Endoscopic transnasal interseptal approach for invasive clival tumors: development of an approach method regarding maximal preservation of the nasal anatomy

Neurologia Medico-chirurgica
Masahiro ShinNobuhito Saito

Abstract

Asian people frequently show small noses, narrow nasal apertures, and congestive mucosa on the turbinates and septum. To reduce the risk of nasal morbidity with increased radicality for skull base tumors in these patients, we developed endoscopic transnasal interseptal approach (ETISA) in transsphenoidal surgery for invasive clival tumors (ICTs). Indication for ETISA is radical resection for tumors occupying deep ventral skull base regions, confined posterior to the level of the middle turbinates. After removing ethmoidal air cells, the middle turbinates are laterally deflected. A linear incision is made vertically on each side of the septal mucosa, which is separated from the bony septum as far as the sphenoid rostrum. The blades of an adjustable speculum are inserted submucosally, and the bony septum is temporarily displaced. The surgical pathway is widely maintained from the entrance to the deep surgical field without sacrificing the nasal mucosa and turbinates. Thirty-two consecutive patients with clival tumors (18 chordomas, 11 chondrosarcomas, 3 others) were treated. Bilateral middle turbinectomy was routinely performed in the initial 3 patients, but in only 4 of the remaining 29 (3 unilaterally, 1 bilaterally). Tumor was...Continue Reading

References

Jul 1, 1997·Journal of Neurosurgery·H D Jho, R L Carrau
Oct 2, 2004·Neurosurgery·Paolo CappabiancaEnrico de Divitiis
Mar 23, 2005·Archives of Facial Plastic Surgery·Maged AbdelkaderPaul S White
Aug 5, 2006·Neurosurgery·Giorgio FrankFabio Calbucci
Jun 5, 2007·Journal of Neurosurgery·Masahiko Kitano, Mamoru Taneda
Nov 4, 2008·Journal of Neurosurgery·Ossama Al-MeftySvetlana Pravdenkova
Jan 2, 2009·The Laryngoscope·Adam M ZanationAmin B Kassam
Jan 31, 2009·American Journal of Rhinology·Pongsakorn TantilipikornPeter A Clement
Feb 5, 2009·Neurosurgery·Martina StipplerAmin B Kassam
Mar 31, 2009·Otolaryngologic Clinics of North America·Nipun Chhabra, Steven M Houser
May 5, 2009·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Ivan H El-SayedMichael W McDermott
Sep 3, 2009·Neurosurgical Focus·Chirag D GandhiKalmon D Post
Jul 2, 2010·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Harshita PantAmin B Kassam
Sep 9, 2010·Head & Neck·John R de AlmeidaAllan D Vescan
Oct 5, 2010·Neurologia Medico-chirurgica·Naokatsu SaekiYoshitaka Okamoto
Nov 16, 2011·Acta neurochirurgica·Masaaki Taniguchi, Eiji Kohmura
Dec 1, 2011·Neurosurgery·Juan C Fernandez-MirandaPaul Gardner
Mar 10, 2012·Acta neurochirurgica·Katsuya SaitoKazunari Yoshida
Jan 22, 2013·American Journal of Otolaryngology·Jean Anderson EloyJames K Liu
Sep 17, 2013·The Journal of Craniofacial Surgery·Ji-Hyeon ShinYong Jin Park
Feb 25, 2014·British Journal of Neurosurgery·Mathew Joseph GallagherNijaguna Mathad

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Methods Mentioned

BETA
dissection
ETISA
biopsy

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