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Journal of Neurological Surgery. Part B, Skull Base

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https://www.readbyqxmd.com/read/29765831/quality-of-life-before-and-after-endoscopic-pituitary-surgery-as-measured-by-the-short-form-36
#1
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Angela Oh, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses  To assess quality of life (QOL) after transnasal, endoscopic pituitary surgery using the 36-item short form (SF-36) instrument. Design  Retrospective review was used for this study. Setting  The study was conducted in a tertiary academic medical center. Participants  Patients who underwent endoscopic, transnasal, transsphenoidal surgery for pituitary adenomas between January 1, 2007 and July 1, 2016 and completed preoperative and postoperative SF-36 surveys. Main Outcome Measures  SF-36 survey data as measured by its eight domains (physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, social functioning, pain, and general health)...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765830/long-term-facial-nerve-outcomes-after-microsurgical-resection-of-vestibular-schwannomas-in-patients-with-preoperative-facial-nerve-palsy
#2
Michael A Mooney, Benjamin Hendricks, Christina E Sarris, Robert F Spetzler, Kaith K Almefty, Randall W Porter
Objectives  This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design  A retrospective review. Setting  Single-institution cohort. Participants  Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures  Incidence, House-Brackmann grade. Results  Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765829/injury-of-the-carotid-artery-during-endoscopic-endonasal-surgery-surveys-of-skull-base-surgeons
#3
Nicholas R Rowan, Meghan T Turner, Benita Valappil, Juan C Fernandez-Miranda, Eric W Wang, Paul A Gardner, Carl H Snyderman
Objectives  This study aimed to review endoscopic skull base surgeon experience with internal carotid artery (ICA) injuries during endoscopic endonasal surgery (EES) to provide an estimate of the incidence of ICA injury, the associated factors and identify the best training modalities for the management of this complication. Design  Anonymous electronic survey of past participants at a well-established endoscopic skull base surgery course and a global online community of skull base surgeons. Main Outcome Measures  Relative incidence of ICA injuries during EES, associated anatomic and intraoperative factors, and surgeon experience...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765828/a-cross-sectional-survey-of-the-north-american-skull-base-society-on-vestibular-schwannoma-part-2-perioperative-practice-patterns-of-vestibular-schwannoma-in-north-america
#4
Jamie J Van Gompel, Matthew L Carlson, R Mark Wiet, Nicole M Tombers, Anand K Devaiah M, Devyani Lal, Jacques J Morcos, Michael J Link
Introduction  Perioperative care of vestibular schwannoma (VS) patients is extremely variable across surgeons and institutions making practice patterns difficult to standardize. No data currently exist detailing this practice variability. Methods  The North American Skull Base Society membership was electronically surveyed regarding perioperative care of surgically operated VS patients. Results  There were 87 respondents to the survey. Surgical positioning, surgical approach utilized, and perioperative medical adjuncts are quite variable...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765827/a-cross-sectional-survey-of-the-north-american-skull-base-society-current-practice-patterns-of-vestibular-schwannoma-evaluation-and-management-in-north-america
#5
Matthew L Carlson, Jamie J Van Gompel, R Mark Wiet, Nicole M Tombers, Anand K Devaiah, Devyani Lal, Jacques J Morcos, Michael J Link
Background  Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods  This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results  A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765826/rates-and-locations-of-regional-metastases-in-sinonasal-malignancies-the-mayo-clinic-experience
#6
Brandon W Peck, Kathryn M Van Abel, Eric J Moore, Daniel L Price
Objectives  The objective of this study was to identify factors that may influence the rate and location of regional metastasis in sinonasal malignancies (SNMs). Design  This is a retrospective review. Setting  This study was set at the single-institution tertiary referral center. Participants  A total of 299 patients were treated for SNMs from 1994 to 2014. Main Outcome Measures  The main outcome measures were incidence and distribution of regional metastases. Results  Several histologic subtypes were treated, with squamous cell carcinoma (28...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765825/early-career-surgical-practice-for-cerebellopontine-angle-tumors-in-the-era-of-radiosurgery
