The term is used basically for all procedures that are performed with the help of endoscopes.

Neuroendoscopy History.

Neuroendoscopy Indications.

Endoscopic procedures may be performed purely endoscopic, for example for the treatment of occlusive hydrocephalus and cystic lesions or in combination with the operating microscope for example for the treatment of large tumors of the skull base or vascular lesions. The latter technique is named endoscope-assisted microsurgery (EAM). If endoscopes are used as the only optical tool but manipulations performed along the scope, it is referred to as endoscope-controlled microsurgery (ECM). This technique is recently more and more applied for transnasal skull base surgery.

Endoscopic surgery and endoscope-assisted microsurgery are part of the management paradigm for many neurosurgical diseases.

Improvements in endoscopic techniques in neurosurgery have led to their being utilized not only for endonasal approaches to the skull base but also as an adjuvant in open cranial surgery. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10).

see Endoscopic skull base surgery

see Endoscopic surgery for intracerebral hemorrhage.

see Intraventricular neuroendoscopy.

Endoscopic endonasal approach for pituitary adenoma

Endoscopic endonasal approach for pituitary adenoma


Neuroendoscopic Surgery

The development and refinement of neuroendoscopy has been driven by the persistent desire of neurosurgeons to advance the field and offer less invasive, more efficacious options to patients. This remarkable multimedia book reflects the technological advances achieved in the last two decades in optical fibers, cold light, cameras, and endoscopic instrumentation. Written by an impressive Who’s Who of international neurosurgeons, the outstanding text and videos reflect global contributions to neuroendoscopy.

Current indications for intracranial and intraventricular endoscopy are described in depth, through detailed chapters, stellar videos, professional animations, and exquisite illustrations. The authors share their clinical expertise on procedures ranging from endoscopic third ventriculostomy to transventricular approach of the fourth ventricle. Cover to cover, this book details the differences, alternatives, advantages, and limitations of the flexible neuroendoscope.

This hands-on learning tool will enable neurosurgeons to perform endoscopy of the ventricles and basal cisterns for exploratory purposes and conditions such as hydrocephalus, congenital aqueductal stenosis, tumors, hypothalamic hamartoma, arachnoid cysts, and neurocysticercosis. Additional topics include endoscopic-assisted microvascular decompression and aneurysm surgery, fluorescence, complications, anesthesia, utilization in developing countries, and future trends.

Key Features:

Comprehensive multimedia reference with online access to 50 videos More than 300 meticulously drawn illustrations Beautifully illustrated anatomical chapters that facilitate in-depth understanding of endoscopic anatomy An entire chapter devoted to flexible neuroendoscopy Indications, preoperative preparation, procedure description, intraoperative complications and their management (““risk and rescue”” techniques), expert pearls, postoperative management, and outcomes This volume is a must-have resource for neurosurgery and neurology residents, neurosurgeons, pediatric neurosurgeons, and all physicians involved in the care of patients with intracranial and intraventricular disease.

Cerebrospinal fluid shunt

Tumor biopsy


Endonasal surgery

Ventriculo-cisternal approaches

Brain parenchymal surgery

Skull base surgery.

Pure neuroendoscopic approaches are predominantly used in the treatment of intraventricular and intracystal pathologies, as well as in transnasal approaches to the cranial base.

The majority of endoscopic intraventricular surgery is performed for cerebrospinal fluid (CSF) diversion, but is also frequently used for colloid cyst resection, tumor biopsy, and arachnoid cyst treatment. Improved technology has given the neuroendoscopist an additional margin of confidence by means of improved visualization: preoperative 1.5-T and 3-T magnetic resonance imaging with constructive interference in steady state/fast imaging using steady-state acquisition sequences, high-definition cameras (2 million pixels), and coupling of navigation to the endoscope system.

During the development of these technologies over the past 20 years, multiple large series have reported on complications associated with endoscopic neurosurgery.

see Extended endoscopic endonasal approach

see Endoscopic endonasal approach


Neuroendoscopy complications.

Cavallo LM, Messina A, Cappabianca P, et al. Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurgical focus. Jul 15 2005;19(1):E2.
Cavallo LM, Messina A, Gardner P, et al. Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomical study and clinical considerations. Neurosurgical focus. Jul 15 2005;19(1):E5.
Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurgical focus. Jul 15 2005;19(1):E3.
Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R. Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurgical focus. Jul 15 2005;19(1):E6.
Kassam AB, Snyderman C, Gardner P, Carrau R, Spiro R. The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery. Jul 2005;57(1 Suppl):E213; discussion E213.
Fischer G, Oertel J, Perneczky A. Endoscopy in aneurysm surgery. Neurosurgery. Jun 2012;70(2 Suppl Operative):184-190; discussion 190-181.
Fries G, Perneczky A. Endoscope-assisted brain surgery: part 2–analysis of 380 procedures. Neurosurgery. Feb 1998;42(2):226-231; discussion 231-222.
Perneczky A, Fries G. Endoscope-assisted brain surgery: part 1–evolution, basic concept, and current technique. Neurosurgery. Feb 1998;42(2):219-224; discussion 224-215.
Kalavakonda C, Sekhar LN, Ramachandran P , Hechl P . Endoscope-assisted microsurgery for intracranial aneurysms. Neurosurgery. Nov 2002;51(5):1119-1126; discussion 1126- 1117.
Apuzzo ML, Heifetz MD, Weiss MH, Kurze T. Neurosurgical endoscopy using the side- viewing telescope. Journal of neurosurgery. Mar 1977;46(3):398-400.
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