A major advance in neurosurgery has been the development of new endoscopic techniques for skull base tumors. Skull base tumors pose significant challenges due to their close proximity to important neurovascular structures and potential extension into neural canals or the cavernous sinus. Surgical resection can be associated with significant morbidity, including damage to the optic nerve and leakage of cerebrospinal fluid.

The advantage of the expanded endoscopic approach is that we can now visualize areas in the sella that we could not see previously, enhancing the opportunity for a complete pituitary tumor resection. Unlike the microscope, which focuses light narrowly on the tumor — it is like looking through a keyhole in a door — the endoscope works more like a flashlight, bringing the light and visualization to the tumor.


This technique is of particular value in patients with large tumors with significant suprasellar or cavernous extension.


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