gms | German Medical Science

79. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

30.04. - 04.05.2008, Bonn

Endoscopic surgery of the anterior skull base – model role for interdisciplinary collaboration

Meeting Abstract

Suche in Medline nach

  • corresponding author Jens Oeken - ENT-Dept., Klinikum Chemnitz gGmbH, Chemnitz, Germany
  • Ditmar Hohrein - Neurosurgery, Klinikum Chemnitz gGmbH, Chemnitz, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno68

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2008/08hno68.shtml

Veröffentlicht: 8. Juli 2008

© 2008 Oeken et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: We perform resections at the area of the sella and clivus via an endoscopic endonasal approach in cooperation between ENT and neurosurgery on a regular basis.

Patients and methods: From 12/2006 to 04/2008 we performed 24 operations at 24 pat. (13♂; 11♀, average age: 56 y.). Patients suffered from following diagnoses: 21×pituitary adenoma, 1×melanoma mestastasis, 1×clivus chordoma and 1×clivus mucocele. All operations were done four-handed transsphenoidal-endoscopically. The ENT-surgeon carried out the sphenoidectomy and the neurosurgeon the tumour resection resp. biopsy. We used an optoelectronic navigation system (Vector Vision®). CT- and MRI-data were used sequentially.

Results: We were able to resect the adenoma resp. to take a biopsy of the tumour in all cases. In one case an additional FESS had to be done because of a nasal polyposis. No intraoperative complications occured. We observed one oculomotor nerve palsy due to a neuroborreliosis at the third postoperative day, which recedes completely under antibiotics within a week. There were four cases of liquorrhoea, which required revision surgery in two cases. Navigation was absolutely necessary. We changed from surface registration without skull fixation (16 pat.) to fiducial registration with skull clamp fixation (8 pat.) because it was more accurate. There was no need for a C-bow. Endoscopic view showed advantages even to the neurosurgeon because of the possibility to look inside the operation cave and to use angled view if it is necessary.

Conclusions: The endoscopic surgery of the anterior skull base as interdisciplinary collaboration by means of modern navigation systems is a new minimal-invasive surgical method, which proved itself excellently.