Endoscopic transcranial and intracranial resection: Case series and design of a perioperative management protocol

Evan R. Ransom, John Lee, John Y K Lee, James N. Palmer, Alexander G Chiu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purely endoscopic resections of transcranial/intracranial pathology represent an exciting minimally invasive option for some patients. There is an abundance of literature on surgical techniques, though very little deals with perioperative management, which is critical for good outcomes. We present a detailed case review and a perioperative management protocol with specific reference to skull base and neuroanatomy. We performed a retrospective chart review and analysis of outcomes and complications by approach and design and prospective employment of a perioperative management protocol in a major tertiary care referral hospital. We included patients undergoing endoscopic skull base approaches by the two senior surgeons from September 2005 to April 2009, selecting of transcranial/intracranial cases for detailed review. Our main outcome measures included perioperative morbidity, mortality, and complications; degree of resection; recurrence rate; and survival. Fifteen patients met study criteria. No perioperative mortality occurred. There were two major and four minor complications. Mean follow-up was 15 months; 11/13 patients with malignancies had no evidence of disease. A perioperative management protocol was designed from these data and has resulted in decreased lumbar drainage and increased fluid/electrolyte monitoring. Endoscopic transcranial/intracranial anterior skull base surgery is both safe and effective when a complete understanding of the surgery and perioperative management is achieved.

Original languageEnglish (US)
Pages (from-to)13-21
Number of pages9
JournalSkull Base
Volume21
Issue number1
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Skull Base
Neuroanatomy
Mortality
Tertiary Healthcare
Tertiary Care Centers
Electrolytes
Drainage
Outcome Assessment (Health Care)
Pathology
Morbidity
Recurrence
Survival
Neoplasms

Keywords

  • anterior skull base
  • endoscopic
  • Extended endonasal approach
  • skull base neoplasm

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Endoscopic transcranial and intracranial resection : Case series and design of a perioperative management protocol. / Ransom, Evan R.; Lee, John; Lee, John Y K; Palmer, James N.; Chiu, Alexander G.

In: Skull Base, Vol. 21, No. 1, 2011, p. 13-21.

Research output: Contribution to journalArticle

Ransom, Evan R. ; Lee, John ; Lee, John Y K ; Palmer, James N. ; Chiu, Alexander G. / Endoscopic transcranial and intracranial resection : Case series and design of a perioperative management protocol. In: Skull Base. 2011 ; Vol. 21, No. 1. pp. 13-21.
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