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Surgical Outcomes of Extended Endoscopic Endonasal Approach for Skull Base Lesions.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
The extended endoscopic endonasal approach (EEEA) has emerged as a transformative technique in the surgical management of skull base lesions [1-3]. By utilizing natural nasal corridors, this minimally invasive approach provides direct midline access to a wide range of anterior, middle, and posterior skull base lesions, including pituitary adenomas, craniopharyngiomas, meningiomas, and chordomas [1,6]. Compared to traditional transcranial approaches, EEEA offers several advantages such as improved visualization with angled endoscopes, reduced brain retraction, and potentially lower morbidity [2,4].
Despite these advantages, achieving gross total resection (GTR) remains challenging and is influenced by multiple factors. Lesion characteristics such as size, location, consistency, and degree of invasion into critical neurovascular structures-particularly the cavernous sinus and internal carotid artery-play a crucial role [7,8]. Additionally, surgical factors including the chosen approach, reconstruction technique, and surgeon experience significantly impact the extent of resection and postoperative outcomes [4,5].
Understanding the predictors that influence the extent of resection is essential for optimizing surgical planning, improving patient outcomes, and minimizing complications such as cerebrospinal fluid leakage and neurological deficits [7]. Therefore, evaluating surgical outcomes and identifying key predictive factors in EEEA for skull base lesions remains an important area of ongoing research.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Amr Gamal Hussein, specialties
- Telefoonnummer: 01067651618
- E-mail: amrgamalz@yahoo.com
Studie Locaties
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Asyut, Egypte
- Assiut University
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Contact:
- Assiut University Assiut Assiut University, Assiut University
- Telefoonnummer: Assiut University
- E-mail: vp_grad@aun.edu.eg
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
1. Adult patients aged 18 years or older. 2. Patients with radiologically confirmed skull base lesions (based on MRI ± CT) involving the anterior, middle, or posterior skull base.
3. Patients undergoing lesion resection using the extended endoscopic endonasal approach (EEEA).
4. Lesions amenable to endoscopic endonasal access, including: Pituitary adenomas with extrasellar extension Craniopharyngiomas Skull base meningiomas Chordomas and other midline skull base lesions 5. Availability of complete preoperative assessment, including: Clinical evaluation Neuro-ophthalmological assessment (when applicable) Radiological imaging 6. Availability of detailed intraoperative data, including surgical approach and intraoperative findings.
7. Availability of early postoperative MRI (within 72 hours to 3 months) to assess the extent of resection.
8. Patients with adequate postoperative follow-up (minimum 3 months) for evaluation of outcomes and complications.
Exclusion Criteria:
1. Patients aged less than 18 years. 2. Patients who underwent transcranial approaches. 3. Lesions not primarily involving the skull base or not suitable for endoscopic endonasal access.
4. Patients with incomplete clinical, radiological, or operative data. 5. Absence of early postoperative MRI, making assessment of the extent of resection unreliable.
6. Patients with insufficient follow-up (less than 3 months). 7. Cases managed by biopsy only without attempted lesion resection. 8. Patients with severe comorbidities significantly affecting surgical outcome (e.g., advanced systemic disease), if they introduce bias in outcome assessment.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: skull base lesions
Surgical Outcomes of Extended Endoscopic Endonasal Approach for Skull Base Lesions.
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Surgical Outcomes of Extended Endoscopic Endonasal Approach for Skull Base Lesions
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Extent of lesion resection
Tijdsspanne: 2 years
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Extent of lesion resection (Gross total resection vs Subtotal resection) based on postoperative MRI
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2 years
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Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- Arbolay OL, Gonzalez JG, Gonzalez RH, Galvez YH. Extended endoscopic endonasal approach to the skull base. Minim Invasive Neurosurg. 2009 Jun;52(3):114-8. doi: 10.1055/s-0028-1119414. Epub 2009 Jul 31.
- Lopez-Arbolay O, Gonzalez-Gonzalez J, Rojas-Manresa JL. [Extended endoscopic endonasal approach to skull base]. Neurocirugia (Astur). 2012 Nov;23(6):219-25. doi: 10.1016/j.neucir.2012.05.003. Epub 2012 Aug 1. Spanish.
Nuttige links
Studie record data
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Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- Skull base lesions
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Bestudeer gegevens/documenten
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publicatie
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