#7
Giannantonio Spena, Tommaso Sorrentino, Roberto Altieri, Luca Redaelli de Zinis, Roberto Stefini, Pier Paolo Panciani, Marco Fontanella
We analyzed the outcomes of patients with large cerebellopontine angle (CPA) tumors treated by a skull-base team in which two surgeons (one neurosurgeon and one otological surgeon) were in the beginning of their careers (<40 years old). Data of patients operated on between April 2012 and March 2016 were reviewed. All factors related to surgical training were considered. Thirty-one patients had vestibular schwannomas, while 26 had meningiomas. Mean tumor diameter was 30.6 mm (range, 23-49 mm) for schwannomas and 35 mm (range, 22-51 mm) for meningiomas...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765824/changing-trends-in-the-management-of-esthesioneuroblastoma-irish-and-international-perspectives
#8
Robbie S R Woods, Thavakumar Subramaniam, Mary Leader, Rory McConn-Walsh, James Paul O'Neill, Peter D Lacy
Objectives  Evaluation of the changing trends in esthesioneuroblastoma in an Irish context and review of management options nationally to clarify the best current therapeutic approach by comparing with international research on this uncommon malignancy. Design  Retrospective review. Setting  Tertiary referral center. Participants  All patients presenting with esthesioneuroblastoma in Beaumont hospital or on the National Cancer Registry of Ireland between 1994 and 2013. Main Outcome Measures  Recurrence-free and overall survival...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765823/the-natural-growth-rate-of-residual-juvenile-angiofibroma
#9
Nicholas R Rowan, Amanda L Stapleton, Molly E Heft-Neal, Paul A Gardner, Carl H Snyderman
Objectives  Examine the postoperative growth rate of residual juvenile angiofibroma (JA) in a large series of patients relative to pediatric growth parameters and other prognostic factors. Establish an algorithm for postoperative surveillance of patients with JA. Design  Retrospective case series. Setting  Tertiary referral academic center. Participants  Pediatric patients undergoing surgical resection of JA between September 2005 and June 2015. Main Outcome Measures  Postoperative recurrence and tumor growth rates...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765822/minimally-invasive-surgery-for-resection-of-parapharyngeal-space-tumors
#10
Irit Duek, Gill E Sviri, Salem Billan, Ziv Gil
Background  Surgical removal of parapharyngeal space tumors (PPST) poses challenges due to the complex anatomy of the region. PPSTs are routinely resected by a transcervical approach using blind finger dissection. Large PPSTs or those located high at the skull base, often require transmandibular or infratemporal fossa approaches, associated with considerable morbidity. Objective  Here, we describe an approach for PPST removal that comprises transcervical endoscopic, with or without transoral robotic technique...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765821/potential-surgical-exposure-of-the-parapharyngeal-internal-carotid-artery-by-endonasal-transoral-and-transcervical-approaches
#11
Kangsadarn Tanjararak, Smita Upadhyay, Thanakorn Thiensri, Jun Muto, Boonsam Roongpuvapaht, Daniel M Prevedello, Ricardo L Carrau
Objectives  Endoscopic and endoscopic-assisted approaches to the parapharyngeal space have been reported; however, their potential for vascular exposure has not been previously assessed. This study aims to compare the potential exposure and control of the parapharyngeal internal carotid artery (ppICA) via various approaches. Design and Main Outcome Measures  Ten cadaveric specimens were dissected bilaterally, exposing the ppICA via endonasal, transoral, and transcervical approaches. Length of the exposed vessel and potential control were assessed (feasibility and time required to place an encircling suture)...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765820/a-comparative-analysis-of-endoscopic-assisted-transoral-and-transnasal-approaches-to-parapharyngeal-space-a-cadaveric-study
#12
Xicai Sun, Bo Yan, Huy Q Truong, Hamid Borghei-Razavi, Carl H Snyderman, Juan C Fernandez-Miranda
Background  Surgical resection of parapharyngeal space (PPS) tumors is very challenging. An endoscopic-assisted surgical approach to this region requires detailed and precise anatomic knowledge. The main purpose of this study is to describe and compare the detailed anatomy of the PPS via transnasal transpterygoid (TP) and endoscopic-assisted transoral (TO) approaches. Materials and Methods  Six fresh injected cadaver heads (12 sides) were prepared for dissection of the PPS via TP and TO approaches. Computed tomography (CT) with image-based navigation (Navigation System II; Stryker, Kalamazoo, Michigan, United States) was used to identify bony structures around the PPS...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765819/complications-in-salvage-surgery-for-nasal-and-paranasal-malignant-tumors-involving-the-skull-base
