Endoscopic endonasal transsphenoidal surgery using a skull reference array and laser surface scanning.
Lesions of the skull base are increasingly being resected via the endoscopic, endonasal, transphenoidal approach. We have successfully treated 33 consecutive patients with pituitary lesions using this technique in combination with BrainLAB skull reference array and laser surface scanning for surgical navigation. This technique affords several advantages over neuronavigation based on adhesive-mounted fiducial registration. Rigid fixation in a Mayfield clamp is not required, which allows for flexibility with respect to positioning of the head during the procedure. This is particularly important as extension and flexion of the head provide greater exposure to the clivus and anterior skull base respectively. Also, this technique obviates the need for additional preoperative MRI, thereby reducing cost and delays.
Greenfield
J P
JP
Weill Cornell Brain Tumor Center, Weill Medical College of Cornell University, 525 E. 68th Street, New York, NY 10021, USA.
Howard
B M
BM
Huang
C
C
Boockvar
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery*; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D010911:Pituitary Neoplasms / Q000601:surgery*; D011300:Preoperative Care / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000033:anatomy & histology / Q000601:surgery*; D016896:Treatment Outcome