, Germany: Endo-Press; 2004.Google Scholar
  9. 9.
    Lam A, Holbrook E. Skull base anatomy and CSF rhinorrhea, 2012.CrossRefGoogle Scholar
  10. 10.
    Palmer JN, Chiu AG. Atlas of endoscopic sinus and skull base surgery: Elsevier Health Sciences; 2013.Google Scholar
  11. 11.
    Moore KL, Dalley AF, Agur AM. Clinically oriented anatomy: Lippincott Williams & Wilkins; 2013.Google Scholar
  12. 12.
    Frank G, Pasquini E. Cavernous sinus: endoscopic endonasal approaches. In: Endoscopic approaches to the skull base, vol. 26: Karger Publishers; 2012. p. 119–39.Google Scholar
  13. 13.
    Lyons BM. Surgical anatomy of the skull base. In: Donald PJ, editor. Surgery of the skull base. Philadelphia: Lippincott-Raven Publishers; 1998. p. 15–30.Google Scholar
  14. 14.
    Martins C, Yasuda A, Campero A, de Alencastro L, Inoue K, Rhoton A. Microsurgical and endoscopic anatomy of the parasellar region. In: Stamm AC (ed) Transnasal endoscopic skull base and brain surgery: tips and pearls; Thieme Medical Publisher, New York, 2011, pp 211-223Google Scholar
  15. 15.
    Prevedello D, Kassam A, Otto B, Ditzel Filho L, de Lara D, Carrau R. Endoscopic approaches to the skull base: the coronal plane. In: Endoscopic approaches to the skull base, vol. 26: Karger Publishers; 2012. p. 104–18.Google Scholar
  16. 16.
    Son HJ, Chandra RK. Pterygopalatine/pterygomaxillary space approaches and internal maxillary artery. Atlas of endoscopic sinus and skull base surgery, 2012, p. 209Google Scholar
  17. 17.
    Tewfik MA, Wormald PJ. Pterygopalatine and infratemporal Fossae. In: Stamm AC, editor. Transnasal endoscopic skull base and brain surgery: tips and pearls, vol. 2011. New York, Stuttgart: Thieme Medical Publisher; 2011. p. 293–300.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • M. Kürşat Gökcan
    • 1
    Email author
  • Süha Beton
    • 1
  • Babur Küçük
    • 1
  1. 1.Medical Faculty, Department of OtorhinolaryngologyAnkara UniversityAnkaraTurkey

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