Advances in Skull Base Reconstruction After Transnasal Endoscopy

Abstract

Endoscopic transnasal approach have experienced rapid development and gradual maturation in just a few decades (Kassam AB, Prevedello DM, Carrau RL, et al, 2011; Eloy J A, Vivero R J, Hoang K, et al, 2009). It has expanded from the removal of conventional pituitary tumours to the application of an endoscopic extended transsphenoidal approach for the resection of tumours in the intrasellar, suprasellar and even ventricular systems (Cappabianca P, Cavallo L M, Esposito F, et al, 2008). Larger bone and dural defects at the skull base, causing more severe postoperative complications and resulting in a multiplication of the healthcare burden (Eloy J A, Shukla P A, Choudhry O J, et al, 2013). Skull base Reconstruction after tumour removal has become a great challenge. Currently, skull base reconstruction is mainly divided into soft and rigid reconstruction, and soft reconstruction is represented by the technique of pedicled nasal septum mucosal flap (PNSF) (Thorp B D, Sreenath S B, Ebert C S, et al, 2014)0. As for rigid reconstruction, it is still controversial (Shin J, Forbes J, Lehner K, et al, 2019; Eloy J A, Shukla P A, Choudhry O J, et al, 2012). From the current studies, rigid reconstruction has a role that cannot be ignored. In this article, we will describe the development of skull base surgery and several high-profile skull base reconstruction techniques.