RNfinity
Research Infinity Logo, Orange eye of horus, white eye of Ra
  • Home
  • Submit
    Research Articles
    Ebooks
  • Articles
    Academic
    Ebooks
  • Info
    Home
    Subject
    Submit
    About
    News
    Submission Guide
    Contact Us
  • Login/sign up
    Login
    Register

Biomedical

The learning curve in endoscopic transsphenoidal skull-base surgery: a systematic review

rnfinity

info@rnfinity.com

orcid logo

Abdulraheem Alomari,

Abdulraheem Alomari


Mazin Alsarraj,

Mazin Alsarraj


Sarah Alqarni

Sarah Alqarni


  Peer Reviewed

copyright icon

© attribution CC-BY

  • 0

rating
456 Views

Added on

2024-12-17

Doi: https://doi.org/10.1186/s12893-024-02418-y

Related Subjects
Anatomy
Biochemistry
Epidemiology
Genetics
Neuroscience
Psychology
Oncology
Medicine
Musculoskeletal science
Pediatrics
Pathology
Pharmacology
Physiology
Psychiatry
Primary care
Women and reproductive health

Abstract

Background

The endoscopic endonasal transsphenoidal approach (EETA) has revolutionized skull-base surgery; however, it is associated with a steep learning curve (LC), necessitating additional attention from surgeons to ensure patient safety and surgical efficacy. The current literature is constrained by the small sample sizes of studies and their observational nature. This systematic review aims to evaluate the literature and identify strengths and weaknesses related to the assessment of EETA-LC.

Methods

A systematic review was conducted following the PRISMA guidelines. PubMed and Google Scholar were searched for clinical studies on EETA-LC using detailed search strategies, including pertinent keywords and Medical Subject Headings. The selection criteria included studies comparing the outcomes of skull-base surgeries involving pure EETA in the early and late stages of surgeons’ experience, studies that assessed the learning curve of at least one surgical parameter, and articles published in English.

Results

The systematic review identified 34 studies encompassing 5,648 patients published between 2002 and 2022, focusing on the EETA learning curve. Most studies were retrospective cohort designs (88%). Various patient assortment methods were noted, including group-based and case-based analyses. Statistical analyses included descriptive and comparative methods, along with regression analyses and curve modeling techniques. Pituitary adenoma (PA) being the most studied pathology (82%). Among the evaluated variables, improvements in outcomes across variables like EC, OT, postoperative CSF leak, and GTR. Overcoming the initial EETA learning curve was associated with sustained outcome improvements, with a median estimated case requirement of 32, ranging from 9 to 120 cases. These findings underscore the complexity of EETA-LC assessment and the importance of sustained outcome improvement as a marker of proficiency.

Conclusions

The review highlights the complexity of assessing the learning curve in EETA and underscores the need for standardized reporting and prospective studies to enhance the reliability of findings and guide clinical practice effectively.

Key Questions

1. What is the endoscopic endonasal transsphenoidal approach (EETA)?

EETA is a minimally invasive surgical technique used to access the skull base and pituitary region through the nasal passages.

2. Why does EETA have a steep learning curve?

The complexity of the anatomy, the need for advanced endoscopic skills, and the management of potential complications contribute to the steep learning curve.

3. How many cases are needed to overcome the EETA learning curve?

The median estimated number of cases required is 32, with a range from 9 to 120 cases, to achieve proficiency.

4. What factors influence the learning curve in EETA?

Factors include the surgeon's prior experience, the complexity of cases, availability of advanced equipment, and quality of training programs.

5. How can the learning curve for EETA be improved?

Implementing standardized training protocols, utilizing simulation-based education, and engaging in mentorship programs can help flatten the learning curve.

Summary Video Not Available

Review 0

Login

ARTICLE USAGE


Article usage: Dec-2024 to May-2025
Show by month Manuscript Video Summary
2025 May 127 127
2025 April 65 65
2025 March 64 64
2025 February 61 61
2025 January 109 109
2024 December 30 30
Total 456 456
Show by month Manuscript Video Summary
2025 May 127 127
2025 April 65 65
2025 March 64 64
2025 February 61 61
2025 January 109 109
2024 December 30 30
Total 456 456
Related Subjects
Anatomy
Biochemistry
Epidemiology
Genetics
Neuroscience
Psychology
Oncology
Medicine
Musculoskeletal science
Pediatrics
Pathology
Pharmacology
Physiology
Psychiatry
Primary care
Women and reproductive health
copyright icon

© attribution CC-BY

  • 0

rating
456 Views

Added on

2024-12-17

Doi: https://doi.org/10.1186/s12893-024-02418-y

Related Subjects
Anatomy
Biochemistry
Epidemiology
Genetics
Neuroscience
Psychology
Oncology
Medicine
Musculoskeletal science
Pediatrics
Pathology
Pharmacology
Physiology
Psychiatry
Primary care
Women and reproductive health

Follow Us

  • Xicon
  • Contact Us
  • Privacy Policy
  • Terms and Conditions

5 Braemore Court, London EN4 0AE, Telephone +442082758777

© Copyright 2025 All Rights Reserved.