Update on endoscopic endonasal resection of skull base XXXX .

@entity1 @entity227 @entity66 @entity5 @entity1653 @entity204
BACKGROUND: The objective of this work was to report success rates as well as potential obstacles in transnasal endoscopic resection of anterior skull base @entity1653 . METHODS: The study design was a case series with chart review at tertiary referral centers in South Australia and New Zealand. The @entity1 were 37 consecutive @entity1 who underwent endoscopic resection of skull-base @entity1653 between 2004 and 2013. Review of @entity1 charts and operative details were performed. Outcomes including complications are reported. RESULTS: Eighty-four percent of @entity1 were @entity1 . There were 28 primary and 9 revision cases. @entity5 locations were as follows: 14 olfactory groove/subfrontal; 12 planum/jugum sphenoidale; 7 tuberculum sellae; 3 clinoidal; and 1 clival. Vision change was the most common presenting symptom. Mean @entity5 volume was 33.68 cm(3) , mean diameter was 2.78 cm. Average operating times decreased with an initial learning curve and then plateaued. @entity5 larger than 60 cm(3) took an average of 10 hours to resect. Gross total removal was achieved in 29 @entity1 . There were no perioperative @entity204 . Two @entity204 occurred within 1 year of surgery. Postoperative cerebrospinal fluid (CSF) leaks occurred in 13 @entity1 . Seventy-five percent of @entity1 presenting with @entity227 . Of the 29 @entity1 considered to have had complete resection at surgery, one was found to have @entity66 on a postoperative magnetic resonance imaging (MRI) and another one later developed radiological evidence of recurrence. CONCLUSION: Using a 2-team approach, @entity1653 of the skull base were successfully removed via an intranasal endoscopic technique. Although complete resection is typically possible even with large @entity5 , the lengthy resection required time for @entity5 larger than 60 cm(3) (diameter >= 4 cm) may obviate some of the advantages of this approach. The rate of postoperative CSF leak decreases when a synthetic dural substitute is added but does not approach zero.
