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Expanded endoscopic endonasal approach for extending suprasellar and third ventricular lesions
Giuliano Silveira-Bertazzo1,2, Sunil Manjila3, Ricardo L Carrau1,4
1Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, OH, USA.
Acta Neurochirurgica
|May 10, 2020
Summary
Expanded endoscopic endonasal approaches offer a safe route to midline skull base tumors. This technique enhances surgical safety and exposure for treating suprasellar lesions.
Area of Science:
- Neurosurgery
- Endoscopic Skull Base Surgery
Background:
- Expanded endonasal approaches provide direct midline skull base access from anterior cranial fossa to ventral foramen magnum.
- Surgical techniques like bone drilling and dural opening are critical for safe suprasellar tumor debulking.
Purpose of the Study:
- To describe an expanded endoscopic endonasal approach for suprasellar lesions.
- To highlight surgical pearls and pitfalls for enhanced safety using image-guided dissections.
Main Methods:
- Stepwise image-guided dissections of transnasal intra-third-ventricular anatomy.
- Comparison of subchiasmatic and suprachiasmatic trajectories via trans-lamina terminalis and trans-tuber cinereum approaches.
Main Results:
- The endoscopic endonasal transsellar-transtubercular-transplanum approach allows rostral extension.
- This route is safe and feasible for accessing suprasellar lesions.
Conclusions:
- Expanded endoscopic endonasal approaches provide a safe and feasible route for suprasellar lesions.
- The described technique facilitates access to subchiasmatic, suprachiasmatic, and intraventricular regions.
