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Updated: Jan 29, 2026
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
4.3K
Lessons learned in the evolution of endoscopic skull base surgery.
Theodore H Schwartz1,2,3, Peter F Morgenstern1, Vijay K Anand2
1Departments of1Neurological Surgery and.
Journal of Neurosurgery
|February 6, 2019
Summary
Endoscopic skull base surgery (ESBS) offers advantages for specific skull base tumors compared to traditional transcranial surgery (TCS). Experienced surgeons can achieve excellent patient outcomes with ESBS for appropriate pathologies.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Minimally Invasive Techniques
Background:
- Endoscopic skull base surgery (ESBS) is a newer approach to ventral skull base pathology.
- Controversy exists regarding its efficacy compared to traditional transcranial surgery (TCS).
- Rigorous study is needed to validate the benefits of less invasive techniques.
Purpose of the Study:
- Compare surgical outcomes of ESBS and TCS for various skull base pathologies.
- Evaluate the evolution of ESBS results over time (pre-2012 vs. 2012-2017).
- Determine the optimal application of ESBS in neurosurgery.
Main Methods:
- Comparative analysis of surgical results for ESBS versus TCS.
- Inclusion of pathologies: craniopharyngioma, meningioma, esthesioneuroblastoma, chordoma, chondrosarcoma.
- Stratification of data by time period to assess outcome trends.
Main Results:
- ESBS shows advantages for craniopharyngiomas and chordomas.
- For specific meningiomas, ESBS offers similar resection rates with improved visual outcomes and comparable complication rates in recent series.
- TCS remains superior for olfactory groove meningiomas; ESBS is preferred for low-grade esthesioneuroblastomas, while high-grade tumors may require craniofacial approaches.
Conclusions:
- Endoscopic skull base surgery is a maturing, effective approach for select pathologies when performed by experienced surgeons.
- ESBS is demonstrably in patients' best interest for appropriate indications.
- Continuous critical evaluation of outcomes is vital for optimizing ESBS application and patient care.
Keywords:
CFR = craniofacial resectionESBS = endoscopic skull base surgeryGTR = gross-total resectionOG = olfactory grooveOS = overall survivalPFS = progression-free survivalPS = planum sphenoidaleTCS = transcranial surgeryTS = tuberculum sellaechondrosarcomachordomacraniopharyngiomacraniotomyendonasalendoscopicesthesioneuroblastomameningiomapituitary surgeryskull base
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