Utility of a rotation-suction microdebrider for tumor removal in endoscopic endonasal skull base surgery.
The microdebrider is a common tool used in endoscopic sinus surgery for removing polypoid and sinonasal tissue. It uses rotating blades and an integrated suction device for controlled removal of tissue under video-endoscopic visualization. To our knowledge, the application of the microdebrider for endoscopic removal of skull base tumors has not been reported. This study aimed to investigate the utility of the rotation-suction microdebrider as a tool for endoscopic endonasal removal of solid and fibrous skull base tumors. Thirty-two patients underwent endoscopic endonasal skull base surgery where the rotation-suction microdebrider was used as the primary tool for tumor removal and debulking. Pathologies included a variety of anterior skull base meningiomas, sinonasal skull base malignancies, juvenile nasopharyngeal angiofibromas, schwannomas, and other skull base lesions. Gross total and near total removal was achieved in 87.5% (28/32) of patients, and subtotal removal was performed in 12.5% (4/32) of patients. The microdebrider allowed efficient debulking and removal of solid and fibrous tumors, such as meningiomas, that were not responsive to standard ultrasonic aspiration. There were no complications of orbital or neurovascular injury, or thermal injury to the nostril. The rotation-suction microdebrider is a useful tool for endoscopic endonasal removal of skull base tumors. This is particularly useful for solid and fibrous tumors that are not responsive to standard ultrasonic aspiration. For intracranial tumors, it is critical to remain inside the tumor capsule during debulking so as to avoid injury to the surrounding neurovascular structures.
Department of Neurological Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07101, USA.
Smruti K
SK
Patel
Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
Qasim
Q
Husain
Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
Arjuna B
AB
Kuperan
Department of Neurological Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07101, USA; Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
Jean Anderson
JA
Eloy
Department of Neurological Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07101, USA; Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA. Electronic address: james.liu@umdnj.edu.
James K
JK
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000295:instrumentation*; D012189:Retrospective Studies; D012399:Rotation; D019292:Skull Base Neoplasms / Q000601:surgery*; D013396:Suction; D055815:Young Adult
Endoscopic endonasal approach; Endoscopic skull base surgery; Microdebrider; Skull base tumor; Tumor aspiration device