title: Endoscopic skull base surgery: evaluation of current clinical outcomes.
abstract: Endoscopic skull base surgery is one of the most recent fields of neurosurgery. Successive innovations were developed throughout history so that the current concepts that rule this surgical field could be reached. The current paper presents the evolution of endoscopic surgery and its current results on the treatment of skull base tumor, based on a review of meta-analysis and clinical series. A PubMed search for articles published between January 1990 and January 2014 about "endoscopic skull base surgery", "endoscopic transsphenoidal approach", "endoscopic treatment of parasellar tumors" and "suprasellar lesions" was performed. According to the current data, endoscopic surgery seems to be superior to open and transsphenoidal microscopic removal of giant pituitary adenomas. Endoscopy is at least as successful as transsphenoidal microsurgery for the removal of pituitary adenomas and craniopharyngiomas. Transcranial open approaches, in the context of anterior midline skull base meningiomas, present higher rates of gross total resection, fewer complications and better clinical results than endoscopy approaches. The rate of postoperative CSF leakage has been significantly reduced with the introduction of new techniques such as the Hadad-Bassagasteguy flap but still represent one of the most important complications of this technique. Currently, selected tumors located at the anterior, middle and posterior fossa can be adequately assessed using the endoscope with low rates of postoperative CSF leaks. Endoscopic surgery has substantially evolved in the last decades through the collaboration of different teams around the world. The endoscope is now an essential tool in the neurosurgery armamentarium with great potential for new applications in the nearby future.
authors.affiliation: Department of Neurosurgery, State University of Campinas, São Paulo, Brazil - jpaulocavalcante@yahoo.com.br.
authors.forename: Joao P
authors.initials: JP
authors.lastname: Almeida
authors.affiliation: Department of Neurosurgery, Fortaleza General Hospital, Fortaleza, Brazil.
authors.forename: Lucas A
authors.initials: LA
authors.lastname: de Albuquerque
authors.affiliation: Department of Neurosurgery, State University of Campinas, São Paulo, Brazil.
authors.forename: Mateus
authors.initials: M
authors.lastname: Dal Fabbro
authors.affiliation: Department of Ear, Nose and Throat Surgery, State University of Campinas, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sampaio
authors.affiliation: Monterrey Technological Institute, Ignacio A. Santos School of Medicine, Monterrey, Mexico.
authors.forename: Roberto
authors.initials: R
authors.lastname: Medina
authors.affiliation: Monterrey Technological Institute, Ignacio A. Santos School of Medicine, Monterrey, Mexico.
authors.forename: Martin
authors.initials: M
authors.lastname: Chacon
authors.affiliation: Department of Neurosurgery, Fortaleza General Hospital, Fortaleza, Brazil.
authors.forename: Jackson
authors.initials: J
authors.lastname: Gondim
mesh_terms: D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D044583:Neuroendoscopy / Q000009:adverse effects / Q000266:history / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D010911:Pituitary Neoplasms / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*