Endoscopic transseptal approach with a bilateral nasoseptal flap in challenging skull-base tumors.

Endoscopic transseptal approach with a bilateral nasoseptal flap in challenging skull-base tumors.

World Neurosurg. 2018 Apr 09;:

Authors: Kim DH, Hong YK, Jeun SS, Park JS, Kim SW, Cho JH, Park YJ, Kim SW

Abstract
OBJECTIVE: To examine the utility of an endoscopic transseptal approach and the creation of a bilateral nasoseptal flap using a two-nostrils/four-hands technique in patients with challenging skull-base tumors.
METHODS: The medical records of patients operated on via an endoscopic transseptal approach between 2009 and 2017 were retrospectively reviewed. Two patients with ossifying fibroma, two with orbital hemangioma, two with trigeminal nerve schwannoma, and one patient each with juvenile angiofibroma, meningioma, and myxofibrosarcoma were included in the study. The surgical technique and endoscopic anatomy are presented.
RESULTS: The mean age of the four male and five female patients was 39.9 ± 14.8 years. The evaluated technique the complete resection of all seven tumors with minimal nasal morbidity after a mean follow-up of 15.2 ± 9.4 months.
CONCLUSIONS: The endoscopic transseptal approach, by creation of a bilateral nasoseptal flap using a two-nostrils/four-hands technique, improves surgical visualization and increases instrument maneuverability. Surgical access to challenging skull-base tumors is therefore afforded. The procedure also reduces nasal morbidity by preserving the lacrimal apparatus and anterior maxilla structures, and avoiding septal perforation and traumatic nose traction.

PMID: 29649644 [PubMed - as supplied by publisher]

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