title: [Endonasal skull base endoscopy].
abstract: OBJECTIVE
  The endoscopic endonasal techniques used in skull base surgery have evolved greatly in recent years. Our study objective was to perform a qualitative systematic review of the likewise systematic reviews in published English language literature, to examine the evidence and conclusions reached in these studies comparing transcranial and endoscopic approaches in skull base surgery.
  
  
  METHODS
  We searched the references on the MEDLINE and EMBASE electronic databases selecting the systematic reviews, meta-analyses and evidence based medicine reviews on skull based pathologies published from January 2000 until January 2013. We focused on endoscopic impact and on microsurgical and endoscopic technique comparisons.
  
  
  RESULTS
  Full endoscopic endonasal approaches achieved gross total removal rates of craniopharyngiomas and chordomas higher than those for transcranial approaches. In anterior skull base meningiomas, complete resections were more frequently achieved after transcranial approaches, with a trend in favour of endoscopy with respect to visual prognosis. Endoscopic endonasal approaches minimised the postoperative complications after the treatment of cerebrospinal fluid (CSF) leaks, encephaloceles, meningoceles, craniopharyngiomas and chordomas, with the exception of postoperative CSF leaks.
  
  
  CONCLUSIONS
  Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in skull base surgery.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: simal_jua@gva.es.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Simal-Julián
authors.forename: Pablo
authors.initials: P
authors.lastname: Miranda-Lloret
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pancucci
authors.forename: Rocío
authors.initials: R
authors.lastname: Evangelista-Zamora
authors.forename: Pedro
authors.initials: P
authors.lastname: Pérez-Borredá
authors.forename: Pablo
authors.initials: P
authors.lastname: Sanromán-Álvarez
authors.forename: Laila
authors.initials: L
authors.lastname: Perez-de-Sanromán
authors.forename: Carlos
authors.initials: C
authors.lastname: Botella-Asunción
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D002817:Chordoma / Q000601:surgery; D004724:Endoscopy / Q000379:methods; D006801:Humans; D008579:Meningioma / Q000601:surgery; D009666:Nose; D019291:Skull Base / Q000601:surgery*
keywords: Base de cráneo; Cerebrospinal fluid leak; Chordoma; Cordoma; Craneofaringioma; Craniopharyngioma; Endoscopia; Endoscopy; Fístula de líquido cefalorraquídeo; Meningioma; Skull base