European Archives of Oto-Rhino-Laryngology

, Volume 267, Issue 5, pp 649–663 | Cite as

Endoscopic endonasal skull base surgery: past, present and future

  • Paolo Castelnuovo
  • Iacopo DallanEmail author
  • Paolo Battaglia
  • Maurizio Bignami
Review Article


Endoscopic techniques have undergone tremendous advancement in the past years. From the management of phlogistic pathologies, we have learned to manage skull base lesions and even selected intracranial diseases. Current anatomical knowledge plus computer-aided surgery has enabled surgeons to remove large lesions in the paranasal sinuses extending beyond the boundaries of the sinuses themselves. In this sense, management of benign diseases via endoscopic routes is nowadays well accepted whilst the role of endoscopic techniques in sinonasal malignancies is still under investigation. Nowadays, it is possible to tackle different pathologies placed not only in the ventral skull base, but also extended laterally (infratemporal fossa and petrous apex) and even, in really selected cases, within the orbit. The ability to resect and reconstruct has improved significantly. At the moment, the improvement in surgical techniques, like the four-handed technique, has rendered endoscopic procedures capable of managing complex pathologies, according the same surgical principles of the open approaches. From now onwards, frameless neuronavigation, modular approaches, intraoperative imaging systems and robotic surgery are and will be an increasingly important part of endonasal surgery, and they will be overtaken by further evolution.


Endoscopic Endonasal Skull base Pituitary Malignancies 



All the authors certify that they have no financial relationship with any entity mentioned in the paper. No sponsor is involved in the paper.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Paolo Castelnuovo
    • 1
  • Iacopo Dallan
    • 2
    Email author
  • Paolo Battaglia
    • 1
  • Maurizio Bignami
    • 1
  1. 1.Department of OtorhinolaryngologyUniversity of InsubriaVareseItaly
  2. 2.2nd ENT UnitAzienda Ospedaliera Universitaria PisanaPisaItaly

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