Postoperative management following endoscopic skull base surgery

Area of Science:

• Neurosurgery
• Otolaryngology
• Minimally Invasive Surgery

Background:

• Endoscopic skull base surgery offers minimally invasive access to complex intracranial pathologies.
• Standardized postoperative care protocols are crucial for optimizing patient recovery and minimizing complications.

Purpose of the Study:

• To review current evidence on postoperative management strategies following endoscopic skull base surgery.
• To identify areas of heterogeneity in practice and highlight the need for further research.

Main Methods:

• Comprehensive literature review of studies focusing on postoperative care after endoscopic skull base procedures.
• Analysis of current evidence regarding various management aspects, including level of care, medications, and interventions.

Main Results:

• Postoperative management includes decisions on care level, laboratory monitoring, pain and nausea control, prophylactic therapies (antibiotics, antithrombotics, antiepileptics), cerebrospinal fluid (CSF) pressure management, activity, nasal care, and imaging.
• Evidence-based guidelines for many aspects of postoperative care are lacking, leading to practice variations.

Conclusions:

• Despite advancements, significant heterogeneity exists in postoperative management practices after endoscopic skull base surgery.
• A deficit of high-level studies hinders the development of robust, evidence-based guidelines and powerful meta-analyses.