Jason Voorhees

ENT freak
Oct 24, 2013
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Hi...

I wanted to know what is the role of both the ENT and NS in procedures such as transsphenoidal and transcribiform approach for skull base tumors (pituitary adenomas, olfactory shcwannomas , to name a few)

Do fellowships trained rhinologists get to do the whole procedures without any help from NS??

Thanks in advance for your time!! Haha these forum rocks!!!
 

neutropeniaboy

Blasted ENT Attending
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Feb 10, 2002
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It's pretty institution dependent.

Here most of the sinus cancers are done by the H&N guys open, and when NS is required, they do the craniotomy and intracranial work.

For pituitary surgeries, our sinus guys do the approach and NS does the resection and csf leak repair.

I'm willing to bet the approaches are primarily ENT and any intracranial tumor resection is done by NS. Some ents may do all the reconstruction. Some may do none of it.
 

Leforte

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Feb 2, 2004
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As NPB indicated, it is institution dependent. When I got out, I teamed up with a new NS oncologist and she used me for all the endoscopic TN/TS approaches. She did the resection and I then did the closures. This eventually led to our working on other more advanced cases together. It really is a matter of your comfort level with your training, your availability and ability to work with NS. Many of their cases can go on for hours and this can have an impact on your own OR time. If you are in another room while NS finishes the resection, you'll need to be able to come back in quickly to close. I adjusted my academic time to coincide with the times that NS and I work together and use the time that they were doing their part to work on other things.
 

neutropeniaboy

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Personally, I think the sinus guys are all wanna be skull base surgeons. ;)

Lateral skull base... The only skull Base!
 

neutropeniaboy

Blasted ENT Attending
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Feb 10, 2002
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They do perform some cool stuff. Having done sinus surgery, of course, I can say that I much prefer the binocular vision and depth of field with the microscope. Since they don't have it done sinus surgery, I think that's a pretty good display of talent.