Perioperative adjuncts in endoscopic skull base surgery

The field of endoscopic skull base surgery has rapidly evolved in the past decade and is now an accepted treatment modality for a variety of pathologies in the sinonasal cavities and anterior skull base. Inherent to the development of the field are a variety of technologies and surgical adjuncts that are utilized during various aspects of the surgeries. Understanding the indications, utility and limitations of these adjuncts is critical to the endoscopic skull base surgeon. Additionally important is a discussion of the process with which new surgical devices are integrated into clinical practice. The current article discusses this process in general terms and explores the role of stereotactic navigation, fluorescein, powered instrumentation and lumbar drainage in endoscopic skull base surgery.