09-13, 09:30–10:00 (Europe/Istanbul), Rhinology 3 (HILTON-Connie 1)
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.
This proposal aims to present contemporary evidence and comprehensive insights into endoscopic skull base surgery (ESBS) reconstruction by synthesizing expert interviews with current evidence. Key topics include CSF leak management, defect site strategies, reconstructive techniques, and postoperative care. The findings provide stepwise algorithms and highlight commonalities, discrepancies, and areas requiring further research.
Edward Kuan, MD, MBA, FARS is Division Chief of Rhinology and Skull Base Surgery, co-director of the Comprehensive Skull Base Program, and Professor of Otolaryngology-Head and Neck Surgery and Neurological Surgery at the University of California, Irvine. He received his medical degree from UC Irvine. He then completed residency training in otolaryngology-head and neck surgery at UCLA, followed by fellowship training in rhinology and skull base surgery at the University of Pennsylvania.
His research interests include evidence-based skull base reconstruction and biological basis of and management principles for sinonasal tumors. He has published more than 350 peer-reviewed original articles, reviews, and book chapters in the highest-impact otolaryngology and neurosurgery journals and is a regular invited speaker for both clinical topics and his research nationally and internationally. He is actively involved in the American Rhinologic Society, serving on the Board of Directors as Education Coordinator; North American Skull Base Society; and Triological Society, where he is a fellow member.
He is the primary editor of a textbook on skull base reconstruction and is the primary editor of the International Consensus Statement on Allergy and Rhinology - Sinonasal Tumors document. He also serves as an associate editor of International Forum of Allergy & Rhinology and American Journal of Rhinology & Allergy, and also on the editorial board of Rhinology.