What is endoscopic skull base surgery?
Endoscopic surgery allows access to the skull through the nasal cavity, without the need to open the skull, using endoscopes.
The base of the skull is the bony part that supports the brain and separates it from the rest of the head. Underneath are the nerves and vessels leading to the brain, and underneath are the nasal structures, sinus cavities, facial bones and the muscles associated with mastication.
This technique is preferable to traditional surgery, as it offers multiple advantages:
- Better duration of the intervention
- Operate in areas considered inaccessible and in tumors of large dimensions.
- Absence of facial scars
- Improved functional results
- Shorter hospital stay
Why is it performed?
This treatment is applied in operations on tumors or lesions located in the roof of the nostrils, in direct contact with the cranial cavity. It makes it possible to treat tumors that were previously considered impossible to treat.
Among the different applications of endoscopic cranial surgery are the following:
- Pituitary tumors
- Clivus and odontoid
- Resection of tumors in the anterior cranial fossa, middle cranial fossa and pterygomaxillary fossa.
- Cerebrospinal fluid fistulas.
Endoscopic surgery allows access to the skull through the nasal cavity.
What does it consist of?
This minimally invasive surgery allows the endoscopic approach through the nasal cavity, without having to open the skull.
The optical and endoscopic tools used in the treatment are introduced through the nasal cavity. These allow the surgeon to visualize the operative field in high definition through stereoscopic cameras with optical fibers. His vision is three-dimensional and in full color, with high resolution and magnified image.
The use of a control mechanism, i.e., monitoring of the cerebral and facial nerves during the operation, helps to avoid injury to the nerves.
Preparation for endoscopic skull base surgery
For this kind of operation it is necessary to have a multidisciplinary team composed of specialists in Neurosurgery, Otorhinolaryngology and Neurophysiology.
The specialist may require information on the patient’s medical history, a blood test or an electrocardiogram, among others.
Before the operation, the patient is given general anesthesia, so that he/she will not feel any pain. The patient will breathe through a tube in the airway to maintain mechanical respiration.
Care after the operation
The postoperative period has no major complications, although it will depend on the degree of difficulty of the operation performed.
Once the patient recovers from anesthesia, the specialist will perform a neurological evaluation and will comment on how the treatment has gone. Depending on the type of operation, the patient will be in an intensive care or general ward and will be hospitalized for a few days.
Alternatives to this treatment
Endoscopic skull base surgery is one of the most advanced surgeries today, especially because it is a minimally invasive and very comfortable technique. This does not mean that other techniques, such as craniotomies, are no longer applied.