F AC U LTY

Neurosurgery:1 Daniel Prevedello2 Verena Gellner 3 Marco Verstegen4 Wouter van Furth ENT:1 Ricardo Carrau2 Paolo Castelnuovo3 Iacopo Dallan4 Isam Alobid 5 Christos Georgalas 6 Sean Carrie 7 Philippe Herman8 Marc Jorissen9 Maarten Kleijwegt10 Jose Hardillo

3rd Endoscopic Skull base Masterclass and Symposium

22nd, 23rd and 24th of June 2016Leiden University Medical Center

Leiden, The Netherlands

WEDNESDAY 22ND JUNE 2016

MINI SYMPOSIUM Management of sinonasal and skull base malignancies: In this mini symposium the current management of sinonasal and skull base malignant tumors will be discussed. The symposium uses the format of organised mini-debates where controversial topics are discussed after an expert argues in favour, and one argues against a proposition. Short “how do I do it” and “teaching pearls” lectures are used to update the participants of the latest developments. Cases presented by the moderator will be discussed by panel of experts

12:30 - 13.00 Registration

13:00 - 13:30 Welcome and introduction of participants

1 Sinonasal tumors Diagnosis, Staging and Decision – Making

13:30 - 14:15 moderator: Georgalaspanel members: Hardillo, Kleiwegt, Jorissen, Castelnuovo10 min presentation of introduction and 1 case by moderator followed by 2 faculty members commenting and participant discussion total of 15 min. • From diagnosis to work-up: The role of CT, MRI and PET (Hardillo)

• Adenocystic carcinoma of the paranasal sinus with pulmonary nodule • Follow up after surgery: How long, how often and how: The role of imaging (Kleiwegt)

• Olfactory neuroblastoma Kadish C / Dulguerov T4 three years after transnasal craniectomy: Endoscopy, MRI or PET CT for follow up?

• The role of Histology in management decision – making: (Castelnuovo) • Grade 3-4 Olfactory Neuroblastoma, SNUC and Neuro-Endocrine tumors

• Intraoperative surgical margins and frozen section: Always, sometimes, never? (Jorissen)

2 Controversial Indications : The role of surgery, chemotherapy and radiotherapy

14:15 - 15:00 moderator: Castelnuovopanel members: Jorissen, Castelnuovo, Carrau, Carrie)6 min per speaker (1 defending, 1 attacking the statement) 3 min discussion with participants, 15 min per statement• Unilateral surgery followed by DxT is the treatment of choice in a 60 year old patient with a Unilateral

Olfactory Neuroblastoma reaching but not eroding the skull base (Jorissen for, Castelnuovo against)• (Neo-adjuvant) Chemotherapy is indicated for a 42 year old with a SNUC with intracranial extension (Carrie

for, Herman against)• Prophylactic treatment of the neck in Kadish C olfactory neuroblastoma is always indicated (Carrau for/

Castelnuovo against)• Orbital exenteration is indicated in a 41 year old with an non-ITAC adenocarcinoma “involving” the orbit (i.e

eroding lamina papyracea and compressing (microscopically invading?) the periorbita (Carrie for/ Carrau against)

15:00 - 15:30 Tea break

3 Surgical state of the art: How I do it (Castelnuovo, Carrau, Herman, Jorissen)

15:30 - 16:00 Adenocarcinoma of the paranasal sinus: Our technique (Jorissen)

16:00 - 16:30 Management of chondrosarcomas and chordomas of the petroclival region (Carrau)

16:30 - 17:00 Endoscopic naso-pharyngectomy for NPC: How I do it (Herman)

17:00 - 17:30 Nuances in technique for malignant sinonasal tumors (Castelnuovo).

17:30 - 18:00 Closing statement – Consensus on management of paranasal malignancies (Jorissen, Herman, Castelnuovo, Carrau)

THURSDAY 23ND JUNE 2016

LECTURES 08:00 - 08:30 Trans - Sphenoidal route Endoscopic anatomy of the nasal and sella region CARRIE

08:30 - 09:00 Pituitary surgery - tips and tricks VERSTEGEN

09:00 - 09:30 Trans - Planum and Trans -Tuberculum

Endoscopic anatomy of the transplanum and transtuberculum approach - TS Meningiomas VAN FURTH

09:30 - 10:00 Surgery of craniopharyngiomas GELLNER

10:00 - 10:30 Coffee break (30 minutes)

10:30 - 10:45 Trans - Clivus Anatomy of the transclival approach PREVEDELLO

10:45 - 11:00 Surgical technique of the transclival approach - posterior fossa chordomas PREVEDELLO

11:00 - 11:15 Miscellaneous I Collaboration between ENT and Neurosurgeon GEORGALAS

11:15 - 11:45 Closure of CSF leaks and the use of a pericardial flap ALOBID

11:45 - 12:15 New technologies in Endoscopic Skull Base surgery BREEDVELD

12:15 - 13:30 Joint Photograph and Lunch (1h 15 min)

DISSECTION 13:30 - 14:30 Transphenoida l route (20 minutes demonstration - 40 minutes participant dissection)

14:30 - 15:30 Transplanum / Transtuberculum

(20 minutes demonstration - 40 minutes participant dissection)

15:30 - 16:00 Coffee Break

16:00 - 18:00 Transclivus 20 minutes demonstration - 40 minutes participant dissection)

FRIDAY 24TH JUNE 2016

LECTURES 08:00 - 08:15 Transpterygoid / Lateral Window

Anatomy of the transpterygoid window DALLAN

08:15 - 08:30 Transpterygoid approach: surgical technique DALLAN

08:30 - 09:00 Tumors of the petrous apex VAN FURTH

09:00 - 09:15 Transcribriform Anatomy of the transcribriform window GEORGALAS

09:15 - 09:30 Surgical technique of the transcribriform approach - GEORGALAStips and tricks

09:30 - 09:45 Malignant sinonasal tumors - evidence and controversies JORISSEN

09:45 - 10:15 Coffee break(30 minutes)

10:15 - 10:45 Orbital window Transorbital / Transpalpebral windows DALLAN

10:45 - 11:15 Miscellaneous II Systematic approach to skull base reconstruction CARRAU

11:15 - 11:45 Dealing with catastrophic bleeding PREVEDELLO

11:45 - 12:15 QOL issues in Endoscopic Skull Base Surgery ALOBID

12:15 - 12:45 Complications of endoscopic skull base surgery CARRAU

12:45 - 13:45 Lunch (1h)

DISSECTION 13:45 - 14:45 Ethmoidectomy / Draf 3 20 minutes demonstration - 40 minutes participant dissection)

14:45 - 15:45 Transcribriform approach 20 minutes demonstration - 40 minutes participant dissection)

15:45 - 16:16 Coffee Break

16:15 - 17:15 Transpterygoid approach / Transorbital approach

20 minutes demonstration - 40 minutes participant dissection)