Endoscopic transmaxillary approach in resection of lateral skull base tumor

Abstract

The resection of lateral skull base tumour has always been a crucial and difficult aspect of skull base surgery. Its operation development has experienced several evolutionary phases, including unaided eye-surgery which could result in huge trauma, microsurgery and completely endoscopic surgery. At present, the endoscopic technique known for its panoramic visibility, minimal invasion and extensive scope of operation, has opened up a brand new perspective for the lateral skull base tumour surgery. Currently, the approach of lateral skull base tumour endoscopic surgery can be generalized as endoscopic transmaxillary approach (ETA). And based on different pathways and methods to expose the maxillary sinus, ETAs can be divided into three, endonasal transmaxillary approach(ENTA), endoscopic sublabial transmaxillary approach (ESTA) and combined approach, while ENTA includes ipsilateral endonasal transmaxillary approach (IENTA), prelacrimal recess approach (PRA), contralateral endonasal transseptal approach (CENTA) and transnasal Denker approach. In this paper, on the basis of the summarization of ETAs related historical evolution, anatomical studys and clinical researches, the merit and demerit of all sorts of ETAs are compared and analyzed. We hope this review could act as a reference for selecting the personalized endoscopic surgery approach of lateral skull base tumour. Key words: Skull base neoplasms; Maxillary sinus; Endoscopy