Troubles neurologiques

Endoscopic Endonasal Approach to Skull Base Lesions. Surgical Outcome

Abstract

Orestes Lopez Piloto

Introduction: The complexity of the pathology treated by this route, frequently of tumor origin, lies in the close anatomical relationship that they have with
important neurovascular structures which, most of the time, are deformed, displaced or completely engulfed in them.
Methods: A retrospective, descriptive, cross-sectional study was carried out. The universe of study was made up of all the patients operated by an endoscopic
endonasal approach at the Institute of Neurology and Neurosurgery, in the period from May 2017 to April 2021.
Results: A sample of 65 patients was identified. The average age was 52 years. Among the treated lesions, patients with pituitary macroadenomas (52.3%),
followed by craniopharyngioma (20%) predominated. The postoperative complications that were recorded in our series were postoperative CSF fistula, epistaxis
and vascular lesion (frontopolar artery) with a total of 3 cases (4.6%) and two deaths (2.9%) The degree of tumor resection in our series was total in 64.7% of the
cases operated on by both the standard endoscopic endonasal approach (21.5%) and the extended approach for 43.2%.
Conclusion: The endoscopic endonasal approach is a fundamental tool for the management of most lesions of the anterior cranial base and the sellar / parasellar
region because it allows for extensive resections with a relatively low number of complications.