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J Neurol Surg B Skull Base 2014; 75(03): 165-170
DOI: 10.1055/s-0033-1358375
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Transnasal Surgery as a Replacement for Maxillotomy Techniques to Approach the Central Skull Base: Fewer Complications and More Acceptable to Patients?

David Choi
1   Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
,
Ashok Subramanian
1   Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
,
Vivian Elwell
1   Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
,
Peter Andrews
2   Department of ENT, The Royal National Throat Nose Ear Hospital, London, United Kingdom
,
David Roberts
3   Department of ENT, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
,
Michael Gleeson
1   Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
3   Department of ENT, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
› Author Affiliations
Further Information

Publication History

08 June 2013

19 August 2013

Publication Date:
12 March 2014 (online)

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Abstract

Objectives To compare the complication rates of endoscopic transnasal and open maxillotomy approaches for the central skull base.

Design Retrospective review.

Setting Single-center study, London, United Kingdom.

Participants From 1992 to 2012, 81 patients underwent surgery for skull base lesions, 59 by maxillotomy and 22 by endoscopy.

Main Outcome Measures Total time of surgical anesthesia, blood loss, complications, duration of tracheal intubation, duration of hospital stay, myelopathy score, and mortality rate.

Results The surgical time, blood loss, and duration of the postoperative intubation period were significantly less with endoscopy (p < 0.001). Requirements for intensive care, ward stay, and total hospital stay were also significantly less in the endoscopic group (p = 0.01, p < 0.001, and p < 0.001, respectively). The complication rate was lower with transnasal endoscopic surgery.

Conclusion In patients for whom open maxillotomy or endoscopic surgery are both feasible, the preference should be to perform endoscopic surgery, with better visualization and fewer complications.

Keywords

maxillotomy - endoscopy - skull base - surgery - complications
 

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