Transnasal Endoscopic Surgery: Surgical Techniques and Complications

Area of Science:

• Otolaryngology
• Neurosurgery
• Surgical Oncology

Background:

• Sinonasal malignancies require careful surgical planning.
• Both open craniofacial resection (CFR) and endoscopic transnasal techniques are available.
• Endoscopic approaches offer advantages like reduced hospitalization and no facial incisions.

Purpose of the Study:

• To compare the outcomes and complications of endoscopic endonasal resection versus traditional open approaches for sinonasal malignancies.
• To highlight the technical advantages of endoscopic surgery, including magnification for precise tumor margin identification.

Main Methods:

• Review of surgical approaches for sinonasal malignancies.
• Comparison of morbidity, hospitalization, and complication rates between open and endoscopic techniques.
• Discussion of intraoperative decision-making for combined cranioendoscopic resection when necessary.

Main Results:

• Endoscopic approaches demonstrate lower morbidity, shorter hospital stays, and avoidance of facial incisions compared to open techniques.
• Technical benefits of endoscopic surgery include magnified visualization of tumor margins and anatomical structures.
• Postoperative complications, though possible, are generally less severe and frequent with endoscopic surgery.

Conclusions:

• Endoscopic endonasal resection is an acceptable and effective treatment for select skull base malignancies.
• When performed by experienced surgeons, outcomes are comparable to traditional external approaches.
• Careful planning and patient selection are crucial for successful endoscopic treatment of sinonasal malignancies.