#13
Masanori Teshima, Hirotaka Shinomiya, Naoki Otsuki, Hidehito Kimura, Masaaki Taniguchi, Kazunobu Hashikawa, Eiji Kohmura, Ken-Ichi Nibu
Objective  Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design  Retrospective study. Setting  Kobe University Hospital. Participants  Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765818/targeted-epidural-blood-patch-treatment-for-refractory-spontaneous-intracranial-hypotension-in-china
#14
Fei-Fang He, Li Li, Min-Jun Liu, Tai-Di Zhong, Qiao-Wei Zhang, Xiang-Ming Fang
Objective  An epidural blood patch (EBP) is the mainstay of treatment for refractory spontaneous intracranial hypotension (SIH). We evaluated the treatment efficacy of targeted EBP in refractory SIH. Methods  All patients underwent brain magnetic resonance imaging (MRI) with contrast and heavily T2-weighted spine MRI. Whole spine computed tomography (CT) myelography with non-ionic contrast was performed in 46 patients, and whole spine MR myelography with intrathecal gadolinium was performed in 119 patients...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588906/complications-of-extended-endoscopic-endonasal-surgery-in-elderly-patients
#15
Tyler J Kenning, Carlos D Pinheiro-Neto
Extended endoscopic endonasal procedures are not unique among surgical interventions in carrying increased risk in the elderly population. There are, however, components of the procedure, namely high-flow cerebrospinal fluid leaks, that do result in the potential for increased perioperative morbidity for these patients. We present the case of a 77-year-old male with a large invasive pituitary macroadenoma resected through a transplanum-transtuberculum-transsellar endonasal approach. A gross total resection was obtained with resolution of the patient's preoperative ophthalmologic deficits...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588905/endoscopic-endonasal-resection-of-a-suprasellar-pituitary-adenoma-mimicking-tuberculum-sellae-meningioma-in-a-patient-with-an-intrasellar-persistent-trigeminal-artery
#16
Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Mostafa Shahein, E Antonio Chiocca, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588904/endoscopic-endonasal-approach-for-complex-macroadenoma-with-suprasellar-and-retrochiasmatic-extension
#17
Edinson Najera, Carl H Snyderman, Juan C Fernandez-Miranda
In this video, we describe the technical nuances of an endoscopic endonasal approach (EEA) for a complex macroadenoma with suprasellar and retrochiasmatic extension. The patient is a 51-year-old male with several years' history of progressive visual loss. Neuro-ophthalmology assessment revealed a profound visual loss with homonymous hemianopsia and left optic nerve atrophy. His pituitary hormonal profile was normal. The options for surgical approach included transcranial, endoscopic endonasal, or a combination of both...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588903/endoscopic-endonasal-transoculomotor-triangle-approach-for-the-resection-of-a-pituitary-adenoma-with-ambient-cistern-extension
#18
Georgios Andrea Zenonos, Eric Wesley Wang, Juan C Fernandez-Miranda
Objectives  The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588902/gross-total-resection-of-chordoid-glioma-of-the-third-ventricle-via-anterior-interhemispheric-transcallosal-transforaminal-approach-at-two-stages
#19
Ihsan Dogan, Melih Ucer, Mustafa Kemal Başkaya
Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages. In this video, we present a case of retrochiasmatic anterior third ventricular tumor that was operated via anterior interhemispheric transcallosal transforaminal approach...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588901/endoscopic-endonasal-transtuberculum-sellae-approach-for-the-resection-of-suprasellar-intrainfundibular-epidermoid-cyst
#20
Alaa S Montaser, Juan M Revuelta Barbero, Mostafa Shahein, Alexandre B Todeschini, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 49-year-old female presented with intense headaches of 3 months duration. Brain magnetic resonance imaging (MRI) was performed and showed a sellar-suprasellar lesion extending into the third ventricle. A presumptive diagnosis of a craniopharyngioma was made. Since the patient did not have any visual deficits, she opted for conservative management. Four months later, she started to have progressive deterioration of vision; thus, surgery was indicated. The patient underwent endoscopic endonasal resection of the lesion through a transtuberculum sellae approach...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
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