Recent progress in endoscopic skull base surgery: Functional preservation and multiportal approaches.

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• Endoscopic skull base surgery (ESBS) has evolved significantly over two decades.
• ESBS is increasingly applied to diverse pathologies, including sinonasal malignancies.
• Recent advancements show ESBS efficacy in complete resection with reduced morbidity for complex lesions.

Purpose of the Study:

• To review the evolution of functional preservation in ESBS.
• To explore the development and application of multiportal approaches in ESBS.
• To highlight progress in olfactory function preservation during ESBS.

Main Methods:

• Review of recent studies and surgical techniques in ESBS.
• Analysis of preoperative assessments and surgical advancements.
• Examination of multiportal approaches combining endoscopic endonasal with other endoscopic techniques.

Main Results:

• Improved olfactory function preservation through advanced techniques.
• Demonstrated feasibility of preserving olfaction even with olfactory groove resections.
• Development of multiportal approaches (e.g., transorbital, transmaxillary, transoral) for extensive pathologies.
• Successful resection of complex lesions with limited morbidity using combined approaches.

Conclusions:

• ESBS techniques have advanced, improving functional preservation, particularly olfaction.
• Multiportal approaches extend the reach of endoscopic surgery for complex skull base pathologies.
• These innovative techniques require continued critical evaluation for efficacy and maturation.