Evolution of reconstructive techniques following endoscopic expanded endonasal approaches.
Harvey Cushing first popularized the transsphenoidal route to the sella turcica, and Jules Hardy subsequently refined it by adding the operating microscope. Over the ensuing decades, attempts at extending the application of this approach have been advanced by Edward Laws and others. With the evolution of endoscopic approaches, the natural expansion of their use to intradural lesions followed. For the expanded endonasal approach to become a viable option, the paramount concerns surrounding consistent reconstruction of the dura mater must be overcome. In this review the authors chronicle the evolution of the reconstruction technique they currently use after performing expanded endonasal approaches. They also report the use of a balloon stent to buttress the reconstruction and counter the effects of graft migration and cerebrospinal fluid fistula formation. The technique described in this report represents an important step forward in the reconstruction of defects resulting from expanded endonasal approaches.
Kassam
Amin
A
Department of Neurological Surgery, Minimally Invasive Neurosurgery Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. kassamab@upmc.edu
Carrau
Ricardo L
RL
Snyderman
Carl H
CH
Gardner
Paul
P
Mintz
Arlan
A
D004724:Endoscopy / Q000266:history* / Q000379:methods*; D049673:History, 20th Century; D006801:Humans; D009296:Nasal Cavity / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000266:history / Q000379:methods*; D012658:Sella Turcica / Q000601:surgery*; D013537:Sutures