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Journal of Neurological Surgery. Part B, Skull Base

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https://www.readbyqxmd.com/read/28875123/costs-and-perioperative-outcomes-associated-with-open-versus-endoscopic-resection-of-sinonasal-malignancies-with-skull-base-involvement
#1
Terence S Fu, Eric Monteiro, Ian Witterick, Allan Vescan, Gelareh Zadeh, Fred Gentili, John R de Almeida
Objective  To compare financial and perioperative outcomes between endoscopic and open surgical approaches in the surgical management of sinonasal malignancies. Design  Retrospective chart review. Setting  Tertiary care hospital. Participants  Patients undergoing surgical resection of a sinonasal malignancy from January 2000 to December 2014. Main Outcome Measures  In-hospital costs, complications, and length of stay (LOS). Results  Of 106 patients, 91 received open surgery (19 free flap and 72 non-free flap) and 15 were treated with purely endoscopic approaches...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875122/the-utility-of-sentinel-node-biopsy-for-sinonasal-melanoma
#2
Michael S Oldenburg, Daniel L Price
Objective  Report two positive sentinel node biopsies for sinonasal melanoma. Design  Retrospective review. Setting  Academic tertiary care center. Participants  Patients who underwent sentinel node biopsy for sinonasal melanoma between November 1, 2014 and November 1, 2015. Main Outcome Measures  Clinical course. Results  Two patients were identified. Patient 1 (83M) presented with a sinonasal melanoma anterior to the left inferior turbinate and was clinically N0 neck. Lymphoscintigraphy revealed two sentinel nodes in the ipsilateral and three in the contralateral cervical basins...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#3
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875120/rater-reliability-of-the-hardy-classification-for-pituitary-adenomas-in-the-magnetic-resonance-imaging-era
#4
Michael A Mooney, Douglas A Hardesty, John P Sheehy, C Roger Bird, Kristina Chapple, William L White, Andrew S Little
Objectives  The Hardy classification is used to classify pituitary tumors for clinical and research purposes. The scale was developed using lateral skull radiographs and encephalograms, and its reliability has not been evaluated in the magnetic resonance imaging (MRI) era. Design  Fifty preoperative MRI scans of biopsy-proven pituitary adenomas using the sellar invasion and suprasellar extension components of the Hardy scale were reviewed. Setting  This study was a cohort study set at a single institution...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875119/indocyanine-green-fluorescence-to-evaluate-nasoseptal-flap-viability-in-endoscopic-endonasal-cranial-base-surgery
#5
Edward E Kerr, Ali Jamshidi, Ricardo L Carrau, Raewyn G Campbell, Leo F Ditzel Filho, Bradley A Otto, Daniel M Prevedello
Objectives  The pedicled nasoseptal flap (NSF) has dramatically reduced postoperative cerebrospinal fluid leakage following endoscopic endonasal approach (EEA) surgery. Although rare, its arterial supply may be damaged during harvest or may be preoperatively damaged for numerous reasons. Early recognition permits harvesting a contralateral flap before sacrificing its pedicle as part of the surgical exposure or use of an alternative flap. Design  Technical feasibility study and case series. Setting  Tertiary care university-associated medical center...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875118/multimodality-management-of-cavernous-sinus-hemangiomas-an-institutional-experience
#6
Dwarakanath Srinivas, Pragyan Sarma, Dhaval Shukla, Dhananjay Bhat, Paritosh Pandey, Sampath Somanna, Ananthakrishna Chandramouli
Objective  Cavernous sinus hemangiomas (CSHs) are benign lesions accounting for less than 2% of the cavernous sinus tumors. They provide a formidable surgical challenge because of their vascularity and their being surrounded by critical neurovascular structures. In this study, one of the largest in available literature, we analyze our experience in the management of these unusual tumors and review the available literature. Materials  This is a retrospective analysis of patients who were managed surgically (both microsurgical and Gamma knife radiosurgery [GKRS]) for CSH at our Institution from 2007 to 2015...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875117/fascia-lata-free-flap-anastomosed-to-the-superior-trochlear-system-for-reconstruction-of-the-anterior-skull-base
