Cranial Base Surgery

Drs. L. Dade Lunsford, Carl H. Snyderman, and Paul Gardner discuss cranial base surgery.

Educational objectives:

Upon completion of this activity, participants should be able to:

•Discuss the history of stereotactic radiosurgery (SRS)
•Describe the application of SRS in skull base tumors
•Define objectives of SRS as an alternative or adjuvant management for skull base tumors
•List the major advancements in skull base surgery
•Describe the principles of open and endoscopic skull base surgery
•Discuss factors that contributed to the success of the skull base surgery program at the UPMC.
•Describe the limitations of the endoscopic endonasal approach
•List techniques for achieving hemostasis
•Discuss the principles of endoscopic endonasal surgery

Reading Resources:

1. Kano H, Lunsford LD, Flickinger J, Yang, H-C, Flannery T, Awan N, Niranjan A, Novotny J, Kondziolka D:  Stereotactic radiosurgery for arteriovenous malformations, Part 1: management of Spetzler-Martin grade I and II AVMs.  J Neurosurg 116(1), 11-20, 2012.
2. Kano H, Kondziolka D, Flickinger J, Yang, H-C, Flannery T, Awan N, Niranjan A, Novotny J, Lunsford LD:  Stereotactic radiosurgery for arteriovenous malformations, Part 2: management of pediatric patients.  J Neurosurg Ped 9(1), 1-10, 2012.
3. Kano H, Kondziolka D, Flickinger JC, Yang HC, Park KJ, Flannery TJ, Liu X, Niranjan A, Lunsford LD.  Aneurysms increase the risk of re-bleeding after stereotactic radiosurgery for hemorrhagic arteriovenous malformations.  Stroke 2012(43), 2586-2591, 2012. (http://stroke.ahajournals.org/content/early/2012/08/09/STROKEAHA.112.664045) ePub, 8/9/2012.
4. Snyderman CH, Carrau RL, Kassam AB, Zanation A, Prevedello D, Gardner P, Mintz A.  Endoscopic skull base surgery: principles of endonasal oncological surgery.  J Surg Oncol. 2008 Jun;97(8):658-64.
5. Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB.  What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base.  Keio J Med.  2009  Sep;58(3):152-60.
6. Hartl DM, Ferlito A, Silver CE, Takes RP, Stoeckli SJ, Suarez C, Rodrigo JP, Sesterhenn AM, Snyderman CH, Terris DJ, Genden EM, Rinaldo A.  Minimally invasive techniques for head and neck malignancies: current indications, outcomes and future directions.  Eur Arch Otorhinolaryngol.  2011 Sep;268(9):1249-57. 
7. Kassam A, Snyderman CH, Carrau RL, Gardner P, Mintz A.  Endoneurosurgical hemostasis techniques: lessons learned from 400 cases.  Neurosurg Focus.  2005 Jul 15;19(1): E7.
8. Snyderman CH, Carrau RL, Kassam AB, Zanation A, Prevedello D, Gardner P, Mintz A.  Endoscopic skull base surgery: principles of endonasal oncological surgery.  J Surg Oncol. 2008 Jun;97(8):658-64.
9. Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB.  What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base.  Keio J Med.  2009  Sep;58(3):152-60.

Disclosures:

Dr. Lunsford has financial interests with the following any entity or entities producing health care goods or services as indicated below:

• Consultant: Eleckta AB, Stockholm
• Stockholder: Eleckta AB, Stockholm

Doctors Snyderman and Gardner have no relevant relationships with any entities producing health care goods or services.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits^TM and self-assessment credits toward Part 2 of the ABS MOC Program. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 4/25/2013 | Last Modified On: 4/25/2013 | Expires: 4/25/2014