High definition endoscope

A collaborating team (otolaryngologists and neurosurgeons) performed all surgeries via the EEA by using the two-surgeon, binostril, three- to four-hand technique under direct visualization via a high-definition endoscope (Karl Storz, Tuttlingen, Germany). A Vector Vision Sky (Brainlab, Munich, Germany) or S7 (Medtronic, Fridley, MN, USA) navigation system was used for anatomical identification. The otolaryngologist was in charge of scoping all surgical procedures and surgical procedures from the nasal cavity to the preparation of sphenoid sinus bony resection. Moreover, at the end of the surgery, the otolaryngologist performed the reconstructive procedures making the SSMF and packing the nasal cavity. Meanwhile, the neurosurgeon was in charge of opening the sellar floor, all skull bases, and clivus. Furthermore, the neurosurgeon was in charge of the tumor resection, dural suturing, and multilayer cranial base repair.