Endoscopic Endonasal Skull Base Surgery

Endoscopic endonasal skull base surgery (EESBS) is a minimally-invasive surgical procedure used to treat pathologies of the skull base, the interface of the sinonasal passages and the brain. Roughly 20,000 EESBS cases are performed in the US annually. During EESBS, the pathology is accessed by making a defect in the dura mater, a membrane between the sinonasal and intracranial space, which may cause cerebrospinal fluid (CSF) leakage during the procedure. Repair of the dural defect with grafts is a critical step, as a postoperative CSF leak may result in reoperation, a 10% to 40% risk of meningitis, or even death. Thus, EESBS is only as effective as its reconstruction. However, reconstruction is challenging and time-intensive due to limited surgical tools and anatomical variables such as pressure from CSF pulsations. Thus, surgeons need a method that reduces the technical difficulty of reconstruction. Our solution is a surgical instrument that allows surgeons to simultaneously tuck multiple sides of the graft underneath the dura during reconstruction, thereby reducing operating time and the risk of postoperative CSF leaks.

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