• Giacomo Bertolini, Harisinh Parmar, Sajeev Vadakkedam, Nargiza Saatova, Tamerlan Koniev, Ranjeet Chaurasia, Diego Mazzatenta, and Iype Cherian.
• Department of Neurologic Surgery, Krishna Institute of Medical Sciences, Karad, India; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. Electronic address: giacomo.bertolini@studio.unibo.it.
• World Neurosurg. 2022 Nov 1; 167: 152155152-155.

ObjectiveThe endoscope and exoscope are gaining momentum as alternative visualization tools in the neurosurgical field, trying to overcome the limitations of an operative microscope and support minimally invasive approaches. However, few case series are available in the literature regarding their use in skull base surgery, especially in combined assisted resection, and their usefulness still needs to be proved.MethodsAn illustrative case to present the feasibility and minimally invasive advantages of a combined exoscopic- and endoscopic-assisted resection is reported.ResultsA 22-year-old man presented with a history of seizures and dizziness. Brain imaging showed a lesion involving the anteromedial middle fossa invading the interpeduncular cistern and impinging the brainstem, suggestive of an epidermoid cyst. A combined exoscopic- and endoscopic-assisted resection through a pterional transcavernous approach was planned and performed. No neurologic deficit occurred after the surgery, providing further evidence about the usefulness and safety of this hybrid technique.ConclusionsCombined exoscopic and endoscopic resection is also feasible and safe in complex skull base surgery. Moreover, this technique seems to be effective for minimizing the surgical invasiveness in skull base lesions.Copyright © 2022 Elsevier Inc. All rights reserved.

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