Canula-assisted endoscopy in bi-portal transphenoidal cranial base surgery: technical note


The binasal fully endoscopic transphenoidal approach in skull base surgery requires a specific learning curve and expertise and, even in the hands of experienced surgeons, can be challenging. Quick and efficient endoscopic access can be impeded by factors like a deviated nasal septum and/or very narrow nasal cavity. For this reason, we developed a simple technique to facilitate rapid maneuvering of the endoscope in and out of the nose in the case of a narrow surgical corridor. Using a canula in situ in one of the nostrils, the endoscope can be maneuvered in and out of the nose to rapidly reach the surgical target without inadvertent mucosal trauma that can cause bleeding. This technique is very simple and is particularly helpful for novice neuroendoscopists who are trying to navigate the confines of a narrow nasal cavity, especially when they are assisting more experienced colleagues.

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The authors have no personal financial or institutional interest in the devices described in this article.

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Correspondence to Antonio Di Ieva.

Additional information

Michael D. Cusimano and Antonio Di Ieva contributed equally to this work.

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Cusimano, M.D., Di Ieva, A., Lee, J. et al. Canula-assisted endoscopy in bi-portal transphenoidal cranial base surgery: technical note. Acta Neurochir 155, 909–911 (2013).

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  • Canula-assisted endoscopy
  • Endoscopic bi-portal technique
  • Binostril technique
  • Skull base
  • Skull base tumors
  • Transphenoidal approach
  • Extended endoscopic approach