Strategies for Improving Visualization During Endoscopic Skull Base Surgery

Janalee K Stokken; Ashleigh Halderman; Pablo F Recinos; Troy D Woodard; Raj Sindwani

doi:10.1016/j.otc.2015.09.008

Strategies for Improving Visualization During Endoscopic Skull Base Surgery

Otolaryngol Clin North Am. 2016 Feb;49(1):131-40. doi: 10.1016/j.otc.2015.09.008.

Authors

Janalee K Stokken¹, Ashleigh Halderman², Pablo F Recinos³, Troy D Woodard³, Raj Sindwani⁴

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
² Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue/A71, Cleveland, OH 44195, USA.
³ Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue/A71, Cleveland, OH 44195, USA; Minimally Invasive Cranial Base and Pituitary Surgery Program, Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
⁴ Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue/A71, Cleveland, OH 44195, USA; Minimally Invasive Cranial Base and Pituitary Surgery Program, Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address: sindwar@ccf.org.

PMID: 26614833
DOI: 10.1016/j.otc.2015.09.008

Abstract

The nasal cavity has a robust vascular supply, and bleeding is a primary obstacle to the minimally invasive skull base technique. Venous bleeding, including the cavernous sinus, can be managed with various techniques using hemostatic materials and pressure. A thorough understanding of the skull base vascular anatomy is vital for avoiding injury to major arteries and having confidence to control venous bleeding to optimize the endoscopic view and tumor resection.

Keywords: Cavernous sinus; Endoscopic; Hemostasis; Paranasal sinus; Skull base; Surgery.

Publication types

Review

MeSH terms

Cavernous Sinus / pathology*
Embolization, Therapeutic / methods*
Endoscopy / standards*
Hemorrhage / prevention & control
Hemorrhage / therapy*
Hemostasis
Humans
Nasal Cavity / pathology
Neurosurgical Procedures / standards*
Nose / surgery
Paranasal Sinuses / pathology
Skull Base / surgery
Skull Base Neoplasms / surgery