46
Vol. 66, No. 1 2015
Northeast Florida Medicine
Otolaryngology
Sinonasal oncologic surgery has also advanced significantly
with the advent of intraoperative surgical navigation systems
and high-definition fiberoptic nasal endoscopy. This has
transformed the area of conventional skull base surgery and
intracranial surgery into a new discipline. Surgical access to
the anterior cranial fossa can now be obtained transnasally,
obviating the need for craniotomy and extensive facial
degloving surgery and their inherent risks of increased
morbidity and mortality. Surgical access can be obtained
from the cribriform plate of the anterior cranial fossa to the
foramenmagnum in an anterior-posterior plane. Endoscopic
skull base procedures can now be performed by a team of
otolaryngologists and neurosurgeons, allowing removal of
pituitary tumors, meningoceles, meningiomas, chordomas,
and esthesioneuroblastomas.
20
Conclusion
It is an exciting time in the field of Rhinology. Promising
areas of ongoing investigation include the expanded use
of transnasal balloon technology for conditions such as
Eustachian tube obstruction.
21
Efforts are also underway
to combine sinus balloon technology with intraoperative
stereotactic navigation. Given the pace of change witnessed
over the past decades and as long as the medical payment
system supports the uses of new technology, these authors
expect significant advances to continue.
v
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