Edward Kuan
Sessions
Contemporary Evidence in Sinonasal Malignancy Treatment 2026
Endoscopic skull base surgery (ESBS) reconstruction principles remain a topic of limited consensus. This lecture summarizes the evidence, controversies, and comprehensive themes by synthesizing the experiences of ESBS experts and comparing these insights with current published evidence. We present the findings from this project involving qualitative interviews with 68 experts from 40 academic teams across 13 countries. Based on these interviews, 10 stepwise algorithms for common skull base reconstruction scenarios were proposed. Specific topics include cerebrospinal fluid (CSF) leak flow rate, defect site, the role of extranasal flaps and impact of radiation, layers of reconstruction, reconstructive materials, nasal packing, tissue sealants, lumbar drains, and postoperative management. Commonalities and discrepancies among expert practices were summarized. While ESBS reconstruction remains complex with diverse strategies, the focus of this project and talk is to showcase this work which aims to guide surgeons by pooling extensive expert experience. Further research with higher-quality evidence is needed to standardize and optimize management approaches in this challenging field.