Minimally invasive endoscopic resection of sinonasal and anterior skull base malignant neoplasms

The evolution of minimally invasive endoscopic techniques, coupled with advances in surgical instrumentation and computer-aided surgery, has greatly facilitated the management of complex sinonasal and skull-base pathology. This accrued experience has facilitated consideration of the treatment of malignant neoplasms of the paranasal sinuses and skull base via the endoscopic route. This strategy uses the rigid endoscope as the primary surgical modality for resection of neoplasms within the paranasal sinus confines, along with the adjacent orbit and skull base. The endoscopic approach has been demonstrated to be effective, with surgical outcomes approaching the traditional open craniofacial resection, providing unparalleled visualization, avoidance of facial incisions and reduction in morbidity. This article outlines the salient components of the endoscopic paradigm for minimally invasive tumor resection, focusing on requisite technology, surgical techniques and patient outcomes.