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Journal of Neurological Surgery. Part B, Skull Base

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https://www.readbyqxmd.com/read/28725523/a-method-of-locating-the-dehiscence-during-middle-fossa-approach-for-superior-semicircular-canal-dehiscence-surgery
#1
Joel S Beckett, Lawrance K Chung, Carlito Lagman, Brittany L Voth, Cheng Hao Jacky Chen, Bilwaj Gaonkar, Quinton Gopen, Isaac Yang
Objectives  Superior semicircular canal dehiscence (SSCD) results from a defect in the middle cranial fossa floor. One challenge during SSCD repair is the lack of a consistent landmark. This study proposes a reference point above the external auditory canal at the level of the zygoma as the inferior craniectomy edge during surgery. Design  This is a retrospective review of patients with SSCD. Setting/Participants  A total of 72 cases of SSCD in 60 patients were repaired via a middle fossa approach at a single institution...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725522/pathogenetic-analysis-of-sinonasal-teratocarcinosarcomas-reveal-actionable-%C3%AE-catenin-overexpression-and-a-%C3%AE-catenin-mutation
#2
Andrew C Birkeland, Sarah J Burgin, Megan Yanik, Megan V Scott, Carol R Bradford, Jonathan B McHugh, Scott A McLean, Stephen E Sullivan, Jacques E Nor, Erin L McKean, J Chad Brenner
Objective  Sinonasal teratocarcinosarcomas are rare, aggressive tumors of the skull base. Treatment options are limited and outcomes are poor. Little is known in regard to the genetic factors regulating these tumors. Characterization of actionable molecular alterations in these tumors could provide potentially successful therapeutic options. Methods  We performed targeted exome sequencing on an index sinonasal teratocarcinosarcoma specimen to identify potential driver mutations. We performed immunohistochemical stains for β-catenin on paraffin-embedded tissue on the index tumor and a subsequent teratocarcinosarcoma...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725521/naso-or-orbitocutaneous-fistulas-after-free-flap-reconstruction-of-orbital-exenteration-defects-retrospective-study-systematic-review-and-meta-analysis
#3
Patrick Tassone, Kurren S Gill, David Hsu, Gurston Nyquist, Howard Krein, Jurij R Bilyk, Anna P Murchison, James J Evans, Ryan N Heffelfinger, Joseph M Curry
Objective  Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence and risk factors for NOF after orbital exenteration. Study Design  Retrospective chart review, systematic review, meta-analysis. Setting  Tertiary care center. Participants  Patients undergoing free flap reconstruction following orbital exenteration. Records were reviewed for clinicopathologic data, operative details, and outcomes...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725520/mucosal-thickening-occurs-in-contralateral-paranasal-sinuses-following-sinonasal-malignancy-treatment
#4
Alice Z Maxfield, Kyle J Chambers, Ahmad R Sedaghat, Derrick T Lin, Stacey T Gray
Objective  To investigate the incidence and degree of contralateral sinus disease following treatment of sinonasal malignancy (SNM) using radiological findings as an outcome measure. Study Design  Retrospective case series. Setting  Tertiary referral academic center. Participants  Patients with SNM treated with surgical and adjuvant radiotherapy with or without concurrent chemotherapy. Main Outcome Measures  Pre- and posttreatment computed tomography and magnetic resonance imaging scans, Lund-Mackay (LM) score, date of diagnosis, chemotherapy, and dosage of radiation therapy (RT)...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725519/intracranial-hemangiopericytomas-recurrence-metastasis-and-radiotherapy
#5
Ankur R Patel, Bruno C Flores, Vin Shen Ban, Kimmo J Hatanpaa, Bruce E Mickey, Samuel L Barnett
Background  Intracranial hemangiopericytomas (HPCs) are characterized by high recurrence rates and extracranial metastases. Radiotherapy provides an adjunct to surgery, but the timing of therapy and the patients most likely to benefit remain unclear. Methods  A retrospective review of 20 patients with HPC treated at the University of Texas Southwestern Medical Center between 1985 and 2014 was conducted. Recurrence and metastasis rates along with overall survival (OS) were characterized based on therapeutic approach and tumor pathology using Kaplan-Meier and Cox regression analyses...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725518/preferences-and-utilities-for-health-states-after-treatment-of-olfactory-groove-meningioma-endoscopic-versus-open
#6
Christopher M Yao, Alyssa Kahane, Eric Monteiro, Fred Gentili, Gelareh Zadeh, John R de Almeida
Objectives  The purpose of this study is to report health utility scores for patients with olfactory groove meningiomas (OGM) treated with either the standard transcranial approach, or the expanded endonasal endoscopic approach. Design  The time trade-off technique was used to derive health utility scores. Setting  Healthy individuals without skull base tumors were surveyed. Main Outcome Measures  Participants reviewed and rated scenarios describing treatment (endoscopic, open, stereotactic radiation, watchful waiting), remission, recurrence, and complications associated with the management of OGMs...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725517/preoperative-embolization-for-skull-base-meningiomas
