Endonasal Endoscopic Surgery of Skull Base Tumors 1st Edition by Wolfgang Draf, Ricardo Carrau, Ulrike Bockmühl, Amin Kassam, Peter Vajkoczy ISBN 9783131548115 3131548118

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ISBN 10: 3131548118
ISBN 13: 9783131548115
Author: Wolfgang Draf, Ricardo Carrau, Ulrike Bockmühl, Amin Kassam, Peter Vajkoczy

A comprehensive, multidisciplinary perspective on endonasal endoscopic skull base surgery

This book presents a complete step-by-step guide to endonasal endoscopic skull base surgery, written by prominent interdisciplinary specialists and reflecting important recent developments in the field. Combining the fundamentals of skull base anatomy and pathology with current diagnostic and interventional imaging techniques, Endonasal Endoscopic Surgery of Skull Base Tumors provides a solid clinical foundation for anyone working in this challenging and evolving specialty.

Special features:

• State-of-the-art contributions from international experts in endonasal endoscopic skull base surgery
• A 360 degree panoramic assessment of skull base pathologies
• Description of basic and advanced endoscopic procedures based on the endonasal corridor system
• Current tumor-specific strategies, including indications and preoperative work-up, endoscopic surgical techniques, sequel and potential complications, postoperative care, outcomes, and pearls and pitfalls
• Clear and consistent interdisciplinary guidelines for managing the internal carotid artery in skull base surgery, allowing the removal of previously inoperable tumors
• Surgical outcomes from two of the leading international skull base centers, one in Fulda, Germany (formerly headed by Professor Draf), and one joint program at the University of Brescia and University of Varese, Italy

Complete with 500 full-color photographs, anatomic illustrations, flowcharts and tables, Endonasal Endoscopic Surgery of Skull Base Tumors offers a practical management approach and sets a new standard in the field. It is invaluable for all otolaryngologists, head and neck surgeons, neurosurgeons, neuroradiologists, and pathologists who routinely make diagnostic and therapeutic decisions with regard to skull base lesions. It is also an essential text and reference for those who are learning how to perform endonasal endoscopic skull base surgery in a multidisciplinary environment.

Endonasal Endoscopic Surgery of Skull Base Tumors 1st Edition Table of contents:

