Endoscopic endonasal clipping of XXXX : Surgical Technique and Results.

@entity1 @entity64 @entity693 @entity439 @entity2300 @entity438
OBJECTIVE: Microsurgical clipping of @entity438 requires meticulous technique and is usually performed through open approaches. Endoscopic endonasal clipping of @entity438 may utilize the same techniques through an alternative corridor. The aim of this manuscript is to report a series of @entity1 who underwent EEA for microsurgical clipping of @entity438 . METHODS: We conducted a retrospective chart review. Surgical outcome and complications were noted. The conceptual application and the technical nuances of these procedures were discussed. RESULTS: Ten @entity1 underwent EEA for clipping of 11 @entity438 arising from the paraclinoidal ICA (n=9) and vertebrobasilar system (n=2). The ICA @entity439 projected medially whereas the vertebrobasilar artery @entity439 were directly ventral to the brainstem with low-lying basilar apices. One @entity1 required craniotomy for distal control given the size and thrombosed nature of the @entity439 . Proximal and distal vascular control with direct visualization of the @entity439 was obtained in all cases. In all cases, @entity439 were @entity2300 . Among complications, three @entity1 had postoperative CSF leakage and two further complicated with @entity693 . Two @entity1 suffered @entity64 . One recovered completely and the other remains with mild disabling symptoms. CONCLUSIONS: EEAs can provide direct access for microsurgical clipping of rare and carefully selected @entity438 . The basic principles of cerebrovascular surgery have to be followed throughout the procedure. These surgeries require a skull base team with a neurosurgeon well versed in both endoscopic endonasal and cerebrovascular surgery working in concert with an otolaryngologist experienced in skull base endoscopy and reconstruction.
