Endoscopic Skull Base Surgery: Probably Not the Time for Meta-Analyses but Certainly for Prospectively Collected Data

Abstract

n this issue of WORLD NEUROSURGERY, de Divitiis and Laws address an important topic of current discussion in skull I base surgery: What is the approach of choice for skull base tumors of the anterior skull base and suprasellar area? Transnasal or transcranial? Endoscopic or microsurgical? An inquiry of the neurosurgical community with these questions most likely would lead to a wide collection of heterogeneous answers. One article (5) documented ample variability in technical neurosurgery decision making by submitting the case of a young patient with a suprasellar, mainly cystic tumor to 40 neurosurgeons; the result was the suggestion of 10 different approaches. The authors commented that “decades into the era of evidence-based medicine, most neurosurgeons are aware that the vast majority of our day-to-day patient care decisions are not guided by class I evidence, especially those related to surgical procedures” (5).