Endoscopic skull base surgery is performed to remove a tumour in the brain or an abnormality in the upper spinal cord. This procedure is effective for treating brain tumours, and can help patients live a normal life again. Following the procedure, patients must continue therapy and receive MRI scans to assess their progress. It is also important for patients to be surrounded by family members who will support them during their recovery.
Endoscopic
Endoscopic skull base surgery is an increasingly popular method of surgery for benign and malignant conditions. The use of endoscopic techniques has many advantages, including less trauma, increased accuracy and precision, shorter hospital stays, and reduced cosmetic impact. Because of the advances in technology, the field of endoscopic skull base surgery has become more sophisticated and can address a variety of anatomic and pathological conditions. However, some questions about its efficacy still remain. As more data become available, these questions will likely be addressed.
Risks associated with endoscopic skull base surgery include a potential leak of cerebrospinal fluid (CSF). The risk of CSF leakage is higher when the lining of the brain is opened. It can lead to infection if the leak is persistent. To avoid the risk of this complication, a mucosal flap is usually harvested during the procedure and used to seal off the surgical corridor. If a spinal fluid leak is discovered, it may be corrected with another endoscopic procedure, or with a lumbar drain.
During the procedure, a small incision may be made in the nose and skull to allow the neurosurgeon to place an endoscope through the skull base. This is often combined with a MRI scan, which is a computer and magnet-based image of the skull base. This can help the surgeon confirm that the growth has been removed properly.
Transnasal
Transnasal endoscopic skull base surgeries are less invasive than their open counterparts. However, these procedures are not without risk. Using a thin lighted tube with a camera at the tip, doctors can operate on the skull base without cutting or removing any bones. Moreover, the endoscopic surgery requires shorter hospital stays and faster recovery time. The nasal passages are used as a corridor for the endoscope, which navigates through the skull base to reach the tumor. As the doctor performs the procedure, he uses images on a computer screen to guide him and ensure that he has the correct approach.
Transnasal endoscopic skull base surgeries are becoming increasingly popular in recent years. Compared with open skull base surgery, this technique has a lower risk of mortality and morbidity. However, some patients may experience permanent nasal morbidities after surgery. This is why the surgical technique must be refined to reduce potential complications and improve patient quality of life.
Multidisciplinary
Endoscopic skull base surgery is a highly specialized surgery that requires the expertise of a multidisciplinary team. This type of surgery is performed to remove bone tumours from the skull base. The multidisciplinary team consists of a neurosurgeon and an ENT surgeon who collaborate during a single operation using an endoscope.
Multidisciplinary teams are invaluable in the treatment of complex skull base lesions, enabling surgeons to optimize cosmetic and functional outcomes while minimizing the physical and psychological risks. The multidisciplinary approach to skull base surgery has enabled the development of novel endoscopic techniques and the refinement of conventional surgical techniques. One notable example is the management of vestibular schwannomas through endonasal endoscopic techniques, which requires the collaboration of head and neck surgeons and neurosurgeons.
Multidisciplinary teams work together to maximize patient care, improve patient outcomes, and integrate basic and translational research and clinical trials. The benefits of integrating the knowledge of specialists from different fields are many and include increased productivity and recognition of expertise. In addition, multidisciplinary teams are crucial in the face of value-based competition.
Robotic
A novel robotic surgical approach enables adequate endoscopic access for tumor resection in the central and anterior skull base. In addition, it enables precise suturing of dural defects. A robotic arm enables multiple instruments to be placed in the desired locations while the surgeon watches over the surgical field.
A multidisciplinary team of neurosurgeons and ENT surgeons performs the surgery. The ENT surgeon performs the incision inside the nasal cavity, while the neurosurgeon uses an endoscope to operate on the skull base. The robot then moves to the next state of the surgical protocol, which is defined by the surgeon.
The teleoperated robot is programmed with a virtual haptic device that provides feedback. The force generated by the autonomous robot is proportional to the distance between the tool and the obstacle, and the teleoperated robot does not bump into the surgical tool. During the 45-second trial, the robot avoided collision with the surgeon and surrounded the obstacle without bumping into it.
