Objective: To describe extended endoscopic surgical approaches to the skull base.
Setting: Manchester Skull Base Unit, Salford Royal Hospital, Salford, Manchester, UK.
Methods: A literature search of Medline, EMBASE, CINAHL, AMED and the Cochrane Database of Systematic Reviews using the Ovid Collection was conducted to identify scientific publications using keywords including expanded endonasal approach, extended endoscopic endonasal approach, skull base surgery, and endoscopic skull base surgery. The period searched was 1948 to July 2014.
Results: 307 papers were identified. 129 review articles, 71 case series and 107 technical notes were included for discussion.
Discussion: In Part 1 of this series we discussed the evolution of endonasal endoscopic surgery in recent decades, the anatomy of the skull base in both the sagittal and coronal planes, and the disease processes amenable to treatment by the endoscopic approach. This subsequent and final part of this series elaborates on investigation of skull base pathology with a view to endoscopic management, techniques of surgical management, reconstructive procedures, and benefits to the patient of the expanded endoscopic approach.
Conclusions: The frontiers of endoscopic transnasal surgery are ever expanding as new approaches emerge to manage ever more inaccessible lesions. There is still a learning curve to negotiate for experienced endoscopic skull base surgeons. We hope to contribute to this process by providing the reader with a clear understanding of the skull base, endoscopic anatomy and expanded endoscopic surgical approaches.