Combined Exoscopic and Endoscopic Technique for Craniofacial Resection.

Area of Science:

• Neurosurgery
• Head and Neck Surgery
• Surgical Oncology

Background:

• Microscopic visualization is standard for craniofacial resection (CFR).
• Limitations exist in the traditional microscopic approach for complex skull base surgeries.

Purpose of the Study:

• To evaluate the feasibility of the combined exoscopic-endoscopic technique (CEE) as an alternative to the microscope in craniofacial resection (CFR).

Main Methods:

• Retrospective study of eight patients undergoing CFR between September 2019 and July 2021.
• Utilized an exoscope for microsurgery and an endoscope to visualize blind spots during transcranial approaches.
• CEE was applied in anterior CFR, anterolateral CFR, and temporal bone resections.

Main Results:

• The exoscope provided adequate image quality for microsurgery.
• Endoscopic visualization successfully addressed blind spots like the sphenoid sinus lumen and medial temporal bone.
• All eight surgeries were successful with no significant complications.

Conclusions:

• The combined exoscopic-endoscopic technique (CEE) is effective for transcranial skull base surgery, particularly CFR.
• CEE offers advantages in ergonomics, accessibility, and simultaneous surgical procedures.
• This technique enhances visualization and safety in complex craniofacial resections.