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.