Prevention and management of complications in intracranial endoscopic skull base surgery

Development of minimally invasive approaches has become a significant driver across surgical specialties in recent years. Purely endoscopic resections with proper attention to oncologic margins are now possible, with the potential benefit of decreased perioperative morbidity and improved cosmesis compared with traditional open transfacial or craniofacial approaches. Efforts to reduce perioperative morbidity and mortality have been applied with increasing sophistication in the most complex anatomic regions of the human body, including the head and neck. These efforts have resulted in an expanded role of purely endoscopic approaches to the paranasal sinuses, the anterior skull base, and the anterior cranial fossa. This article reviews the current understanding and available literature regarding the diagnosis and management of complications associated with endoscopic anterior skull base surgery.