Transasal endoscopic skull base and brain surgery: tips and pearls

449 Pages·2011·25.15 MB·English

by  Aldo Cassol Stamm

Transnasal Endoscopic Skull Base
and Brain Surgery
Tips and Pearls

Transnasal Endoscopic Skull Base
and Brain Surgery
Tips and Pearls
Aldo Cassol Stamm, MD, PhD
Affiliated Professor
Department of Otolaryngology-Head and Neck Surgery
Federal University of São Paulo
Director
Department of Otolaryngology
Hospital Professor Edmundo Vasconcelos
São Paulo, Brazil
Foreword by
Albert L. Rhoton, Jr., MD
Department of Neurosurgery
University of Florida
Gainesville, Florida
Thieme
New York ∙ Stuttgart
Thieme Medical Publishers, Inc.
333 Seventh Ave.
New York, NY 10001
Executive Editor: Timothy Y. Hiscock
Managing Editor: J. Owen Zurhellen
Editorial Assistant: Tess Timoshin
Editorial Director: Michael Wachinger
Production Editor: Barbara A. Chernow
International Production Director: Andreas Schabert
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Compositor: Agnew’s, Inc.
Printer: Asia Pacific Offset
Library of Congress Cataloging-in-Publication Data
Endoscopic skull base and brain surgery : tips and pearls / Aldo Cassol Stamm, MD, PhD, Editor.
p. ; cm.
Includes bibliographical references and index.
Summary: “The diagnosis and treatment of the diseases of the skull base have changed dramatically in the past few years, transforming the
fields of neurosurgery and otolaryngology-head and neck surgery. The increasing advances in these fields have addressed the ENT physicians
and neurosurgeons to keep up with the expanding information in the exciting area of skull base. By publishing this book, we are presenting a
multidisciplinary approach to the lesions of the skull base. We bring chapters written by the most experienced groups around the world with
both, basic information and the latest advances in macro and surgical anatomy, radiology, anesthesia, endocrinology, and all modalities of
transnasal endoscopic assisted surgical approaches to the anterior, middle, posterior, zygomatic and infra temporal fossae. In addition, the
extended approaches such as to the craniocervical junction and petrous apex are also addressed. Especial emphasis is also given to the
reconstruction techniques”—Provided by publisher.
ISBN 978-1-60406-310-3 (hardback : alk. paper)
1. Skull base—Endoscopic surgery. 2. Brain—Endoscopic surgery. I. Stamm, Aldo Cassol, 1953– editor.
[DNLM: 1. Skull Base—surgery. 2. Brain—surgery. 3. Brain Diseases—surgery. 4. Endoscopy—methods. WE 705]
RD529.E53—2011
617.5’140597—dc22 2010049361
Copyright ©2011 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use,
exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable
to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating,
preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their
efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the
possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors,
editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained
herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use
of such information. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are
advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information
contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for
administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names
even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as
proprietary is not to be construed as a representation by the publisher that it is in the public domain.
Printed in China
5 4 3 2 1
ISBN 978-1-60406-310-3
I dedicate this book to my family: my lovely and devoted wife, Dagmar, and my two children,
Raquel and Guilherme, who have been endlessly supportive and patient during the development of this book.
In honor of my mother, Ada, and in memory of my father, Arno, who provided me with my education.

Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Albert L. Rhoton, Jr.
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Section I . Tips and Pearls: Understanding the Paranasal Sinus and Skull Base
1 . Anatomical Basis of Skull Base Surgery: Skull Osteology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Carolina Martins, Alvaro Campero, Alexandre Yasuda, Luiz Felipe de Alencastro,
Shigeyuki Osawa, and Albert L. Rhoton, Jr.
2 . Anatomy of the Nasal Cavity and Paranasal Sinuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Carolina Martins, Luiz Felipe de Alencastro, Alberto Carlos Capel Cardoso, Alvaro Campero,
Alexandre Yasuda, Jian Wang, Luiz Carlos de Alencastro, and Albert L. Rhoton, Jr.
3 . Imaging in Endoscopic Paranasal Sinus and Skull Base Surgery:
Three-Dimensional Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Rainer Guilherme Haetinger
4 . Nasal Endoscopy in the Preoperative Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Juan Eugenio Salas Galicia, Raúl Omar Cadena Torrero, and María Chávez Méndez
5 . Transnasal Surgical Approaches for Skull Base Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Eduardo Vellutini, Aldo Cassol Stamm, Shirley S.N. Pignatari, and Leonardo Balsalobre Filho
6 . Navigation in Endoscopic Paranasal and Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Benjamin Bleier and Rodney J. Schlosser
7 . Anesthesia in Endoscopic Skull Base and Brain Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Nelson Mizumoto
8 . Postoperative Care in Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Parul Goyal, Devyani Lal, and Peter H. Hwang
Section II . Evolving Concepts in Endoscopic Skull Base and Brain Surgery
9 . Classification of Endonasal Approaches to the Ventral Skull Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Carl H. Snyderman, Harshita Pant, Ricardo L. Carrau, Daniel M. Prevedello,
Paul A. Gardner, and Amin B. Kassam
vii
viii Contents
10 . Endoscopically Assisted Bimanual Operating Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Daniel B. Simmen, Hans Rudolf Briner, and Nick Jones
11 . Technical Innovations and Robotic Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
David W. Kennedy and John M. Lee
Section III . Tips and Pearls in Paranasal Sinus Approaches
12 . Maxillary and Ethmoid Sinuses in Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Nobuyoshi Otori, Kiyoshi Yanagi, and Hiroshi Moriyama
13 . Frontal Sinus Management in Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Kristin Seiberling and Peter-John Wormald
14 . Sphenoid Sinus in Skull Base Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Aldo Cassol Stamm, Shirley S.N. Pignatari, Daniel Timperley, Fernando Oto Balieiro,
and Fábio Pires Santos
Section IV . Tips and Pearls in Orbital and Optic Nerve Surgery
15 . Anatomy of the Orbit and Related Structures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Helder Tedeschi and Albert L. Rhoton, Jr.
16 . Endoscopic Periorbital and Optic Nerve Surgery and Intra-Orbital Resections . . . . . . . . . . . . . . . . . 158
Richard J. Harvey, Raymond Sacks, Aldo Cassol Stamm, and João Flávio Nogueira
Section V . Tips and Pearls in the Transcribriform Approach
17 . Endoscopic Endonasal Approach for Anterior Skull Base Meningiomas . . . . . . . . . . . . . . . . . . . . . . . 167
Amin B. Kassam, Daniel M. Prevedello, Paul A. Gardner, Juan C. Fernandez-Miranda,
Ricardo L. Carrau, and Carl H. Snyderman
18 . Endoscopic Management of Anterior Skull Base Meningoencoephalocele . . . . . . . . . . . . . . . . . . . . . 175
Daniel Timperley, Rodney J. Schlosser, and Richard J. Harvey
Section VI . Tips and Pearls in the Transplanum Approach
19 . Endoscopic Transnasal Craniectomy and the Resection
of Extensive Craniopharyngiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Richard J. Harvey, Aldo Cassol Stamm, Daniel Timperley, and Eduardo Vellutini
20 . Transplanum, Transtuberculum Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Gurston G. Nyquist, Vijay K. Anand, and Theodore H. Schwartz
21 . The Endonasal Transplanum-Transtuberculum Endoscopic Approach
in Pituitary Adenomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Giorgio Frank, Diego Mazzatenta, Vittorio Sciarretta, Matteo Zoli, Giovanni Farneti,
and Ernesto Pasquini
Section VII . Tips and Pearls in the Sellar and Parasellar Approach
22 . Microsurgical and Endoscopic Anatomy of the Parasellar Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Carolina Martins, Alexandre Yasuda, Alvaro Campero, Luiz Felipe de Alencastro,
Kohei Inoue, and Albert L. Rhoton, Jr.
Contents ix
23 . Surgical Indications for Pituitary Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Marcello D. Bronstein
24 . Do’s and Don’ts in Pituitary Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
Dharambir S. Sethi and Beng Ti Ang
25 . Endoscopic Transnasal Pituitary Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Aldo Cassol Stamm, Eduardo Vellutini, Daniel Timperley, and Leonardo Balsalobre
26 . Hydroscopy: Application to Pituitary Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
W. Derek Leight and Brent A. Senior
27 . Endoscopic Cavernous Sinus Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Giorgio Frank, Diego Mazzatenta, Vittorio Sciarretta, Matteo Zoli,
Giovanni Farneti, and Ernesto Pasquini
28 . Transsellar/Transdorsal Approach via a Pituitary Transposition
to the Interpeduncular Cistern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Daniel M. Prevedello, Amin B. Kassam, Juan C. Fernandez-Miranda, Paul A. Gardner,
Ricardo L. Carrau, and Carl H. Snyderman
Section VIII . Tips and Pearls in Endoscopic Transclival Surgery
29 . Endoscopic Anatomy of the Clivus and Posterior Fossa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Luigi Maria Cavallo, Isabella Esposito, Matteo De Notaris, Felice Esposito,
Manfred Tschabitscher, and Paolo Cappabianca
30 . Endoscopic Transnasal Craniectomy: Approaches to the Clivus and Posterior Fossa . . . . . . . . . . . . 275
Aldo Cassol Stamm, Shirley S.N. Pignatari, Eduardo Vellutini, Diego Hermann,
and Daniel Timperley
Section IX . Tips and Pearls in Endoscopic Transmaxillary/Transpterygoid/Infratemporal Approaches
31 . Endoscopic Transethmoid-Pterygoid-Sphenoid Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Davide Locatelli, Ilaria Acchiardi, Matteo Vitali, Frank Rikki Canevari, and Paolo Castelnuovo
32 . Pterygopalatine and Infratemporal Fossae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Marc A. Tewfik and Peter-John Wormald
33 . Endoscopic Surgery for Juvenile Nasopharyngeal Angiofibroma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Paolo Castelnuovo, Andrea Pistochini, Francesca Simoncello, Ignazio Ermoli,
Andrea Bolzoni Villaret, and Piero Nicolai
34 . Lesions of the Petrous Apex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
Carl H. Snyderman, Emiro E. Caicedo, Daniel M. Prevedello, Ricardo L. Carrau,
Paul A. Gardner, and Amin B. Kassam
35 . Transmaxillary Endoscopic Approach to Contralateral Parasellar Lesions . . . . . . . . . . . . . . . . . . . . . 314
Luiz Felipe de Alencastro, Luiz Carlos de Alencastro, Carolina Martins, Ademir Lodetti,
Alberto Carlos Capel Cardoso, Mario Faria, Kohei Inoue, Shigeyuki Osawa,
and Albert L. Rhoton, Jr.
36 . Suprapetrous Approach to Meckel’s Cave and Temporal Fossa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Daniel M. Prevedello, Amin B. Kassam, Ricardo L. Carrau, Juan C. Fernandez-Miranda,
Paul A. Gardner, and Carl H. Snyderman