#7
Kensuke Suzuki, Masaya Nagaishi, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Ryotaro Suzuki, Yosuke Kawamura, Ryuta Nakae, Yoshihiro Tanaka, Akio Hyodo
The results of preoperative embolization for skull base meningiomas were retrospectively evaluated to confirm the efficacy of this procedure. Skull base meningiomas that were treated with preoperative embolization were evaluated in 20 patients. The occluded arteries, embolic materials, treatment time, excision rate, neurologic manifestations, and complications were analyzed. The embolic material was 80% liquid, 30% coils, and 15% particles. The surgery was normally completed within 3 to 5 hours. Blood loss was normally approximately 250 mL, excluding four patients having the following conditions: malignant meningioma, a large tumor located on the medial side of the sphenoidal ridge, the petroclival tumor, and infiltrated tumor into the sigmoid sinus...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725516/how-i-do-it-the-role-of-flexible-hand-held-2%C3%AE-thulium-laser-fiber-in-microsurgical-removal-of-acoustic-neuromas
#8
Luciano Mastronardi, Guglielmo Cacciotti, Raffaele Roperto, Maria Pia Tonelli, Ettore Carpineta
Aims  We performed a retrospective nonrandomized study to analyze the results of microsurgery of acoustic neuromas (AN) using 2μ-thulium flexible hand-held laser fiber (Revolix jr). Methods  From September 2010 to September 2015, 89 patients suffering from AN have been operated on with microsurgical technique via retrosigmoid approach. In 37 cases, tumor resection was performed with the assistance of 2μ-thulium flexible hand-held laser fiber (L-group). Eight cases operated on with the assistance of CO 2 hand-held flexible laser fiber were excluded from this study...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725515/quantitative-anterior-and-posterior-clinoidectomy-analysis-and-mobilization-of-the-oculomotor-nerve-during-surgical-exposure-of-the-basilar-apex-using-frameless-stereotaxis
#9
Aclan Dogan, Justin S Cetas, Gregory J Anderson, Andy Rekito, Johnny B Delashaw
Background  Anterior and posterior clinoidectomies have been proposed to augment exposure of the basilar apex. A sequential quantitative benefit analysis offered by these maneuvers has not been reported. Methods  Fourteen datasets from eight cadaveric specimens were analyzed. A modified orbitozygomatic frontotemporal craniotomy was performed. The extent of proximal control of the basilar artery was determined through the exposed opticocarotid and carotidoculomotor triangles before and after clinoidectomies and mobilization of the third nerve at the porous oculomotarius...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725514/gamma-knife-stereotactic-radiosurgery-for-grade-2-meningiomas
#10
Tamer Refaat, Michelle Gentile, Sean Sachdev, Prarthana Dalal, Anish Butala, Stanley Gutiontov, Irene Helenowksi, Plato Lee, Vythialinga Sathiaseelan, Orin Bloch, James Chandler, John A Kalapurakal
Purpose  This study aims to report long-term clinical outcomes after Gamma Knife radiosurgery (GKRS) for intracranial grade 2 meningiomas. Methods  In this Institutional Review Board approved study, we reviewed records of all patients with grade 2 meningiomas treated with GKRS between 1998 and 2014. Results  A total of 97 postoperative histopathologically confirmed grade 2 meningiomas in 75 patients were treated and are included in this study. After a mean follow-up of 41 months, 28 meningiomas had local recurrence (29...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725513/facial-nerve-schwannomas-mimicking-as-vestibular-schwannomas
#11
Beth N McNulty, Sean Wise, David S Cohen, Jason Bell, Dennis Bojrab, Michael LaRouere, Matthew Kircher, Seilesh Babu
Objective  The objective of this study was to identify preoperative and intraoperative findings that may aid in distinguishing facial nerve schwannomas (FNS) from vestibular schwannomas (VSs), particularly in cases limited to the internal auditory canal (IAC) and cerebellopontine angle (CPA). Study Design  This was a retrospective study. Setting  This study was set at a Tertiary Referral Center. Patients  Seventeen cases from October 2002 to July 2015 with an IAC/CPA mass presumed to be a VS who were found to have a FNS intraoperatively...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28603683/cavernous-sinus-involvement-by-pituitary-adenomas-clinical-implications-and-outcomes-of-endoscopic-endonasal-resection
#12
Abdulrazag Ajlan, Achal S Achrol, Abdulrahman Albakr, Abdullah H Feroze, Erick M Westbroek, Peter Hwang, Griffith R Harsh
Background  Parasellar invasion of pituitary adenomas (PAs) into the cavernous sinus (CS) is common. The management of the CS component of PA remains controversial. Objective  The objective of this study was to analyze CS involvement in PA treated with endoscopic endonasal approaches, including incidence, surgical risks, surgical strategies, long-term outcomes, and our treatment algorithm. Methods  We reviewed a series of 176 surgically treated PA with particular attention to CS involvement and whether the CS tumor was approached medial or lateral to the internal carotid artery...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#13
