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Updated: Jun 21, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Malignant ethmoidal neoplasms: a cranionasal endoscopy approach.

Evaristo Belli¹, Guido Rendine, Noemi Mazzone

¹Department of Maxillofacial Surgery, II Faculty of Medicine and Surgery, Sapienza University, Sant' Andrea Hospital, Rome, Italy.

The Journal of Craniofacial Surgery

|July 24, 2009

Summary

A minimally invasive transcranial endonasal approach enables radical resection of early-stage ethmoid tumors. This endoscopic technique avoids facial incisions, reduces hospital stays, and improves oncological outcomes for anterior skull base surgery.

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Cranial Bones: Lateral View

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...

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Area of Science:

Oncology
Neurosurgery
Otolaryngology

Background:

Craniofacial resection is the standard for anterior skull base tumors.
Endoscopic techniques have advanced surgical capabilities.
Combined transcranial and endonasal approaches offer radical resection without compromising oncological principles.

Purpose of the Study:

To evaluate a transcranial endonasal approach for early-stage (I and II) ethmoid malignant tumors.
To assess the feasibility and benefits of this minimally invasive technique.

Main Methods:

Utilized a transcranial endonasal approach for ethmoid malignant tumors (Stage I/II).
Performed surgery without cutaneous incisions or facial osteotomies.
Employed intraoperative endoscopy for precise osteotomy placement and visualization.

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Main Results:

Achieved complete en bloc resection of tumors.
Eliminated the need for external incisions and facial bone cuts.
Reduced hospitalization duration and accelerated patient recovery.
Facilitated optimal osteotomy placement and enhanced disease removal.

Conclusions:

The transcranial endonasal approach is a viable and effective option for early-stage ethmoid malignant tumors.
This technique offers oncological safety with reduced morbidity.
It potentially enhances the efficacy of postsurgical radiotherapy.