IMPORTANCE Nonchordomatous clival lesions are rare and represent a wide range of different benign and malignant pathologies. For an accurate and specific final diagnosis, biopsy procedures and/or resections followed by histologic examination are mandatory. OBJECTIVE To illustrate the challenges in obtaining a final histologic diagnosis in patients with various types of clival lesions. DESIG...

OBJECTIVE To assess the results of microsurgical endonasal dacryocystorhinostomy with long-term insertion of single or double bicanalicular silicone tubes in canalicular (presaccal) and ductal (postsaccal) stenosis of the nasolacrimal duct system. DESIGN Retrospective follow-up of case series between 1992 and 1996. PATIENTS Thirty-eight patients were included in the study: 19 with ductal st...

OBJECT The extended transsphenoidal approach is a less invasive method for removing purely suprasellar lesions compared with traditional transcranial approaches. Most advocates have used a sublabial incision and a microscope and have reported a significant risk of cerebrospinal fluid (CSF) leakage. The authors report on a series of purely endoscopic endonasal surgeries for resection of suprasel...

OBJECTIVES/HYPOTHESIS Endoscopic endonasal skull base surgery defects require effective reconstruction. Although the nasoseptal flap (NSF) has become our institution's workhorse for large skull base defects with cerebrospinal fluid (CSF) leaks, situations where it is unavailable require secondary flaps. Clinical outcomes, pearls and pitfalls, and an algorithm will be presented for these seconda...

UNLABELLED Gastrointestinal perforation is a complication associated with steroid therapy or hypercortisolism, but it is rarely observed in patients with Cushing's disease in clinical practice, and only one case has been reported as a presenting symptom. Herein, we report a rare case of Cushing's disease in which a patient presented with gastrointestinal perforation as a symptom. A 79-year-old ...

OBJECTIVE Suprasellar meningiomas have been resected via various open cranial approaches. During the past 2 decades, the endoscopic endonasal approach has been shown to be an option in selected patients. We wished to examine the learning curve for parameters such as extent of resection, visual outcome, and complications. METHODS We retrospectively reviewed a consecutive series of patients in ...

PURPOSE To compare the clinical effects of the single wide-diameter bicanalicular silicone tube and the double bicanalicular silicone tube in endonasal dacryocystorhinostomy (DCR) with canalicular trephinization for canalicular obstruction. METHODS We retrospectively reviewed the records of 121 patients with monocanalicular or common canalicular obstruction who had undergone endonasal DCR wit...

Correcting deviations of the caudal septum can be challenging because of cartilage memory, the need to provide adequate nasal tip and dorsal septal support, and the longterm effects of healing. The authors describe a minimally invasive, endonasal approach to the correction of caudal septal deviations. The procedure involves a hemitransfixion incision, unilateral flap elevation, and cartilage re...

Dacryocystorhinostomy (DCR) is the standard procedure for treatment of acquired nasolacrimal duct obstruction (NLDO), which can be performed with an external or endonasal approach. Numerous variations DCR have been described in literature that report varying rates success. The aim this study to describe approach and success rate DCR, nasal mucosa, bone lacrimal mucosa are sequentially removed.

Background: Transcranial approaches were historically the first established routes for craniopharyngiomas resection. Transcranial approaches commonly entail some degree of brain retraction as well as manipulation of neurovascular structures, located between the surgeon and the pathogenic region. A more direct route to the sellar -suprasellar region is provided by the transsphenoidal approach. I...