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Updated: Jan 26, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Published on: July 5, 2021

International consensus statement on endoscopic skull-base surgery: executive summary.

Eric W Wang¹, Paul A Gardner¹, Adam M Zanation²

¹Center for Cranial Base Surgery, Departments of Otolaryngology and Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

International Forum of Allergy & Rhinology

|April 9, 2019

Summary

Endoscopic skull-base surgery (ESBS) offers a multidisciplinary approach to complex conditions. The International Consensus Statement on Endoscopic Skull Base Surgery (ICAR:SB) provides evidence-based recommendations for ESBS, highlighting modest overall evidence levels.

Keywords:

CSF rhinorrhea angiofibroma clival chordoma craniopharyngioma endoscopic endonasal approach endoscopic endonasal skull-base surgery esthesioneuroblastoma evidence-based medicine meningioma nasoseptal flap reconstruction olfactory neuroblastoma pituitary adenoma squamous cell carcinoma

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Area of Science:

Skull Base Surgery
Neurosurgery
Otolaryngology

Background:

Endoscopic skull-base surgery (ESBS) is a rapidly advancing field requiring collaboration between otolaryngology-head and neck surgeons and neurosurgeons.
The growing body of literature on ESBS necessitates critical evaluation of its associated challenges and complications.
The International Consensus Statement on Endoscopic Skull Base Surgery (ICAR:SB) addresses this need through a comprehensive review.

Framework:

The ICAR:SB document systematically reviewed 98 topics in ESBS.
Evidence-based reviews with recommendations (EBRR) and evidence-based reviews (EBR) were developed where sufficient evidence existed.
An iterative review process ensured consensus on the findings.

Implementation:

This executive summary compiles EBR and EBRR findings from ICAR:SB.
Key areas covered include management of cerebrospinal fluid rhinorrhea, intradural tumors, sinonasal malignancies, and clival tumors.
Reconstruction techniques and complications associated with ESBS are also addressed.

Implications:

The ICAR:SB Executive Summary outlines evidence-based recommendations on the benefits, drawbacks, and challenges of ESBS.
The current level of evidence in ESBS is modest, indicating significant opportunities for future research.
Addressing these knowledge gaps is crucial for advancing the field of endoscopic skull base surgery.