New developments in transnasal endoscopic surgery for malignancies of the sinonasal tract and adjacent skull base

Technological advances and technical innovations have spearheaded an expansion in the indications for endoscopic sinonasal surgery, which now extend to the resection of sinonasal and skull base malignancies. This review examines recent advances that have contributed to make this technique feasible and reviews the basis of adopting an endonasal approach.

Oncologic goals developed for traditional skull base surgery can be safely applied to endoscopic skull base surgery. This has been made possible with the advent of better understanding of skull base anatomy from the endonasal perspective, as well as the development of better instrumentation, better hemostatic materials and more reliable reconstructive techniques. Recent publications have reported similar short-term outcomes for endoscopic skull base resection as compared with traditional approaches with lower complication rates.

Transnasal endoscopic surgery is an important part of the surgical armamentarium for the treatment of sinonasal and skull base malignancies. New technologies will further expand the limits of what can be achieved endoscopically. Collaborative multiinstitutional studies with long-term follow-up are crucial in defining the role of endoscopic resection in the treatment of skull base malignancies.