This chapter discusses the unique challenges that endoscopic skull base surgery present to the neuroanesthesiologist. The neuroanesthesiology team plays a vital role in ensuring a safe outcome to this delicate surgery. Highly specialized endoscopic techniques and equipment, together with the use of sophisticated intraoperative monitoring, all mandate skillful anesthesia management that is tailo...

Skull base surgery has been an established neurosurgical discipline since the late 1980s. The initial enthusiasm of achieving eradication of a seemingly inoperable lesion by novel skull base approaches led many neurosurgeons to use radical surgery. The accompanying high morbidity was accepted as inevitable. Over the years, however, many started questioning this philosophy, and the last decade s...

OBJECTIVES/HYPOTHESIS Endoscopic endonasal skull base surgery defects require effective reconstruction. Although the nasoseptal flap (NSF) has become our institution's workhorse for large skull base defects with cerebrospinal fluid (CSF) leaks, situations where it is unavailable require secondary flaps. Clinical outcomes, pearls and pitfalls, and an algorithm will be presented for these seconda...

Objectives To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources A systematic review of English articles using MEDLINE. Review Methods Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles ...

This chapter discusses the unique challenges that endoscopic skull base surgery present to the neuroanesthesiologist. The neuroanesthesiology team plays a vital role in ensuring a safe outcome to this delicate surgery. Highly specialized endoscopic techniques and equipment, together with the use of sophisticated intraoperative monitoring, all mandate skillful anesthesia management that is tailo...

A modifi ed subcranial approach based upon the procedure fi rst described by Joram Raveh is a viable alternative to standard craniofacial resection for treating pathology of the anterior skull base. It is basically an extradural approach providing wide exposure to the anterior skull base with minimal brain retraction; thus decreasing signifi cantly the morbidity. We present here two cases of a ...

Facial and skull base trauma can cause clinically significant epistaxis. Optimal evaluation and treatment require knowledge of the pertinent vascular and skull base anatomy. We describe a patient with extensive skull base injury and epistaxis in whom CT revealed a fracture through the roof of the nasopharynx and arteriography showed injury to the pterygovaginal (pharyngeal) artery. The fracture...

Since the introduction of endonasal endoscopic skull base surgery the exclusive purpose in the management of skull base neoplasms has been to increase survival rates. Recently, given the improved prognosis achieved, more attention has been focused on the functional outcomes such as nasal symptoms and quality of life (QOL). The purpose of this review is to assess the functional outcomes after en...

To demonstrate the phylogenetic changes that have led to the current form of the human skull, dried skulls of various representative vertebrates were examined using plain radiography and high-resolution computed tomography. The latter was chosen rather than pluridirectional tomography in anticipation of its future role as the major method for imaging the skull base. The phylogenetic history of ...