Introduction Endoscopic endonasal approaches (EEAs) provide direct access to pathologies near the median and paramedian ventral skull base. A major principle of endoscopic endonasal surgery is the use of anatomical corridors to safely access skull base lesions with low associated…
Introduction Surgery of the anterior cranial base is often fraught with anxiety and concern because of the close proximity of major neurovascular structures. Often these tumors are extracranial; however, when tumors extend intracranially or invade into the brain parenchyma, a…
Video 117.1 , Video 117.2 , Video 117.3 , Video 117.4 , Video 117.5 , Video 117.6 , Video 117.7 , Video 117.8 , Video 117.9 , Video 117.10 , Video 117.11 Surgery of the central cranial base has evolved…
Introduction A cerebrospinal fluid (CSF) leak defines a fistula between the subarachnoid space and the sinonasal tract. Patients with CSF leaks present with symptoms such as clear nasal discharge and headache or complications such as pneumocephalus, meningitis, or brain abscess.…
Introduction The first description of frontal cranialization was in 1978 by Donald and Bernstein. It consists of meticulous removal of the mucosa of the frontal sinus, eliminating the posterior wall of the sinus and allowing the frontal lobe to come…
Introduction In the preendoscopic era, the osteoplastic flap procedure was the accepted method of management of frontal sinusitis. Initial approaches described in the late 19th century (e.g., the Reidel procedure) conceptualized the complete exenteration of the sinus, including the anterior…
Introduction Chronic frontal sinusitis continues to be a challenge to treat both medically and surgically. Despite the advances in endoscopic sinus surgery, the wide variety of surgical options necessary for treatment of frontal sinusitis speaks to the difficult nature of…
Introduction The endoscopic approach to the frontal sinus is predicated on understanding the anatomy of the frontal recess. The frontal sinus outflow tract is dependent on the anatomic relationships of various structures, including the uncinate process, middle turbinate, agger nasi,…
Introduction Trephination of the frontal sinus can be used in three ways. Traditionally, it was used for the drainage of acute processes such as a Pott’s puffy tumor or bacterial frontal sinusitis. Second, trephination can be combined with transnasal endoscopic…
Introduction The paired sphenoid sinuses are the most posteriorly positioned of the paranasal sinuses. Due to this location, endoscopic approaches to the sphenoid sinus are preferred to address most pathology that may arise in this location. The pathology may be…