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Journal of Neurological Surgery. Part B, Skull Base

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https://www.readbyqxmd.com/read/28603683/cavernous-sinus-involvement-by-pituitary-adenomas-clinical-implications-and-outcomes-of-endoscopic-endonasal-resection
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28593107/minimally-invasive-approach-for-resection-of-parameningeal-rhabdomyosarcoma
#10
Aileen Wertz, Brittny N Tillman, Jennifer V Brinkmeier, Tiffany A Glazer, Andrew D Kroeker, Steven E Sullivan, Erin L McKean
Background  About one-third of rhabdomyosarcomas arise in the head and neck, with parameningeal primaries accounting for half of these. Principles of management involve chemotherapy, radiation, or both, in addition to surgical biopsy, debulking, and complete or near-complete resection. In the head and neck, diagnostic biopsies have historically been performed without attempt at resection due to proximity to critical structures and cosmetic considerations. Methods  Retrospective chart review of three cases of rhabdomyosarcoma at the cranial base managed through minimally invasive endoscopic surgical resection and adjuvant therapy...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593106/a-post-hoc-summary-of-a-memorable-annual-meeting-the-27th-annual-nasbs-meeting-march-1-5-2017-the-roosevelt-hotel-new-orleans-louisiana-united-states
#11
Jacques J Morcos
No abstract text is available yet for this article.
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#12
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321386/computerized-assessment-of-superior-semicircular-canal-dehiscence-size-using-advanced-morphological-imaging-operators
#13
Joel S Beckett, Carlito Lagman, Lawrance K Chung, Timothy T Bui, Seung J Lee, Brittany L Voth, Bilwaj Gaonkar, Quinton Gopen, Isaac Yang
Superior semicircular canal dehiscence (SSCD) describes a pathological aperture at the level of the arcuate eminence. Techniques for quantifying defect size are described with most studies using two-dimensional lengths that underestimate the pathology. The objective of this study is to describe a novel method of measurement that combines manual segmentation of high-resolution computed tomography (HRCT) images of the temporal bone and a morphological skeletonization transform to calculate dehiscence volume. Images were imported into a freely available image segmentation tool: ITK-SNAP (version 3...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321385/the-laparoscopically-harvested-omental-free-flap-a-compelling-option-for-craniofacial-and-cranial-base-reconstruction
#14
Peter D Costantino, David Shamouelian, Tristan Tham, Robert Andrews, Wojciech Dec
Background Management of craniofacial and cranial base tumors is a challenge due to the anatomic intricacies associated with the calvarium, the pathological diversity of lesions that present, and the potential complications. Clinical outcomes in laparoscopically harvested omentum free flaps for cranial base and craniofacial reconstruction are presented in this paper, in the largest case series to date. Methods A retrospective single-center experience for over 10 years with laparoscopically harvested omentum flaps used to reconstruct craniofacial and cranial base defects...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321384/operative-strategies-to-minimize-complications-following-resection-of-pituitary-macroadenomas
#15
Jayesh P Thawani, Ashwin G Ramayya, Jared M Pisapia, Kalil G Abdullah, John Y-K Lee, M Sean Grady
Introduction We sought to identify factors associated with increased length of stay (LOS) and morbidity in patients undergoing resection of pituitary macroadenomas. Methods We reviewed records of 203 consecutive patients who underwent endoscopic endonasal resection of a pituitary macroadenoma (mean age = 55.7 [16-88]) years, volume = 11.3 (1.0-134.3) cm(3). Complete resection was possible in 60/29.6% patients. Mean follow-up was 575 days. Multivariate logistic regression was performed using MATLAB...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321383/direct-endonasal-approach-with-partial-upper-posterior-septectomy-a-rescue-flap-technique-modification
#16
Arturo Sotomayor-González, Armando José Díaz-Martínez, Ramón Radillo-Gil, Everardo García-Estrada, Jesús Alberto Morales-Gómez, Isaac Jair Palacios-Ortiz, Samuel Pérez-Cárdenas, Mauricio Arteaga-Treviño, Ángel Martínez-Ponce De León
Objective Report a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design Prospective study. Setting Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León. Main Outcome Measures Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321382/understanding-the-course-of-vertebral-artery-at-craniovertebral-junction-in-occipital-assimilation-of-atlas-made-simplified-using-conventional-angiography
#17
Anita Jagetia, Tushit Mewda, Ishu Bishnoi, Manoj Bhutte, Hukum Singh, A K Srivastava, Daljit Singh
Introduction Preoperative assessment of vertebral artery (VA) is important to avoid its injury during surgery at craniovertebral junction (CVJ). The main concern is the course of third segment of VA (V3) while performing instrumentation at CVJ, that is, segment of VA from its course through transverse foramen of C2 to its course along the posterior arch of C1. This segment of VA includes its passage through C1 transverse foramen as well. This observational study was done to analyze the course, curvature, and termination of VA in patients with occipital assimilation of atlas at CVJ, a complex congenital anomaly, and compared with the normal course for better understanding especially by young neurosurgeons and spine surgeons...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321381/skull-base-invasion-patterns-and-survival-outcomes-of-nonmelanoma-skin-cancers
#18
Yusuf Dundar, Richard B Cannon, Marcus M Monroe, Luke Oliver Buchmann, Jason Patrick Hunt
Objective Report routes of skull base invasion for head and neck nonmelanoma skin cancers (NMSCs) and their survival outcomes. Design Retrospective. Participants Ninety patients with NMSC with skull base invasion between 2004 and 2014. Major Outcome Measures Demographic, tumor characteristics, and treatments associated with different types of skull base invasion and disease-specific survival (DSS) and overall survival (OS). Results Perineural invasion (PNI) to the skull base occurred in 69% of patients, whereas 38% had direct skull base invasion...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321380/an-evaluation-of-styloidectomy-as-an-adjunct-or-alternative-to-jugular-stenting-in-idiopathic-intracranial-hypertension-and-disturbances-of-cranial-venous-outflow
#19
J Nicholas Higgins, Mathew R Garnett, John D Pickard, Patrick R Axon
Background The extent to which intracranial venous sinus obstruction contributes to idiopathic intracranial hypertension (IIH) is debated. The extent to which extracranial venous obstruction contributes to IIH is virtually unexplored. This article describes an interventional approach to extracranial venous outflow in a group of patients with severe intractable symptoms. Objective To describe our technique and experience of styloidectomy combined with jugular stenting in the treatment of skull base narrowing of the jugular veins...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321379/differentiation-between-posterior-sinuses-using-the-medial-orbital-floor-as-a-landmark
#20
Camila Degen Meotti, Otávio Bejzman Piltcher, Bruno Netto, Jaqueline Lemieszek, Michelle Lavinsky-Wolff, Felipe Marques do Rego Monteiro, Gustavo Rassier Isolan
Objectives This study aims to evaluate the difference in height between the floors of the posterior ethmoid and sphenoid sinuses with respect to the medial orbital floor (MOF) to confirm this difference as a landmark for identification of the posterior sinuses. It also aims to describe this difference regarding the type of pneumatization of the sphenoid sinus (conchal, presellar, and sellar). Design A cross-sectional study was conducted. Study Center The study was conducted at the Department of Radiology of Hospital de Clínicas de Porto Alegre, a tertiary care university hospital in Southern Brazil...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
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