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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
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The learning curve in endoscopic transsphenoidal skull-base surgery: a systematic review
Abdulraheem Alomari1, Mazin Alsarraj2, Sarah Alqarni3
1Neurosurgery Department, East Jeddah Hospital, 2277 King Abdullah Rd, Al Sulaymaniyah, 22253, Jeddah, Saudi Arabia. abdulraheemalomari@hotmail.com.
BMC Surgery
|May 5, 2024
Summary
Surgeons need about 32 cases to master the endoscopic endonasal transsphenoidal approach (EETA) learning curve, improving patient outcomes. Standardized reporting and prospective studies are crucial for reliable EETA assessment.
Area of Science:
- Neurosurgery
- Surgical Education
Background:
- The endoscopic endonasal transsphenoidal approach (EETA) is vital in skull-base surgery but has a steep learning curve (LC).
- Existing literature on EETA LC assessment is limited by small sample sizes and observational designs.
- This review evaluates current literature to identify strengths and weaknesses in assessing EETA LC.
Approach:
- A systematic review adhering to PRISMA guidelines was performed.
- Searched PubMed and Google Scholar for clinical studies on EETA LC using specific keywords and MeSH terms.
- Included studies comparing early vs. late surgical outcomes, assessing at least one surgical parameter, and published in English.
Key Points:
- 34 studies (5,648 patients, 2002-2022) analyzed EETA LC, predominantly retrospective (88%).
- Pituitary adenoma (82%) was the most studied pathology.
- Proficiency, marked by improved outcomes (e.g., EC, OT, CSF leak, GTR), was achieved around a median of 32 cases (range 9-120).
Conclusions:
- Assessing the EETA learning curve is complex.
- Standardized reporting and prospective studies are essential for reliable findings and improved clinical practice.
