Endoscopic resection of skull base tumours utilising the ultrasonic dissector.

OBJECTIVE We report the use and benefits of the ultrasonic dissector in the resection of difficult skull base lesions. METHOD Five case reports are presented, and the utilisation of ultrasonic dissectors in otorhinolaryngology is reviewed. RESULTS The ultrasonic dissector was found to be a useful tool during the endoscopic resection of poorly accessible skull base tumours. Safe dissection and complete removal of all five lesions were achieved without any vascular injury. To our knowledge, this is the first report of the use of the ultrasonic dissector for the resection of sinonasal and skull base tumours. CONCLUSION The ultrasonic dissector was found to be particularly useful during the endoscopic transnasal approach to the petrous apex. During minimally invasive endonasal surgery, benefits include the length of the instrument, speed and precision of dissection, and low risk of vascular injury.