Preoperative and Intraoperative Imaging for Endoscopic Endonasal Approaches to the Skull Base

Endoscopic, expanded endonasal approaches (EEAs) were developed through the collaboration between skull base surgeons (otolaryngologists and neurosurgeons) and neuroradiologists. Full endonasal access to the skull base required a visualization tool (eg, the endoscope) and specialized instrumentation to work through the nostrils. Once these endoscopic technologies were applied, an understanding of sinus anatomy and its relationship to the skull base became the key to the EEA. This bridge between otolaryngologists and neurosurgeons was built through collaboration with skull base radiologists. The radiographic evaluation of skull base anatomy and its relationship with associated tumors remains critical for preoperative planning and intraoperative guidance.