ANATOMICAL DISSECTION COURSE: 3D Exoscopic Skull Base Surgery and Expanded Endoscopic Transnasal Approaches

The course will be held in English and will be aimed at graduated surgeons (Neurosurgeons, Otolaryngologists, MaxillofacialSurgeons, Ophthalmologists) who want to deepen their knowledge and skills in the field of skull base surgery. Endonasal endoscopic approaches to the skull base have evolved significantly over 20 years, magnifying the surgical image and allowing the minimally invasive treatment of various pathologies. More recently, video surgery has evolved with exoscopic techniques, capable of magnifying the three-dimensional image of the surgical field in the open surgical accesses, replacing the microscope. The organization of the course includes two sessions, the first focused on exoscopy with transcranial and transorbital approaches, the second with transnasal and transorbital endoscopic approaches. The purpose of this innovative course is to provide learners with a solid anatomical and clinical basis to deal with the treatment of skull base pathologies through transcranial surgical approaches carried out in 3D exoscopy. This innovative method combines the qualities of traditional microscopic vision with a wider visualization of the surgical field, keeping a ll t he d etails i n f ocus t ogether with improved ergonomics. The second part of the course is aimed at advanced endonasal and transorbital endoscopic techniques to the skull base, in a concept of multiportal surgical approaches. These techniques concern surgical accesses for tumor resection and the consequent repair and reconstruction of defects. Complication control surgical techniques are also shown. Thanks to this didactic approach, the close collaboration between the various specialties involved in the treatment of skull base pathologies takes on the connotation of real team work. The training of couples of surgeons of different specialties is therefore promoted in order to achieve a surgical synergy. The course will also address in detail the diagnostic investigations and the technological tools necessary to deal with this type of pathology. It is a highly innovative course as it will allow the learner to develop practical surgical skills through exercises on anatomical preparations. In this way the learner will be able to concretely reproduce the surgical steps on the speciments that will be proposed both with video and performed directly by the teachers in the master station. Each session will be preceded by two anatomical and surgical techniques lessons, for a total of 5.5 hours, followed by 39 hours of guided anatomical dissection in exoscopy and endoscopy, including extensive discussion with the participants. At the end of the course, there is a written exam to evaluate the learning by the attendees.

FIRST SESSION - 27-28 September 2022

Day 1

08.00   Registration of participants

08:30  Orbit: corridor to skull base (P. Castelnuovo)

09:00  Anesthesiologic hints (A. Bacuzzi)

09:30  Video guided step-by-step esoscopic dissection (Faculty)

13.30  LUNCH

14:30  Anterior esoscopic approaches to skull base (D. Locatelli)

15.00 Video guided esoscopic step-by-step dissection (Faculty)

18.30 End Day 1

Day 2

08.30 Lateral esoscopic approaches to skull base (P. Veiceschi)

09.00 Video guided esoscopic step-by-step dissection (Faculty)

13.30 LUNCH

14.30 Temporoparietal fascial flap (G. Agresta)

      - Combined orbitotomies (D. Rabbiosi, F. Pozzi)

15:00 Video guided esoscopic step-by-step dissection (Faculty)

18.30 End of Day 2

SECOND SESSION - 29 September-1 October 2022

Day 1

08.00 Registration of participants
08.30  Endoscopic endonasal surgical anatomy of the skull base (A. Karligkiotis)
           – Imaging: Radiological anatomy and differential diagnosis of skull-base lesions (A. Mercusi)

09.30 Video guided step-by-step dissection (Faculty)

         Rescue flap, Hadad nasoseptal flap Pituitary and cavernous sinus  approaches 

13.30 LUNCH

14.00 Lunch with Maestro (P. Cappabianca)

14.30 Video guided step-by-step dissection (Faculty)

         Trans-planum, trans-tuberculumn approaches 

18.30 End of Day 1

Day 2

08.30  Multiportal approaches to the skull base (I. Dallan)
           – Sinonasal & skull-base malignant tumors (P. Battaglia)

09.30 Video guided step-by-step dissection (Faculty)

         Trans-clival. Draf procedures 

13.30 LUNCH

14:00 Lunch with Maestro (M. Iacoangeli)

14.30 Video guided step-by-step dissection (Faculty)

         Transcribriform approach, Endoscopic partial maxillectomies

18.30 End of Day 2

Day 3

08.30  Management of skull base complications (D. Locatelli)
09:00 Skull base reconstruction techniques (M. Turri Zanoni)

09.30 Video guided step-by-step dissection (Faculty)

         pterygopalatine fossa, infratemporal fossa

13.30 LUNCH

14:00 Lunch with Maestro (D. Mazzatenta, E. Pasquini)

14.30 Video guided step-by-step dissection (Facyulty)
          -UPPS (Nasopharyngectomy)

          -Endonasal intraconal approaches to orbit - optic nerve decompression

18:30  Take-home message and closing remarks (M. Bignami, P. Battaglia, D. Locatelli, P. Castelnuovo)

Gianluca Agresta

Alberto Daniele Arosio

Alessandro Bacuzzi

Paolo Battaglia

Maurizio Bignami

Lidia Bifone

Luca Cabrini

Frank Rikki Canevari

Paolo Cappabianca

Paolo Castelnuovo

Iacopo Dallan

Francesca De Bernardi

Giuseppe Di Giulio

Roberto Gera

Andrea Giorgianni

Maurizio Iacoangeli

Apostolos Karligkiotis

Alessia Lambertoni

Davide Lepera

Davide Locatelli

Diego Mazzatenta

Anna Mercuri

Ernesto Pasquini

Graziano Pavan

Andrea Pistochini

Fabio Pozzi

Dimitri Rabbiosi

Federico Russo

Antonio Tabano

Mario Turri-Zanoni

Marco Valentini

Pierlorenzo Veiceschi

Luca Volpi