title: Robotic endoscopic sinus and skull base surgery: review of the literature and future prospects.
abstract: OBJECTIVE
  There has been a considerable growth in the indications of endonasal surgery that now include malignant tumours of the nasal fossae and anterior and middle cranial fossa. However, new limitations have also been identified, such as bleeding and cerebrospinal fluid leak, as well as the need to use several instruments simultaneously. Can robotics provide solutions to these problems?
  
  
  METHODS
  Review of the literature based on the three main databases: Medline, Pubmed and Cochrane.
  
  
  RESULTS
  Ten publications were identified. Some authors have developed surgical approaches to the skull base using the da Vinci(®) robot, while others have designed specific robots.
  
  
  CONCLUSIONS
  None of the currently available solutions appears to be completely suitable. The da Vinci(®) robot is very cumbersome and can only be used in the middle cranial fossa via complex and relatively invasive routes. The other robots are laboratory prototypes. We are currently developing an innovative, compact, ergonomic and safe dedicated endoscope holder.
authors.affiliation: LIRMM, CNRS, université Montpellier-2, 161, rue Ada, 34392 Montpellier cedex 05, France; Service d'ORL, hôpital Gui-de-Chauliac, centre hospitalier universitaire de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France. Electronic address: v.trevillot@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Trévillot
authors.affiliation: Service d'ORL, hôpital Gui-de-Chauliac, centre hospitalier universitaire de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Garrel
authors.affiliation: LIRMM, CNRS, université Montpellier-2, 161, rue Ada, 34392 Montpellier cedex 05, France.
authors.forename: E
authors.initials: E
authors.lastname: Dombre
authors.affiliation: LIRMM, CNRS, université Montpellier-2, 161, rue Ada, 34392 Montpellier cedex 05, France.
authors.forename: P
authors.initials: P
authors.lastname: Poignet
authors.affiliation: LIRMM, CNRS, université Montpellier-2, 161, rue Ada, 34392 Montpellier cedex 05, France.
authors.forename: R
authors.initials: R
authors.lastname: Sobral
authors.affiliation: Service d'ORL, hôpital Gui-de-Chauliac, centre hospitalier universitaire de Montpellier, 80, avenue Augustin-Fliche, 34000 Montpellier, France.
authors.forename: L
authors.initials: L
authors.lastname: Crampette
mesh_terms: D004724:Endoscopy; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation; D010256:Paranasal Sinuses / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000295:instrumentation; D019291:Skull Base / Q000601:surgery*
keywords: Paranasal sinuses; Robotics; Skull base; Surgery