Endoscopy is a tool that enables neurosurgeons reach areas in the brain and spinal cord through minimally invasive methods. Such sections were previously accessible only by invasive methods that limited the ability to see the areas of interest. Medical experts are increasingly caring for patients who have undergone surgery for hydrocephalus, Pituitary tumors, peripheral nerve problems, and other intracranial issues. Endoscopic-assisted surgery is an important tool in the neurosurgical armamentarium. The neuroendoscopic technique has laid its roots in the early 20th century. At first, it is used to treat hydrocephalus and removal of the choroid plexus. The new advanced neurosurgeons let neurosurgeons use them in the subarachnoid space and to use their excellent light quality and optical resolution. The neuro endoscope is used in different intracranial procedures as the main tool and used to treat different pathologies.
Endoscopes are used in the skull base surgery to supplement the traditional microscopic visualization technique. In these surgeries, endoscopy increases the exposure of the operative field and offers new information for the surgeon.
Aneurysm Surgery: Surgical clipping is the treatment alternative for intracranial aneurysms. Endoscopy has several benefits in comparison with a micromirror during aneurysm surgery.
Cerebellopontine Angle: The cerebellopontine angle (CPA) is a critical area of the skull base, with vast neurovascular structures and little space. The tumors found in the CPA will disturb the brain stem, nerve function, cerebellum, and Cerebrospinal fluid circulation. Using endoscopy, you can remove such types of tumors, reducing the extra retraction of nerves and vessels.
Vestibular Schwannoma: These are benign tumors that arise from the vestibulocochlear nerve. Endoscopy is used to treat vestibular schwannomas.
Intraparenchymal Lesions Of The Brainstem And Cerebellum: The neurosurgical approach to deep-seated intraparenchymal lesions of the cerebellum and particularly of the brainstem should be kept small to avoid unwanted injuries. In cases of deep-seated brainstem and cerebellum lesions, the patient should be treated with an endoscope.
Meningioma: Surgery of skull base meningiomas is critical. The frequently demanding approach, the close relation with important neurovascular structure, and the possible involvement of bone are the adversities found during the surgical treatment of this complex disease.
The step before treatment of skull base abnormalities is the individual understanding of the disease, the patient’s expectation, and the patient’s anatomy. You can choose the best treatment by analyzing imaging examination and recognition of important anatomical structures, understanding the clinical presentation, and patients’ expectations.
Surgical Clipping: during aneurysm clipping, the endoscopic technique used in combination with the standard microscopic visualization can bring several advantages.
Cerebellopontine Angle Tumor Resection: endoscopy helps in situations maximizing the exposure of the surgical field during the operations in the CPA.
Intrameatal Tumor Resection: Endoscopy is useful during surgery with a deep extension inside the canal.
Microvascular Decompression: The endoscopes are used to inspect the trigeminal and facial nerve root. Using this technique, you can identify the compression site, identify multiple spots of neurovascular contact, and assure decompression at the end of surgery.
Endoscopy is used to treat pathologies including hemifacial spasm, vestibular schwannomas, epidermoid tumors, anterior fossa meningiomas, and aneurysms to get some additional information on the target.