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Frontal skull base surgery combined with endonasal endoscopic sinus surgery
Motohiro Morioka1, Jun-ichiro Hamada, Shigetoshi Yano
1Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan. morioka@kaiju.medic.kumamoto-u.ac.jp
Surgical Neurology
|July 5, 2005
Summary
Combining frontal transbasal surgery with endonasal endoscopic sinus surgery (ESS) effectively prevents postoperative infections in skull base lesion patients. This approach ensures wide drainage and avoids complications, even with pre-existing sinusitis.
Area of Science:
- Neurosurgery
- Otolaryngology
- Surgical Oncology
Background:
- Radical resection of anterior skull base lesions poses a high risk of postoperative infection due to the opening of intracranial, nasal, and paranasal cavities.
- Preventing infection is crucial to minimize complications following these complex surgeries.
Purpose of the Study:
- To evaluate the efficacy of combining endonasal endoscopic sinus surgery (ESS) with the frontal transbasal approach for preventing postoperative infection.
- To assess the safety and effectiveness of this combined surgical technique in patients with anterior skull base lesions.
Main Methods:
- Sixteen patients with anterior skull base lesions underwent surgical resection using the frontal transbasal approach.
- Following lesion removal, endonasal ESS was performed to enlarge sinus ostia, establish wide drainage, and eliminate dead space.
- Endoscopic examination confirmed the absence of residual tumors and cerebrospinal fluid (CSF) leakage.
Main Results:
- The combined approach was successfully used in 16 patients, including those with malignant tumors, benign tumors, and mucoceles.
- Despite 11 patients having preoperative sinusitis, no postoperative infections occurred.
- No complications related to the ESS procedure were observed, and no CSF leakage or residual tumors were detected.
Conclusions:
- Endonasal ESS following frontal skull base surgery is a valuable method for preventing postoperative infections.
- This technique is particularly beneficial for large skull base tumors extending into the paranasal sinuses or nasal cavity, and in patients with active sinusitis.