Management of Complications of Endonasal Cranial Base Surgery

Endoscopic endonasal surgery of the cranial base is maximally invasive surgery and poses many of the same risks as traditional skull base approaches. Preliminary data demonstrates that serious complications can be avoided through a strong foundation in endoscopic skull base anatomy, adherence to principles of surgical dissection, and a dedicated surgical team with proper training and experience. Surgical complications may be categorized by severity, location, organ system or tissue type, and time period. Advances in reconstruction have decreased the incidence of CSF leaks to less than 5%. Major complications such as vascular injury are rare and can be managed using endoscopic techniques. Nasal morbidity is acceptable.