#7
Camilo Reyes, C Arturo Solares, Michael A Fritz, Michael Groves, Heather Bentley
Objectives  This study aims to introduce a novel technique for the reconstruction of the anterior skull base using a free vascularized anterolateral thigh fascia lata free flap (FLFF) anastomosed to the superior trochlear artery (STA). Methods  The diameter of the STA was measured in 38 (76 sides) computed tomography angiographies (CTAs). Independently, six cadaver heads were used to measure the diameter of the supratrochlear system, and the model was applied to one of them. Results  In women, the average diameter of the STA was 2...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875116/performance-of-robotic-assistance-for-skull-base-biopsy-a-phantom-study
#8
Jian-Hua Zhu, Jing Wang, Yong-Gui Wang, Meng Li, Yu-Xing Guo, Xiao-Jing Liu, Chuan-Bin Guo
Objectives  This study aims to evaluate the feasibility of a custom robot system guided by optical cone beam computed tomography (CBCT)-based navigation for skull base biopsy. Design  An accuracy study was conducted. Setting  Platform for navigation and robot-aided surgery technology. Participants  Phantom skull. Main Outcome Measures  The primary outcome measure was to investigate the accuracy of robot-assisted needle biopsy for skull base tumors. A 14-gauge needle was automatically inserted by the five degrees of freedom robot into the intended target, guided by optical navigation...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875115/advantages-and-complications-of-fisch-partial-mastoidotympanectomy-for-tumors-of-the-retromandibular-fossa-and-poststyloid-space
#9
Dominic J Catalano, Michael B Gluth
Objective  This study aims to characterize a single surgeon's experience with resection of tumors of the retromandibular fossa and poststyloid space utilizing the Fisch partial mastoidotympanectomy (FPMT) technique of partial temporal bone resection. Design  Retrospective review. Setting  Academic medical center. Participants  Seven patients who underwent tumor resection with FPMT. Main Outcome Measures  Complications. Results  Six males and one female underwent FPMT, with ages ranging from 44 to 79 years...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875114/comparative-proteomic-profiling-using-two-dimensional-gel-electrophoresis-and-identification-via-lc-ms-ms-reveals-novel-protein-biomarkers-to-identify-aggressive-subtypes-of-who-grade-i-meningioma
#10
Joshua W Osbun, Philip D Tatman, Sumanpreet Kaur, Carolina Parada, Tina Busald, Luis Gonzalez-Cuyar, Min Shi, Donald E Born, Jing Zhang, Manuel Ferreira
Background  Meningomas represent the most common primary intracranial tumor. The majority are benign World Health Organization (WHO) Grade I lesions, but a subset of these behave in an aggressive manner. Protein biomarkers are needed to distinguish aggressive from benign Grade I lesions. Materials and Methods  Pooled protein lysates were derived from five clinically aggressive Grade I and five typically benign WHO Grade I tumors snap frozen at the time of surgery. Proteins were separated in each group using two-dimensional gel electrophoresis (2DGE) and protein spots of interest were identified using liquid chromatography-mass spectrometry (LC-MS)...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875113/fully-endoscopic-minimally-invasive-transrectus-capitis-posterior-muscle-triangle-approach-to-the-posterolateral-condyle-and-jugular-tubercle
#11
Wang Mingdong, Juan C Fernandez-Miranda, Roger Neves Mathias, Eric Wang, Paul Gardner, Hong Wang
Background  We evaluated a transrectus capitis posterior muscle triangle approach to the posterolateral foramen magnum, occipital condyles, jugular tubercle, and the fourth ventricle. We also assessed factors that affect the amount of bone removal required. Objective  To evaluate if the proposed approach is as effective as standard open approaches to expose the lateral portion of the foramen magnum. Methods  The proposed minimally invasive fully endoscopic approach was performed in 15 cadaveric specimens using 4-mm (0- and 45-degree) endoscopes...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28725523/a-method-of-locating-the-dehiscence-during-middle-fossa-approach-for-superior-semicircular-canal-dehiscence-surgery
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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