Endoscopic expanded endonasal approach: preliminary experience with the new 3D endoscope

Area of Science:

• Neurosurgery
• Otolaryngology
• Medical Technology

Background:

• Endoscopic surgery traditionally lacks stereoscopic vision, limiting its application in complex procedures.
• The expanded endonasal approach is crucial for treating supradiaphragmatic lesions and skull base pathologies.

Purpose of the Study:

• To evaluate the early experience and efficacy of a 3D endoscopic expanded endonasal approach for supradiaphragmatic lesions.
• To assess the advantages and limitations of 3D endoscopy in comparison to 2D high-definition endoscopy.

Main Methods:

• A prospective case series of 10 consecutive patients undergoing 3D endoscopic expanded endonasal approach.
• Detailed analysis of surgical technique, complications, patient outcomes, and device-specific benefits and drawbacks.

Main Results:

• The 3D system improved understanding of nasal anatomy and surgical defect plasticity, enhancing confidence in skull base reconstruction.
• A key limitation was observed in narrow nasal spaces, but improved depth perception aided selective nasal structure demolition.
• The approach proved beneficial for both ENT and neurosurgeons in expanded endonasal procedures.

Conclusions:

• The 3D endoscopic system offers significant advantages for expanded endonasal approaches, particularly in skull base surgery.
• Further large-scale prospective studies are required to confirm its oncological equivalence to 2D HD endoscopy.