EXTRADURAL ENDOSCOPIC DISSECTION OF THE ANTERIOR SKULL BASE

A study was conducted from February 29, 1996, to March 28, 1996, at th e University of Brno's Pathology institute in the Czech Republic to ex plore the possible application of craniofacial intracranial endoscopic techniques through minimal skin incisions and trephines in fresh cada vers (3 to 12 hours old). Through the trephines the dura was totally d issected from the bone. After this dissection a standard bicoronal inc ision and a full craniotomy was performed to assess the integrity of t he meninges. This minimally invasive dissection of the skull base with the aid of an endoscope is characterized by fewer skin incisions, the reby avoiding the exposure of subcutaneous tissue, muscle, cranial bon e, and meninges. We find that it is possible to accomplish an accurate and extensive intracranial dissection with the aid of an endoscope. T he potential of this technique is important for craniofacial surgery a s well as for neurosurgery. The objectives of this study were [1] to e xplore endoscopically the craniofacial anatomy to determine the best a pproach and the optimal method for dissecting endocranial structures, and [2] to achieve a safer and more accurate dissection of the skull b ase, evaluating advantages of endoscopic surgery as an alternative met hod for the treament of craniofacial and neurosurgical pathologies.