{"id":1140,"date":"2025-08-21T11:26:17","date_gmt":"2025-08-21T08:26:17","guid":{"rendered":"https:\/\/craniofacial.org.ua\/?p=1140"},"modified":"2025-08-21T13:52:49","modified_gmt":"2025-08-21T10:52:49","slug":"endoscopic-endonasal-approaches-to-the-skull-base-tumors-minimally-invasive-approach-with-achievement-of-radicality-our-experience","status":"publish","type":"post","link":"https:\/\/craniofacial.org.ua\/en\/endoscopic-endonasal-approaches-to-the-skull-base-tumors-minimally-invasive-approach-with-achievement-of-radicality-our-experience\/","title":{"rendered":"Endoscopic endonasal approaches to the skull base tumors: minimally invasive approach with achievement of radicality. Our experience"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1140\" class=\"elementor elementor-1140\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-05eb1ca e-flex e-con-boxed e-con e-parent\" data-id=\"05eb1ca\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5e6ee53 elementor-widget elementor-widget-text-editor\" data-id=\"5e6ee53\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>\u00a0Objective:<\/strong> to optimize surgical tactic of endoscopic endonasal transsphenoidal <br \/>(EET) approaches in cases of tumors with intra- and extracranial extension.<br \/>Material and methods. For the period of 2013\u20132019, we retrospectively reviewed <br \/>39 patients with tumors of intra-extra skull base location or just extracranial <br \/>extension. Tumor location and pathology: tumors in pterygopalatine fossa <br \/>(paraganglioma, carcinoma, neurilemmoma, neurofibroma, chondrosarcoma) <br \/>\u2014 10 (25.6 %), pituitary adenomas with sphenoid sinus and\/or parasellar <br \/>extension \u2014 14 (35.9 %), sphenoid sinus tumors (carcinoma, neurilemmoma, <br \/>fibrous dysplasia, angiofibroma, esthesioneuroblastoma) \u2014 8 (20.5 %), <br \/>petroclival tumors \u2014 6 (15.4 %): hemangiopericytoma \u2014 1, clival tumors <br \/>\u2014 5 (chordoma), sella turcica lesion with posterior clinoid recess extension <br \/>(osteoma) \u2013 1 (2.5 %). The extended EET approaches used were as follows: EET <br \/>+ transpterygoid approach \u2014 22 (56.4 %) (in 4 (18.1 %) cases transmaxillary <br \/>approach was additionally used), extended EET + transclival approach \u2014 4 <br \/>(10.2 %), EET + transcavernous approach \u2014 2 (5.1 %), EET + transethmoidal <br \/>approach \u2014 11 (28.2 %). In all cases, we used Karl Storz rigid 4mm 18cm with <br \/>0 and 30-degree angled optics. The extent of resection was determined based <br \/>on routine postoperative CT scans performed within 24 hours after surgery. <br \/>The volume of resection was evaluated using gadolinium. Gross total resection <br \/>was defined as the resection of 100 % of the target lesion, subtotal resection as <br \/>less than 100 % volumetric reduction of the lesion on postoperative CT scans. <br \/>Further follow-up was done in three, six months and 1 year after surgery, then <br \/>annually by MRI scanning with gadolinium.<br \/>Results. Gross total resection was achieved in 7 (77.8 %) cases of tumor in <br \/>pterygopalatine fossa. In cases of pituitary adenomas with Knosp 3, Knosp 4 <br \/>cavernous sinus extension, gross total resection was achieved in 7 (53.8 %) <br \/>individuals. Sphenoid sinus tumors were totally removed in 5 (62.5 %) cases. <br \/>Subtotal resection was achieved in 11 (28.2 %) cases. Partial resection was <br \/>achieved in 8 (20.5 %) cases. Postoperative complications were observed in <br \/>5 (12.1 %) cases.<br \/>Conclusions Transethmoidal extended endoscopic endonasal approach is <br \/>sufficient and good to access the anterior wall of the cavernous sinus improving <br \/>visualization and better removing of cavernous sinus pathology extension. <br \/>Transpterygoid extended endoscopic endonasal approach provides sufficient <br \/>visualization of pterygopalatine fossa, petroclival region. Transmaxillary <br \/>extension allows reaching the subtemporal region.<br \/>Keywords: skull base tumors; extended endoscopic approaches<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f3a3ef9 e-flex e-con-boxed e-con e-parent\" data-id=\"f3a3ef9\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b9b0335 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"b9b0335\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/wp-content\/uploads\/2025\/08\/183027-article-text-462508-1-10-20200618.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u00a0Objective: to optimize surgical tactic of endoscopic endonasal transsphenoidal (EET) approaches in cases of tumors with intra- and extracranial extension. Material and methods. For the period of 2013\u20132019, we retrospectively reviewed 39 patients with tumors of intra-extra skull base location or just extracranial extension. Tumor location and pathology: tumors in pterygopalatine fossa (paraganglioma, carcinoma, neurilemmoma, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":987,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[],"class_list":["post-1140","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publications-en"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Endoscopic endonasal approaches to the skull base tumors: minimally invasive approach with achievement of radicality. 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