Endoscopic superior ethmoidal approach for anterior cranial base resection: tailoring the approach for maximum exposure with preservation of nasal structures.

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Endoscopic superior ethmoidal approach for anterior cranial base resection: tailoring the approach for maximum exposure with preservation of nasal structures.

World Neurosurg. 2017 Apr 29;:

Authors: Peris Celda M, Kenning T, Pinheiro-Neto CD

Abstract
OBJECTIVE: The traditional endoscopic anterior cranial base resection involves total removal of the ethmoidal cells including middle and superior turbinates. This is associated with increased volume of the nasal cavity postoperatively with more crusting and permanent change of the nasal airflow. The objective is to describe the step-by-step technique and feasibility of the superior ethmoidal approach for anterior cranial base resection with maximum exposure of the anterior cranial base maintaining the middle turbinates, uncinate processes and ostiomeatal complexes intact.
METHODS: Three fresh cadaveric heads were used for dissections. This technique was successfully performed in two consecutive cases of large olfactory groove meningiomas.
RESULTS: In all anatomical dissections, satisfactory exposure of the cranial base was achieved with preservation of the middle turbinate, uncinate process, ethmoid bulla and middle meatus intact bilaterally. Successful resection of two consecutive cases of olfactory groove meningiomas was performed utilizing this approach.
CONCLUSION: The endoscopic superior ethmoidal approach for anterior cranial base resection is a feasible and safe approach that maximizes preservation of the nasal structures while having optimal access to the anterior skull base. It can be used in pathologies that involve the anterior cranial base and do not involve the nasal structures.

PMID: 28465271 [PubMed - as supplied by publisher]

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