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Evolution of synthetic graft materials and dural sealants for cerebrospinal fluid leak repair
Introduction Numerous methods have been developed over the years to assist in providing optimal outcomes and minimize postoperative cerebrospinal fluid leak (CSF) rates after skull base surgery. Especially inherent to the endoscopic approach is incision or resection of dura, which…
Powered instrumentation and bipolar technology in endoscopic endonasal skull base surgery
Introduction Technologic developments in a variety of instruments and tools have been integral in the development and advancement of endoscopic endonasal skull base surgery. From scopes and camera heads to imaging modalities and surgical navigation down to the very instruments…
Advances in endoscopic visualization and surgical navigation
Introduction Endoscopic visualization: Historical context Today, endoscopic endonasal surgery is an important component of skull base surgery. This development has only been possible because of constant evolution of visualization capabilities together with deeper knowledge of anatomy and refinement of surgical…
Role of cerebrospinal fluid diversion in cerebrospinal fluid leak repairs and skull base surgery
Introduction Whether, when, and how to divert cerebrospinal fluid (CSF) after skull base surgery remains a highly controversial topic, and high-quality clinical evidence to guide decisions is lacking. Both otolaryngologists and neurosurgeons encounter such scenarios in daily practice and have…
Postoperative management after reconstruction following skull base tumor surgery
Introduction Endoscopic skull base surgery has transformed the management of skull base tumors. Although these innovations have expanded the scope of the endoscopic endonasal approach beyond the sella and across the floor of the cranial fossa and substantially lowered the…
Free flap reconstruction of skull base defects
Introduction Over the past 50 years, advances in technology, endoscopic techniques, and team approaches have revolutionized the abilities of surgeons to successfully treat sinonasal and skull base malignancies as well as repair skull base and orbital defects. Advancements in reconstruction…
Transorbital and transfrontal approaches to cerebrospinal fluid leak repair
Introduction Surgical repair of cerebrospinal fluid (CSF) leaks can be considered broadly in two categories: open field (e.g., frontal craniotomy or subcranial) and endoscopic (e.g., endoscopic transnasal). Open approaches provide the advantage of wide surgical exposure that allows ease of…
Endoscopic reconstruction of posterior cranial fossa defects
Introduction The effectiveness of any endoscopic surgical procedure on the posterior skull base also relies on the ability to repair the resulting defect, which has been a major challenge over the past decade. The overall goals of reconstruction after endoscopic…
Endoscopic reconstruction of middle cranial fossa defects
Introduction The most common locations for skull base defects of the middle cranial fossa (MCF) are the lateral sphenoid sinus or the thin tegmen of the temporal bone. Defects in the MCF skull base allow a direct communication between the…