Surgical Outcomes of Extended Endoscopic Endonasal Approach for Skull Base Lesions.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 主要终点
- Extent of lesion resection
研究概览
简要总结
Aim of this study is to evaluate the surgical and functional outcomes of the extended endoscopic endonasal approach (EEEA) in the management of skull base lesions, including extent of resection, postoperative complications, and clinical outcomes.
详细描述
The extended endoscopic endonasal approach (EEEA) has emerged as a transformative technique in the surgical management of skull base lesions [1-3]. By utilizing natural nasal corridors, this minimally invasive approach provides direct midline access to a wide range of anterior, middle, and posterior skull base lesions, including pituitary adenomas, craniopharyngiomas, meningiomas, and chordomas [1,6]. Compared to traditional transcranial approaches, EEEA offers several advantages such as improved visualization with angled endoscopes, reduced brain retraction, and potentially lower morbidity [2,4].
Despite these advantages, achieving gross total resection (GTR) remains challenging and is influenced by multiple factors. Lesion characteristics such as size, location, consistency, and degree of invasion into critical neurovascular structures-particularly the cavernous sinus and internal carotid artery-play a crucial role [7,8]. Additionally, surgical factors including the chosen approach, reconstruction technique, and surgeon experience significantly impact the extent of resection and postoperative outcomes [4,5].
Understanding the predictors that influence the extent of resection is essential for optimizing surgical planning, improving patient outcomes, and minimizing complications such as cerebrospinal fluid leakage and neurological deficits [7]. Therefore, evaluating surgical outcomes and identifying key predictive factors in EEEA for skull base lesions remains an important area of ongoing research.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1. Adult patients aged 18 years or older.
- •Patients with radiologically confirmed skull base lesions (based on MRI ± CT) involving the anterior, middle, or posterior skull base.
- •3. Patients undergoing lesion resection using the extended endoscopic endonasal approach (EEEA).
- •4. Lesions amenable to endoscopic endonasal access, including: Pituitary adenomas with extrasellar extension Craniopharyngiomas Skull base meningiomas Chordomas and other midline skull base lesions
- •Availability of complete preoperative assessment, including: Clinical evaluation Neuro-ophthalmological assessment (when applicable) Radiological imaging
- •Availability of detailed intraoperative data, including surgical approach and intraoperative findings.
- •7. Availability of early postoperative MRI (within 72 hours to 3 months) to assess the extent of resection.
- •8. Patients with adequate postoperative follow-up (minimum 3 months) for evaluation of outcomes and complications.
排除标准
- •1. Patients aged less than 18 years.
- •Patients who underwent transcranial approaches.
- •Lesions not primarily involving the skull base or not suitable for endoscopic endonasal access.
- •4. Patients with incomplete clinical, radiological, or operative data.
- •Absence of early postoperative MRI, making assessment of the extent of resection unreliable.
- •6. Patients with insufficient follow-up (less than 3 months).
- •Cases managed by biopsy only without attempted lesion resection.
- •Patients with severe comorbidities significantly affecting surgical outcome (e.g., advanced systemic disease), if they introduce bias in outcome assessment.
结局指标
主要结局
Extent of lesion resection
时间窗: 2 years
Extent of lesion resection (Gross total resection vs Subtotal resection) based on postoperative MRI
次要结局
未报告次要终点
研究者
Amr Gamal Hussein Mohamed
Doctor
Assiut University