title: Endoscopic endonasal transsphenoidal exposure of circle of Willis (CW); can it be applied in vascular neurosurgery in the near future? A cadaveric study of 26 cases.
abstract: OBJECTIVE
  Endonasal transsphenoidal approaches are getting rapidly popular in removing many midline skullbase lesions from crista galli to foramen magnum. For safe removal of these lesions, familiarity with endoscopic endonasal anatomy of circle of Willis is very important. Furthermore, for safe development of this approach in vascular neurosurgery in the near future, endoscopic endonasal exposure of circle of Willis is a fundamental step. The goals in this study were to dissect the circle of Willis completely through the endoscopic endonasal approach and to become more familiar with the views and skills associated with the technique by using fresh cadaveric specimens.
  
  
  METHODS
  After obtaining ethical clearance, 26 fresh cadaver heads were used without any preparation. Using a neuroendoscope, complete exposure of the circle of Willis was done endonasaly, and various observations including relation of circle of Willis was recorded.
  
  
  RESULTS
  Complete exposure of the circle of Willis was made through an endonasal approach in all cases without injuring surrounding structures.
  
  
  CONCLUSIONS
  Endoscopic endonasal extended transsphenoidal exposure of CW can make the surgeon more efficient in removing midline skullbase lesions with safe handling of different parts of circle of Willis and it may help in development of endonasal endoscopic vascular neurosurgery in the near future.
authors.affiliation: Dhaka Medical College Hospital, Department of Neurosurgery, Dhaka, Bangladesh. forhadchowdhury74@yahoo.com
authors.forename: Forhad H
authors.initials: FH
authors.lastname: Chowdhury
authors.forename: Mohammod R
authors.initials: MR
authors.lastname: Haque
authors.forename: Khandkar A
authors.initials: KA
authors.lastname: Kawsar
authors.forename: Shamim
authors.initials: S
authors.lastname: Ara
authors.forename: Quazi Deen
authors.initials: QD
authors.lastname: Mohammod
authors.forename: Mainul H
authors.initials: MH
authors.lastname: Sarker
authors.forename: Atul H
authors.initials: AH
authors.lastname: Goel
mesh_terms: D002102:Cadaver; D002536:Cerebral Arteries / Q000033:anatomy & histology / Q000601:surgery; D002941:Circle of Willis / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery*; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000379:methods*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D019291:Skull Base / Q000033:anatomy & histology; D013100:Sphenoid Bone / Q000033:anatomy & histology*; D014656:Vascular Surgical Procedures / Q000379:methods*