1 History of Endonasal Tumor Surgery

1.1 Introduction

1.2 The Origins of Sinus Surgery

1.3 Development of Visual Tools in Sinus Surgery

1.4 Diagnostic and Radiological Tools

1.5 Powered Instrumentation and Navigation in Sinus Surgery

1.6 Functional Endonasal Sinus Surgery

1.7 The Development of Endonasal Oncologic and Skull Base Surgery

1.8 Conclusions

2 Anatomy of Anterior, Central, and Posterior Skull Base

2.1 The Osseous Anatomy of the Skull Base and Related Regions

2.1.1 Introduction and General Aspects

2.1.2 Anterior Cranial Fossa

2.1.3 Middle Cranial Fossa

2.1.4 Posterior Cranial Fossa

2.1.5 Paranasal Sinuses

2.1.6 Pterygopalatine Fossa (s. Sphenomaxillary Fossa)

2.1.7 Craniocervical Junction

2.2 Vessels and Nerves

2.2.1 Introduction

2.2.2 Vessels

2.2.3 Nerves

2.3 Endoscopic Glance at the Skull Base

2.3.1 Introduction

2.3.2 Anterior Ethmoid Cells

2.3.3 Frontal Sinus

2.3.4 Maxillary Sinus

2.3.5 Posterior Ethmoid

2.3.6 Sphenoid Sinus

2.3.7 Vascularization

2.3.8 Cribriform Plate Window

2.3.9 Sphenoidal Window

2.3.10 Orbital Window

2.3.11 Maxillary Window to the Infratemporal Fossa and the Upper Parapharyngeal Space

3 Etiology, Biology, and Pathology of Skull Base Tumors.

3.1 Introduction

3.2 Definitions

3.2.1 Etiology.

3.2.2 Classification

3.2.3 Prognosis

3.2.4 Prediction

3.3 Meningeal Tumors

3.3.1 Meningiomas

3.3.2 Hemangiopericytoma

3.3.3 Hemangioblastoma

3.3.4 Leptomeningeal Melanocytic Lesions

3.4 Tumors of the Peripheral, Autonomous, and Central Nervous Systems

3.4.1 Schwannomas

3.4.2 Malignant Peripheral Nerve Sheath Tumors

3.4.3 Jugulotympanic Paraganglioma

3.4.4 Pilocytic Astrocytoma

3.4.5 Pilomyxoid Astrocytoma

3.4.6 Ependymoma

3.5 Tumors of the Hematopoietic System

3.5.1 Primary Central Nervous System Lymphomas

3.5.2 Langerhans Cell Histiocytosis

3.5.3 Non-Langerhans Cell Histiocytosis

3.6 Germ Cell Tumors and Dysontogenetic Tumorlike Cysts

3.6.1 Germ Cell Tumors

3.6.2 Teratoma and Tumorlike Dysontogenetic Cysts

3.7 Tumors of the Sellar Region

3.7.1 Pituitary Adenoma

3.7.2 Pituitary Carcinoma

3.7.3 Spindle Cell Oncocytoma of the Adenohypophysis

3.7.4 Pituicytoma

3.7.5 Granular Cell Tumor of the Neurohypophysis

3.7.6 Craniopharyngioma

3.8 Tumors of the Nasal Cavity and Paranasal Sinuses

3.8.1 Schneiderian Papilloma

3.8.2 Sinonasal Squamous Cell Carcinoma

3.8.3 Nasopharyngeal Angiofibroma (Juvenile Nasopharyngeal Angiofibroma)

3.8.4 Nasal Glioma

3.8.5 Esthesioneuroblastoma (Olfactory Neuroblastoma)

3.9 Tumors of the Osseous Skull Base

3.9.1 Plasma Cell Myeloma

3.9.2 Fibrous Dysplasia

3.9.3 Ossifying Fibromyxoid Tumor

3.9.4 Osteoblastoma

3.9.5 Osteosarcoma

3.9.6 Chondroblastoma

3.9.7 Chondrosarcoma

3.9.8 Chordoma

3.10 Tumors of Orbit and Eye

3.10.1 Tumors of the Orbit

3.10.2 Tumors of the Eye

3.10.3 Metastatic Tumors

4 Imaging Assessment and Endovascular Treatment

4.1 Advanced Diagnostic Imaging of Skull Base Tumors

4.1.1 Introduction

4.1.2 Goals of Imaging

4.1.3 Inverted Papilloma

4.1.4 Osteoma

4.1.5 Fibrous Dysplasia

4.1.6 Ossifying Fibroma

4.1.7 Schwannomas

4.1.8 Angiofibroma

4.1.9 Pituitary Adenoma

4.1.10 Craniopharyngioma

4.1.11 Meningioma

4.1.12 Esthesioneuroblastoma

4.1.13 Chordoma.

4.1.14 Sinonasal Malignant Tumors

4.1.15 Squamous Cell Carcinoma

4.1.16 Adenocarcinomas

4.1.17 Adenoid Cystic Carcinoma

