We report our experience with the endoscopic endonasal approaches (EEA) for different craniocervical junction (CCJ) disorders to analyse outcomes and demonstrate the importance and feasibility of anterior C1 arch preservation or its reconstruction. Between January 2009 and December 2013, 10 patients underwent an endoscopic endonasal approach for different CCJ pathologies at our Institution. In ...

OBJECTIVES/HYPOTHESIS Injury to the internal carotid artery is a feared complication of endoscopic endonasal surgery of the skull base. Such an event, although rare, is associated with high morbidity and mortality. Even if bleeding is controlled, permanent neurological defects frequently persist. Many techniques have been developed to manage internal carotid artery rupture with varying degrees ...

INTRODUCTION Removal of the medial orbital wall and periorbit during endoscopic endonasal procedures for malignant tumors or during endoscopic transorbital procedures for intraorbital tumors may cause transient or permanent diplopia, enophthalmos, and strabismus (Fig. 1). Here, we present a simple technique that prevents these complications and allows for a spontaneous reconstruction of the med...

OBJECTIVES/HYPOTHESIS The operative management of infratemporal skull base lesions is challenging. Expanded endonasal approaches to this area can decrease surgical morbidity. Access lateral to the natural nasal corridor can be achieved via a middle meatal antrostomy, medial maxillectomy complemented by a septotomy, or anteromedial maxillotomy (i.e., Denker's approach). We sought to compare the ...

BACKGROUND Microscopic and endoscopic transsphenoidal approaches to the sellar are well established. Surgical freedom is an important skull base principle that can be measured objectively and used to compare approaches. OBJECTIVE To compare the surgical freedom of 4 transsphenoidal approaches to the sella turcica to aid in surgical approach selection. METHODS Four transsphenoidal approaches...

OBJECT Transcranial approaches to clival chordomas provide a circuitous route to the site of origin of the tumor often involving extensive bone drilling and brain retraction, which places critical neurovascular structures between the surgeon and pathology. For certain chordomas, the endonasal endoscopic transclival approach is a novel minimal access, but it is an equally aggressive alternative ...