Extradural endoscopic dissection of the anterior skull base

A study was conducted from February 29, 1996, to March 28, 1996, at the University of Brno's Pathology Institute in the Czech Republic to explore the possible application of craniofacial intracranial endoscopic techniques through minimal skin incisions and trephines in fresh cadavers (3 to 12 hours old). Through the trephines the dura was totally dissected from the bone. After this dissection a standard bicoronal incision and a full craniotomy was performed to assess the integrity of the meninges. This minimally invasive dissection of the skull base with the aid of an endoscope is characterized by fewer skin incisions, thereby avoiding the exposure of subcutaneous tissue, muscle, cranial bone, and meninges. We find that it is possible to accomplish an accurate and extensive intracranial dissection with the aid of an endoscope. The potential of this technique is important for craniofacial surgery as well as for neurosurgery. The objectives of this study were [1] to explore endoscopically the craniofacial anatomy to determine the best approach and the optimal method for dissecting endocranial structures, and [2] to achieve a safer and more accurate dissection of the skull base, evaluating advantages of endoscopic surgery as an alternative method for the treatment of craniofacial and neurosurgical pathologies.