4.1.18 Sinonasal Undifferentiated Carcinoma

4.1.19 Neuroendocrine Carcinoma

4.1.20 Sinonasal Malignant Melanoma

4.1.21 Lymphoma

4.1.22 Metastases

4.2 Endovascular Interventional Procedures of Skull Base Pathologies

4.2.1 Introduction

4.2.2 Basic Principles of Embolization and Techniques

4.2.3 Embolization Materials

4.2.4 Test Occlusion of Vessels—Applications, Principles, and Indications

4.2.5 Applications of Endovascular Therapy

5 Management of the Internal Carotid Artery in Skull Base Tumor Surgery

5.1 Introduction

5.2 Patient Selection.

5.2.1 Tumors Involving the Internal Carotid Artery

5.2.2 Preoperative Diagnostic Procedures.

5.2.3 Patient Selection for Bypass Surgery

5.3 Technique of Extracranial–Intracranial Bypass Surgery

5.3.1 Superficial Temporal Artery to Middle Cerebral Artery Bypass

5.3.2 Intermediate-Flow Bypass with Radial Artery Graft Interposition

5.3.3 High-Flow Bypass with Saphenous Vein Graft Interposition

5.3.4 Excimer Laser-Assisted Nonocclusive Anastomosis

5.3.5 Intraoperative Assessment of Bypass Function

5.3.6 Antiaggregation and Anticoagulation Regimes

5.4 Management of Internal Carotid Artery

5.5 Management of Tumor

5.6 Combined Endovascular and Surgical Approach as an Alternative for Bypass Surgery

5.6.1 Cerebral Perfusion and Hemodynamics

6 Multidisciplinary Endoscopic Skull Base Centers: Delivering Integrated Care.

6.1 Introduction

6.2 Key Features of the Multidisciplinary Team Approach

6.2.1 Formats of Teamwork.

6.2.2 Concepts of Teamwork

6.3 Implementation of a Multidisciplinary Approach to Sinonasal and Skull Base Pathologies

6.3.1 Preoperative Care

6.3.2 Intraoperative Care

6.3.3 Postoperative Care

6.3.4 Long-term Follow-up

6.4 Trends for a Multidisciplinary Team at Endoscopic Skull Base Centers

6.5 Conclusion

7 360° Access to the Skull Base

7.1 Introduction

7.2 Skull Base Surgery: An Evolving Discipline

7.3 The 360° Vision

7.3.1 Overview of Skull Base Approaches

7.3.2 Overview of Approaches to the Anterior Cranial Fossa

7.3.3 Overview of Approaches to the Middle Cranial Fossa

7.3.4 Overview of Approaches to the Posterior Cranial Fossa

7.4 Principles of the 360° Philosophy

8 The Sinonasal Corridor

8.1 Introduction

8.2 Preoperative Planning

8.3 Intraoperative Preparation and Other General Considerations

8.4 Surgical Technique

8.4.1 Basic Sinonasal Corridor

8.4.2 Expanded Sinonasal Corridor

8.5 Complications

8.5.1 Minor Complications

8.5.2 Major Complications

8.5.3 Immediate Complications

8.5.4 Delayed Complications

8.6 Postoperative Care.

8.6.1 Kassel Hospital (Germany)

8.6.2 Ohio State University

8.7 Conclusion

9 Expanded Endoscopic Endonasal Approaches.

9.1 Introduction

9.2 Indications and Preoperative Work-up

9.3 Surgical Technique

9.3.1 General Concepts for Endoscopic Endonasal Skull Base Surgery

9.3.2 Transsellar Approach to Complement an Expanded Endonasal Approach

9.3.3 Expanded Endonasal Approaches: Anatomical Modules

9.4 Complications

9.5 Sequential Learning and Training for Expanded Endonasal Approaches

9.6 Postoperative Care and Outcome

9.7 Conclusion

10 Transpterygoid Approaches

10.1 Introduction

10.2 PreoperativeWork-up and Indications

10.3 Surgical Technique

10.3.1 Perioperative Preparation

10.3.2 Surgical Exposure

10.3.3 Postoperative Care and Outcome

10.4 Complications

