Full endoscopic endonasal transsellar-transclival approach: the modularity concept

Area of Science:

• Neurosurgery
• Otolaryngology
• Endoscopic Skull Base Surgery

Background:

• Endoscopic endonasal approaches (EEAs) are a viable surgical option for treating lesions in the sellar and clival regions.
• These approaches offer an alternative to traditional open surgeries for complex skull base pathologies.

Purpose of the Study:

• To describe the step-by-step methodology of a fully expanded EEA to the middle and lower clivus.
• To illustrate the modularity concept of EEAs for treating perisellar lesions, using a craniopharyngioma with clival extension as an example.

Main Methods:

• Detailed description of the expanded endoscopic endonasal approach to the middle and lower clivus.
• Application of a modular strategy to tailor the approach based on lesion location within the sellar region.
• Case presentation of a craniopharyngioma with clival extension to demonstrate the modular concept.

Main Results:

• The transsellar-transclival EEA facilitates complete resection of lesions in the sellar and infrasellar areas.
• This surgical technique is associated with a low rate of complications.

Conclusions:

• The transsellar-transclival EEA is an effective method for achieving complete tumor removal in the sellar and infrasellar regions.
• This approach offers a safe and effective treatment option with a favorable complication profile.