Operative field temperature during transnasal endoscopic cranial base procedures

Area of Science:

• Neurosurgery
• Otolaryngology
• Medical Technology

Background:

• Limited data exists on the safety of endoscopic skull base exploration.
• Procedures expose vital neural structures to illumination and thermal energy from surgical tools.
• Understanding intraoperative thermal dynamics is crucial for patient safety.

Purpose of the Study:

• To measure temperature changes near skull base structures and within the intradural space.
• To assess thermal risks associated with extended endoscopic transnasal approaches.

Main Methods:

• Continuous temperature recording using implantable thermocouples during six endoscopic procedures.
• Placement of thermocouples in the esophagus and the operative field at the skull base.

Main Results:

• Operative field temperature increased from ~37°C to 42-43°C during procedures.
• Temperatures peaked at 45°C during cauterization/aspiration and 62°C during drilling.
• Esophageal temperature remained stable, indicating localized heating.

Conclusions:

• Endoscopic skull base surgery leads to significant intraoperative temperature increases.
• Sudden temperature spikes pose a risk to neural structures.
• Monitoring and managing intraoperative temperatures are essential to reduce potential complications.