title: Feasibility of piezoelectric endoscopic transsphenoidal craniotomy: a cadaveric study.
abstract: OBJECTIVE
  Endoscopic transsphenoidal approach has become the gold standard for surgical treatment of treating pituitary adenomas or other lesions in that area. Opening of bony skull base has been performed with burrs, chisels, and hammers or standard instruments like punches and circular top knives. The creation of primary bone flaps-as in external craniotomies-is difficult.The piezoelectric osteotomes used in the present study allows creating a bone flap for endoscopic transnasal approaches in certain areas. The aim of this study was to prove the feasibility of piezoelectric endoscopic transnasal craniotomies. Study Design. Cadaveric study.
  
  
  METHODS
  On cadaveric specimens (N = 5), a piezoelectric system with specially designed hardware for endonasal application was applied and endoscopic transsphenoidal craniotomies at the sellar floor, tuberculum sellae, and planum sphenoidale were performed up to a size of 3-5 cm(2).
  
  
  RESULTS
  Bone flaps could be created without fracturing with the piezoosteotome and could be reimplanted. Endoscopic handling was unproblematic and time required was not exceeding standard procedures.
  
  
  CONCLUSIONS
  In a cadaveric model, the piezoelectric endoscopic transsphenoidal craniotomy (PETC) is technically feasible. This technique allows the surgeon to create a bone flap in endoscopic transnasal approaches similar to existing standard transcranial craniotomies. Future trials will focus on skull base reconstruction using this bone flap.
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria ; Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Peter Valentin
authors.initials: PV
authors.lastname: Tomazic
authors.affiliation: Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria ; Department for Neurosurgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Gellner
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria ; Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koele
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria.
authors.forename: Georg Philipp
authors.initials: GP
authors.lastname: Hammer
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Braun
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria ; Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Claus
authors.initials: C
authors.lastname: Gerstenberger
authors.affiliation: Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria ; Department for Neurosurgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Clarici
authors.affiliation: Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria ; Department for Neurosurgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
authors.forename: Etienne
authors.initials: E
authors.lastname: Holl
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria ; Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Hannes
authors.initials: H
authors.lastname: Braun
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26/28, 8036 Graz, Austria ; Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Stammberger
authors.affiliation: Rhinoneurosurgery Group, Medical University of Graz, 8036 Graz, Austria ; Department for Neurosurgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Mokry
mesh_terms: D002102:Cadaver; D003399:Craniotomy / Q000379:methods*; D004724:Endoscopy; D005240:Feasibility Studies; D006801:Humans; D059745:Piezosurgery / Q000379:methods*; D013100:Sphenoid Bone / Q000601:surgery*; D013524:Surgical Flaps