Endoscopic approaches to the cranial base: perspectives and realities

We describe the development of transnasal endoscopic approaches to the cran ial base in an interdisciplinary series of 103 patients, including 13 in th e pediatric age group. Our aim was to define, with the aid of different cas e reports, the possibilities of endoscopic techniques in tumor resection, f istula repair, the treatment of mucoceles and meningoceles, and of combined intracranial and endoscopic approaches. The advantages of these minimally invasive approaches are panoramic visualization, rapidity and reduction of the cosmetic and functional disabilities in comparison with other conventio nal approaches, and a better capacity for identifying and developing key la ndmarks for surgery. On the other hand, endoscopic surgery requires an exsa nguine operation field, technical improvements in instruments, and specific skills. Interdisciplinary collaboration in endoscopic approaches has prove d useful in integrating experiences without overlap between fields, and in broadening possibilities: in our opinion endoscopic approaches will certain ly be important in the future of cranial base surgery.