Bone removal with a new ultrasonic bone curette during endoscopic endonasal approach to the sellar-suprasellar area: technical note.

Abstract

Accessing intradural lesions via an extended endoscopic endonasal approach requires a relatively large bony removal over the skull base. We describe the Sonopet ultrasonic bone curette with a new dedicated endonasal hand-piece. We used this ancillary device in 27 nonconsecutive endonasal procedures for different skull base lesions (18 standard pituitary operations and 9 extended approaches for either meningiomas or craniopharyngiomas). The ultrasonic bone curette with endonasal hand-piece was easy to use and effective during the removal of the bone covering or when close to the carotid and optic prominences, as well as in preserving the integrity of the superior intercavernous sinus. In only 1 case was small tearing of the dura mater observed during the bony removal. No cases of injury to the major neurovascular structures occurred. The Sonopet ultrasonic bone curette is a useful tool during endoscopic endonasal skull base surgery.