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Endoscopic endonasal approach to the ethmoidal planum: anatomic study.

Matteo de Notaris¹, Isabella Esposito, Luigi Maria Cavallo

¹Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.

Neurosurgical Review

|March 14, 2008

Summary

This study details the endoscopic endonasal approach for anterior skull base lesions. Anatomical measurements in cadavers show its feasibility for accessing midline lesions, including intradural tumors.

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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

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Published on: July 5, 2021

Area of Science:

Neurosurgery
Otolaryngology
Anatomy

Background:

The endoscopic endonasal technique is established for extradural lesions below the ethmoidal planum.
Collaboration between otolaryngologists and neurosurgeons expands its use to intradural lesions.
This necessitates a detailed anatomical understanding of the endoscopic corridor.

Purpose of the Study:

To identify key anatomical landmarks and critical zones for endoscopic endonasal approaches to the anterior skull base.
To provide precise measurements for safe surgical navigation.

Main Methods:

Anatomical dissection and measurement using an endoscopic endonasal approach in six fresh cadaver heads.
Unilateral and bilateral measurements of landmarks related to the midline anterior skull base.

Main Results:

A wide exposure of the midline anterior skull base was achieved.
Maximum lateral extension measured 25.33 mm between medial orbital walls at the cribriform plate.
Mean distance between anterior and posterior ethmoidal arteries was 16 mm.

Conclusions:

The endoscopic endonasal route is a minimally invasive technique for the ethmoidal planum.
Adequate anatomical knowledge and endoscopic skill are crucial for safe execution.
This approach is suitable for selected intradural lesions like meningiomas and esthesioneuroblastomas.