International consensus statement on endoscopic skull‐base surgery: executive summary

Endoscopic skull-base surgery (ESBS) is a rapidly growing discipline that often combines the expertise of otolaryngology-head and neck surgeons and neurosurgeons to provide care for these challenging conditions. As the field has grown, so too has the literature evaluating this surgical approach and the challenges and complications associated with these interventions. An international, multidisciplinary effort to critically evaluate and grade the current literature on ESBS has resulted in the International Consensus Statement on Endoscopic Skull Base Surgery (ICAR:SB). This Executive Summary highlights the key findings of the ICAR:SB document.Following the prior methodology of the ICAR statements, the ICAR:SB document consists of 98 topics in ESBS that underwent a systematic review. When sufficient evidence exists, an evidence-based review with recommendation (EBRR) or evidence-based review (EBR) was created and then underwent an iterative review process until consensus was achieved. This Executive Summary recapitulates these findings.This summary complies the EBR and EBRR from the ICAR:SB document in the management of numerous skull-base pathologies including cerebrospinal fluid rhinorrhea, intradural tumors, sinonasal malignancies, and clival tumors, as well as the key issues of reconstruction after and the complications associated with ESBS.The ICAR:SB Executive Summary recaps the evidenced-based recommendations concerning the advantages, limitations and challenges of ESBS in the management of diverse skull-base pathologies. Although multifactorial in nature, the overall level of evidence in ESBS is modest. This represents an opportunity to address these knowledge gaps moving forward.