Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Background: The introduction of the endoscope in transsphenoidal surgery has allowed access to lesions located in complex regions of the skull base under direct visual control. With the application of this technique, our group started treating pituitary tumours and from 2009 onwards began treating skull base lesions through extended endoscopic endonasal approaches. The aim of the present study is to report our experience with extended endoscopic approaches. Indications, results, limitations and complications of this new technique are also discussed. Material and methods: From January 2007 to January 2012, the endonasal approach was used in 40 patients with different cancerous lesions. Results: Total tumour removal, as assessed by postoperative magnetic resonance imaging, occurred in 30/40 patients (75%), but in 10 patients only partial removal was possible. Major complications, including cerebrospinal fluid leak, were observed in 5/40 patients (8%). One patient died 3 months after surgery due to a severe systemic sepsis. Conclusion:The extended endoscopic endonasal approach could be used as a minimally invasive and innovative technique for the removal of selected skull base lesions.