A review of clinical and surgical outcomes of endoscopic endonasal skull base surgery in a Tertiary Center in Sarawak

Background: Endoscopic endonasal approach (EEA) for skull base tumor has been extensively developed in recent years. Objectives: To review the demographic data, indications, clinical presentations and surgical outcomes of endoscopic endonasal skull base surgeries performed. Methods: A retrospective analysis on all patients who had undergone endoscopic endonasal skull base surgery at the Skull Base Unit (ENT & Neurosurgery) from December 2013 to December 2015. Results: A total 34 cases were operated on during the study period. Female patients account for 44% of patients while 56% were male patients, with ages ranging from 8 to 77 years, with the mean age of 51.88 years. Majority of the cases were pituitary tumors (41%), followed by sinonasal tumors (15%), meningioma (12%), clival tumor (8%), cerebrospinal fluid (CSF) leak repair (8%) and frontal mucocoele (6%). Transsellar approach was the commonest approach (41%) followed by the transclival, transplanum, transfrontal approaches. In about 80% of cases, CSF leak was encountered intraoperatively and was successfully repaired endoscopically with the Hadad-Bassagasteguy flap and with the insertion of a lumbar drain. Only one case (3%) of CSF leak was noted postoperatively which was then successful repaired endoscopically with a nasoseptal flap. Systemic complications and intracranial infections were seen in 3 cases (8%) and were managed accordingly. No cases of epitaxis requiring surgical intervention were noted post operatively

Stress myocardial perfusion imaging for the evaluation and triage of chest pain in the emergency department: A randomized controlled trial

10.1007/s12350-013-9736-9Journal of Nuclear Cardiology2061002-1012JNCA