Akademik Veri Yönetim Sistemi
EANS 2025, Vienna, Avusturya, 5 - 09 Ekim 2025, ss.19-20, (Özet Bildiri)
Endoscopic endonasal approach (EEA) has become a well-established approach for skull base pathologies, providing a minimally invasive corridor to access various lesions. While the technique has been extensively studied for common skull base tumors, data on extremely rare pathologies remain limited. Our study aims to present our experience with rare skull base lesions managed via the endoscopic endonasal approach, highlighting the challenges associated with preoperative diagnosis, intraoperative decision-making, and surgical strategy modifications. Methods A retrospective analysis was conducted on patients who underwent endoscopic endonasal surgery at Bahcesehir University and Kocaeli Universtiy Department of Neurosurgery up to December 2024. Among 6,177 endoscopic endonasal procedures performed, 41 patients with exceptionally rare skull base pathologies were identified. Each tumor type was separately evaluated for differences in resection rates, complication rates, and recurrence patterns. Results These included 6 pituitary pituicytomas, 5 plasmacytomas, 5 xanthogranulomas, 4 granular cell tumors, 3 giant cell tumors, 2 cases each of germinoma, hemangioma, Langerhans cell histiocytosis, malignant epithelial tumor, and oncocytoma, and 1 case each of aneurysm, bone cyst, angiofibroma, ependymoma, Hodgkin lymphoma, lymphoid hyperplasia, B-cell acute lymphoblastic leukemia, neurinoma, osteosarcoma, and teratoma. Conclusions Even in highly experienced centers, rare skull base pathologies pose unique diagnostic and surgical challenges. The discrepancy between preoperative and intraoperative findings often necessitates real-time strategic adaptations. In these rare cases, for optimizing patient outcomes requires a comprehensive understanding of skull base anatomy, flexibility in surgical planning, readiness for sudden strategy modifications, and a multidisciplinary approach.