11 Endoscopic Transsphenoidal Pituitary Surgery: Endoneurosurgery

11.1 Introduction

11.2 Indications

11.3 Surgical Technique

11.3.1 Standard Technique

11.3.2 Extended Approaches

11.4 Materials and Methods

11.4.1 Preoperative and Postoperative Evaluation

11.4.2 Pituitary Adenoma Outcome Analysis

11.4.3 Results

11.5 Complications

11.5.1 Rhinosinusal Complications

11.5.2 Intrasellar Complications

11.5.3 Suprasellar and Parasellar Complications

11.5.4 Medical Complications

11.6 Discussion

11.6.1 Expediency

11.6.2 Good Tolerance

11.6.3 Effectiveness

11.6.4 Complications

11.6.5 Final Remarks

12 Tumor-Specific Strategies

12.1 Inverted Papilloma

12.1.1 Introduction.

12.1.2 Technical Considerations

12.1.3 Surgical Technique

12.1.4 Postoperative Care and Follow-up

12.1.5 Complications

12.1.6 Conclusions

12.2 Juvenile Angiofibroma.

12.2.1 Introduction

12.2.2 Site of Origin and Patterns of Spread

12.2.3 DiagnosticWork-up

12.2.4 Staging Systems

12.2.5 Surgical Strategies and Perioperative Management

12.2.6 Postoperative Surveillance

12.2.7 Outcome

12.2.8 Is There Any Role for Nonsurgical Treatments?

12.3 Esthesioneuroblastoma

12.3.1 Introduction

12.3.2 Imaging Features

12.3.3 Histologic Findings

12.3.4 Surgery

12.3.5 Principles

12.3.6 Expanded Endoscopic Endonasal Approach to the Anterior Skull Base: Surgical Technique

12.3.7 Outcomes

12.3.8 Discussion

12.4 Meningiomas

12.4.1 Introduction

12.4.2 General Surgical Strategy

12.4.3 Anatomical Considerations and Limitations

12.4.4 Preoperative Evaluation

12.4.5 Surgical Technique: General Considerations Specific to Meningiomas Approached via an Expanded

12.4.6 Complications

12.4.7 Postoperative Care and Outcome

12.4.8 Conclusion

12.5 Chordoma

12.5.1 Introduction

12.5.2 Clinical Features

12.5.3 Pathology

12.5.4 Imaging

12.5.5 Prognostic Factors

12.5.6 Anatomy of the Clivus

12.5.7 Classification System

12.5.8 Management

12.5.9 Adjuvant Treatment

12.5.10 The Endoscopic Approach for Clival Chordoma Resection

12.5.11 Conclusion

13 Dural Reconstruction

13.1 Introduction

13.1.1 The “Pre-endoscopic” Era.

13.1.2 The “Endoscopic” Era

13.1.3 Skull Base Reconstruction

13.2 Skull Base Reconstruction

13.2.1 Available Materials (Grafts and Flaps)

13.2.2 Indications and Duraplasty Techniques

13.3 Postoperative Care and Follow-up

13.4 Results

13.5 Conclusions

14 Prevention and Management of Complications.

14.1 Introduction

14.2 Vascular Complications

14.2.1 Vascular Complications in the Approach Phase

14.2.2 Vascular Complications in the Dissecting Phase

14.3 Other Complications

14.3.1 Neurological Complications

14.3.2 Endocrine Complications

14.3.3 Cerebrospinal Fluid Leak

14.3.4 Infections

14.4 Final Remarks

15 Surgical Results

15.1 Long-term Outcome of Endonasal Resection of Sinonasal and Skull Base Malignancies (Fulda, Kasse

15.1.1 Introduction

15.1.2 Surgical and Oncological Principles of Endonasal Tumor Surgery

15.1.3 Results of Endonasal Surgery for Malignancies

15.2 Endoscopic Resection of Sinonasal and Skull Base Tumors (Varese, Brescia School)

15.2.1 Introduction

15.2.2 Fibro-osseous Lesions

15.2.3 Inverted Papilloma

15.2.4 Juvenile Nasopharyngeal Angiofibroma

15.2.5 Malignant Tumors of the Sinonasal Tract and Adjacent Skull Base

Index

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