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Daniel C. Kreatsoulas, Varun S. Shah, Bradley A. Otto, Ricardo L. Carrau, Daniel M. Prevedello and Douglas A. Hardesty

With the advent of improved repair techniques and the durability of pedicled mucosal flaps, an endonasal endoscopic approach (EEA) offers the possibility of no external incisions and potentially lower surgical morbidity than does a traditional craniotomy. Modern repair techniques for postoperative defects (i.e., surgical/iatrogenic CSF leaks from tumor resection) are durable and have a low failure rate. 4 Several small cohorts demonstrate relatively good repair success rates of 80%–94% for spontaneous leaks via endoscopic techniques but have not addressed the

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Graeme F. Woodworth, Kunal S. Patel, Benjamin Shin, Jan-Karl Burkhardt, Apostolos John Tsiouris, Edward D. McCoul, Vijay K. Anand and Theodore H. Schwartz

medially situated lesions, is limited. Endonasal endoscopic approaches, on the other hand, offer a “medial-to-lateral” route, which places the cranial nerves on the far side of the surgical corridor. We consider this approach a safer corridor when applied to soft tumors that arise medially and push the neurovascular structures laterally, thereby forming a safe passage into the medial, and sometimes even the lateral, CS. Further safety is afforded by angled endoscopes that allow direct visualization of tumor debulking in this area. Since the contents of the lateral CS

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Peter G. Campbell, Brian McGettigan, Adam Luginbuhl, Sanjay Yadla, Marc Rosen and James J. Evans

effect on the rate of ophthalmological and endocrinological dysfunction after craniopharyngioma resection. Although not all tumors are amenable to an endonasal endoscopic approach, this small case series appears to support its use to provide a high rate of endocrine function preservation and visual recovery, while simultaneously attaining substantial resections. Other small case series in the literature demonstrate reasonable resection rates corresponding to favorable ophthalmological and endocrinological outcomes. A purely endoscopic technique, in appropriately

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Andrew R. Conger, M.S., Joshua Lucas, Gabriel Zada, Theodore H. Schwartz and Aaron A. Cohen-Gadol

extending to extrasellar locations were approached via the transcranial routes. As endoscopic technology, instrumentation, and relevant anatomical mastery have improved, the indications for transsphenoidal craniopharyngioma surgery have broadened, 13 and an emerging body of literature suggests that for most craniopharyngiomas, the degree of resection via the endonasal endoscopic approach in experienced hands is comparable or superior to those of transcranial routes, 7 , 12 , 18 , 21 , 23 but less invasive, potentially leading to improved visual outcome and shorter

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Matei A. Banu, Amancio Guerrero-Maldonado, Heather J. McCrea, Victor Garcia-Navarro, Mark M. Souweidane, Vijay K. Anand, Linda Heier, Theodore H. Schwartz and Jeffrey P. Greenfield

, or eroding into immature bone alter these developmental patterns. Data about the effect of different pathological entities on the development and maturation of the pediatric skull base are scarce. Skull base development continuously shifts bony landmarks and changes anatomical corridors commonly used in endonasal endoscopic approaches (EEAs) for skull base lesions. 10 To date, limited characterization of pneumatization and growth patterns has been attempted, however, most measurements found in the literature mainly focus on parameters relevant to sinus surgery

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Shigeki Kubo, Hiroshi Hasegawa, Toshihiko Inui, Shinsuke Tominaga and Toshiki Yoshimine

R econstruction of the floor of the sella turcica is often necessary during transsphenoidal pituitary surgery for many reasons such as prevention of postoperative cerebrospinal fluid rhinorrhea in the case of an inadvertent leak of that fluid at the time of surgery. 5 Because of its minimal invasiveness, the endonasal endoscopic approach has been used increasingly in pituitary surgery instead of the conventional sublabial transsphenoidal approach. 1–4 Unfortunately, in the former approach the narrow nasal conduit restricts surgical manipulation. During

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Tomasz A. Dziedzic, Vijay K. Anand and Theodore H. Schwartz

, using an endonasal endoscopic approach. Case Report History A 4-year-old right-handed girl was diagnosed with a swollen right eye and proptosis that had persisted for 16 months. MRI revealed a lesion within the medial orbital cavity that was hypointense on T1- and T2-weighted images; diffusion restriction and contrast enhancement were also observed. At the time of the diagnosis the patient underwent tumor biopsy through an orbital incision. Pathological examination demonstrated an embryonal subtype of rhabdomyosarcoma. The patient was treated with

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Juan C. Fernandez-Miranda, Nathan T. Zwagerman, Kumar Abhinav, Stefan Lieber, Eric W. Wang, Carl H. Snyderman and Paul A. Gardner

medial-to-lateral endonasal endoscopic approach to pituitary adenomas invading the cavernous sinus . J Neurosurg 120 : 1086 – 1094 , 2014 24527820 10.3171/2014.1.JNS131228

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Matei A. Banu, Alpesh Mehta, Malte Ottenhausen, Justin F. Fraser, Kunal S. Patel, Oszkar Szentirmai, Vijay K. Anand, Apostolos J. Tsiouris and Theodore H. Schwartz

caudal as the clivus and odontoid, including olfactory groove meningiomas. 4 , 6 , 7 , 13 , 14 , 25 , 26-29 , 30 , 35 , 36 The advantages of the endonasal endoscopic approach are early devascularization of the tumor, preservation of the sagittal sinus, and the lack of frontal lobe retraction. Furthermore, this technique allows rapid access to intranasal regions that have been potentially invaded by the tumor, such as the ethmoid sinus. However, one major downside is the fact that manipulation of the olfactory apparatus is required, with inevitable damage and

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G. Rene Alvarez Berastegui, Shaan M. Raza, Vijay K. Anand and Theodore H. Schwartz

. The former requires a craniotomy, and the latter can be done through an extradural minimally invasive endonasal endoscopic approach. In this paper, we describe the latter technique, which utilizes a novel clival cranial base cranioplasty process, and discuss its advantages over previously reported techniques. Case Report History and Examination A right-handed 55-year-old female patient with a history of a prolactinoma presented to our institution with a several-year history of visual deterioration, which had worsened over the past month and described as