Evaluation of craniofacial endoscopic surgery

Low-level olfactory neuroblastoma is preferred by ESBS, but high-level olfactory neuroblastoma usually requires open-cranial surgeryThere is little data on cartilage sarcoma, but early results show that ESBS appears to have some advantage skilled in total removal and reducing the rate of disability as long as surgeons are familiar with complex surgical procedures- Excerpted from the article.Schwartz TH, etJ Neurosurg2019 Feb 1;130 (2):337-346doi: 10.3171/2018.10.JNS1821542006, Charles Wilson published an article in the British Medical Journal on the initiation and obstacles of new technologies for clinical application of neurosurgery, with the aim of illustrating that new technologies may pose risks and may prove in future practiceBecause the excitement of technological innovation often makes people forget an important prerequisite, which is whether new technologies improve the quality of clinical treatmentIf this prerequisite is not met, it should be abandonedHe cites cases such as superficial temporal-middle temporal bypass bypass, which was first used rapidly as an innovative treatment and later found to be ineffective, which was largely abandonedWilson points out that even if there are barriers to the introduction of new technologies, it is an inevitable trend to promote new technologies as long as they are proven to bring the greatest benefits to patients after they are strictly compared to existing technologiesendoscopic skull base surgery (ESBS) has been popularized in the field of neurosurgery as a new technology, but it also encounters certain doubts and obstaclesThe procedure is easy to use, offers a large number of courses to provide training opportunities for young doctors, and is known as "minimally invasive surgery" which is so attractive to patients that it is quickly rolled outHowever, many neurosurgery experts have questioned the effectiveness and safety of randomized controlled clinical trials that compare with traditional surgical methodsTheodore HSchwartz, of Neurosurgery at Cornell University New York Presbyterian Hospital, and others reviewed ESBS-related literature published between 2008 and 2012 and 2012 to 2017, reviewed the development of ESBS, compared the results of treatment for several different types of tumors with craniofacial surgery (transcranial surgery, TCS), summarized the benefits of ESBS and the direction of improvement The paper was published in J Neurosurg in February 2019 authors compared two different periods between 2012 and 2012-2017, using ESBS and TCS to remove craniopharyngoma (craniopharyngioma), pre-cranial bascommena (anterior skull base meningioma), oltheneuroblastoma (estheieuroblastoma or olfactory neuroblastoma), spinal protoma The efficacy of chordomas and cartilage sarcoma showed that the rate of total excision of ESBS was significantly better than TCS for cranial tube tumors and spinal stomas; TCS had a higher proportion of full excision of olphaculatoma and fewer postoperative complications Low-level olfactory neuroblastoma is preferred by ESBS, but high-level olfactory neuroblastoma usually requires open-cranial surgery There is little data on cartilage sarcoma, but early results show that ESBS appears to have some advantages in total removal and reduction of the residual rate as long as surgeons are familiar with complex surgical procedures (Tables 1-6) Table 1 ESBS and TCS to treat cranial pharynx tumor efficacy GTR: Full excision; CSF Leak: cerebrospinal fluid leakage Table 2 ESBS compared the efficacy of ESBS with TCS treatment of butterfly bone platform (PS) meningioma and saddle connox (TS) meningioma Table 3 ESBS and TCS to treat the effect of olphinmenacoma Table 4 ESBS and TCS to treat the efficacy of olfactory neuroblastoma Table 5 ESBS and TCS to treat spinal stoma efficacy Neuro-deficit: neurological dysfunction Table 6 ESBS and TCS to treat cartilage sarcoma efficacy authors concluded that the development of new surgical methods and ways to treat intracranial tumors needs to be compared with the existing traditional standard approach The evolution of the new surgical approach is closely related to the surgeon's learning process and the application of new equipment, helping to make the technology increasingly effective and safe ESBS is recognized as a minimally invasive technique in a range of cranial tumor therapy Looking back at recent literature on ESBS treatment of craniopharypharypharyum tube tumors, precranial meningiomas, olfactory neuroblastoma, spinal stoma and cartilage sarcoma, the authors believe that ESBS treatment of cranial tube tumors, spinal stoma, butterfly bone platform meningioma, saddle suk Conjunctivinoma, olphaculatoma and low-level olfactory neuroblastoma have obvious advantages, while for certain types and areas of tumors, ESBS is similar to or less effective in traditional ways, if no further improvement, ESBS is not the preferred surgical solution.