The defect created is the same that is achieved in conventional approaches. He said that the defect can be covered with vascularized flaps. One thing that we have learned over the last decade is the use of a Foley balloon as an external bolster to maintain support during the early healing period.
Explore This IssueOctober 2008
He said that cerebrospinal fluid leaks that were a major complication in early endonasal procedures have been corrected with the use of flaps. With use of the septal mucosa flap, we have decreased our leak rate down from about 25 percent to about 5 to 10 percent. In fact, our leak rate is now 4 percent overall and 7 percent in high-flow leak situations, which is comparable for what has been reported in the open approach, he said.
We have to remember that the extent of surgery is determined by the biological behavior of the tumor, Dr. Snyderman said. The endoscope is just a tool. It is not the endoscope versus the microscope. It is about choosing the best approach for the patient and the tumor.
Dr. Snyderman disclosed that he has possible financial conflicts of interest with Karl Storz Endoscopy America and Stryker Navigation and Instruments.
©2008 The Triological Society