Advances in approaches to the cranial base: minimizing morbidity

Area of Science:

• Neurosurgery
• Skull Base Surgery
• Minimally Invasive Techniques

Background:

• Cranial base surgery has advanced significantly, focusing on complete tumor resection and reconstruction.
• The subcranial/subfrontal approach, initially for trauma, is now used for tumors and anomalies.
• Endoscopic techniques offer practical benefits for various skull base disorders.

Purpose of the Study:

• To review recent innovations in cranial base surgery.
• To highlight the evolution and application of surgical approaches.
• To assess the efficacy and limitations of current techniques, particularly endoscopic methods.

Main Methods:

• Review of historical and recent surgical approaches for cranial base pathologies.
• Discussion of subcranial/subfrontal and endoscopic techniques.
• Evaluation of outcomes including resection completeness, reconstruction, morbidity, and recovery.

Main Results:

• Innovative techniques enable complete resection and watertight reconstruction with minimal incisions.
• Endoscopic approaches demonstrate practical utility and promising efficacy for benign, infectious, and inflammatory skull base disorders.
• Advantages include minimal recovery time, functional preservation, and aesthetic benefits.

Conclusions:

• Modern cranial base surgery prioritizes maximal resection and reconstruction with minimal patient impact.
• Endoscopic surgery is effective for non-malignant conditions, offering significant patient benefits.
• Further long-term data is required to establish the efficacy of endoscopic approaches for malignancies.