R Alex Harbison, Yangming Li, Angelique M Berens, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives  Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design  Case series. Setting  Tertiary academic center. Participants  A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures  Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593114/transient-exacerbation-of-nasal-symptoms-following-endoscopic-transsphenoidal-surgery-for-pituitary-tumors-a-prospective-study
#14
Benjamin M Davies, Erica Tirr, Yi Yuen Wang, Kanna K Gnanalingham
Object  Endoscopic transsphenoidal surgery is the commonest approach to pituitary tumors. One disadvantage of this approach is the development of early postoperative nasal symptoms. Our aim was to clarify the peak onset of these symptoms and their temporal evolution. Methods  The General Nasal Patient Inventory (GNPI) was administered to 56 patients undergoing endoscopic transsphenoidal surgery for pituitary tumors preoperatively and at 1 day, 3 days, 2 weeks, 3 months, and 6 to 12 months postoperatively...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593113/the-added-value-of-diffusion-magnetic-resonance-imaging-in-the-diagnosis-and-posttreatment-evaluation-of-skull-base-chordomas
#15
Ezgi Guler, Burce Ozgen, Melike Mut, Figen Soylemezoglu, Kader Karli Oguz
Objectives  To determine the use of diffusion-weighted imaging (DWI) in the pre- and posttreatment evaluation of skull base chordomas. Design  Retrospective study. Setting  Tertiary care university hospital. Participants  In total, 17 patients with histopathological diagnosis of chordoma who had magnetic resonance (MR) imaging and DWI were evaluated. Of them, 13 patients had posttreatment MR imaging including DWI. Main Outcome Measures  Three apparent diffusion coefficient (ADC) values were obtained from tumor, and an ADC value was measured from pons for the purpose of normalization...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593112/comparative-neurologic-outcomes-of-salvage-and-definitive-gamma-knife-radiosurgery-for-glomus-jugulare-a-20-year-experience
#16
Daniel V Wakefield, Garrett T Venable, Noam A VanderWalde, L Madison Michael, Jeffery M Sorenson, Jon H Robertson, David Cunninghan, Matthew T Ballo
Objective  This case series investigates management of glomus jugulare (GJ) tumors utilizing definitive and salvage Gamma Knife stereotactic radiosurgery (GKSRS). Methods  A retrospective chart review was performed to collect data. Statistical analysis included patient, tumor, and treatment information. Results  From 1996 to 2013, 17 patients with GJ received GKSRS. Median age was 64 years (range, 27-76). GKSRS was delivered for definitive treatment in eight (47%) and salvage in nine (53%) patients. Median tumor volume was 9...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593111/phantosmia-and-dysgeusia-following-endoscopic-transcribriform-approaches-to-olfactory-groove-meningiomas
#17
Andrew S Venteicher, Jay I Kumar, Emma A Murphy, Stacey T Gray, Eric H Holbrook, William T Curry
The endoscopic, endonasal transcribriform approach (EETA) is an important technique used to directly access the anterior skull base and is increasingly being used in the management of olfactory groove meningiomas (OGMs). As this approach requires removal of the cribriform plate and olfactory epithelium en route to the tumor, patients are anosmic postoperatively. Here, we report the development of phantosmia and dysgeusia in two patients who underwent EETAs for OGMs, which has not yet been reported in the literature...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593110/endoscopic-endonasal-transclival-approach-versus-dual-transorbital-port-technique-for-clip-application-to-the-posterior-circulation-a-cadaveric-anatomical-and-cerebral-circulation-simulation-study
#18
Jeremy N Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin Cetas, William Cameron
Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593109/extent-of-endoscopic-resection-for-anterior-skull-base-tumors-an-mri-based-volumetric-analysis
#19
Ian J Koszewski, Gregory Avey, Azam Ahmed, Lucas Leonhard, Matthew R Hoffman, Timothy M McCulloch
Objective  To determine the volume of ventral skull base tumor removed following endoscopic endonasal (EEA) resection using MRI-based volumetric analysis and to evaluate the inter-rater reliability of such analysis. Design  Retrospective case series. Setting  Academic tertiary care hospital. Participants  EEA patients November 2012 to August 2015. Main Outcome Measures  Volumetric analysis of pre- and immediately postoperative MR imaging was performed independently by two investigators. The percentage of total tumor resected was evaluated according to resection goal and tumor type...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593108/nano-hemostats-and-a-pilot-study-of-their-use-in-a-large-animal-model-of-major-vessel-hemorrhage-in-endoscopic-skull-base-surgery
#20
Alistair Jukes, Jae Murphy, Sarah Vreugde, Alkis Psaltis, P J Wormald
Nano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
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