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Mazda K Turel, Christopher J Chin, Allan D Vescan, Fred Gentili
Chronic rhinosinusitis (CRS) is a common health problem in the Western world. CRS is classified as CRS with (CRSwNP) and without (CRSsNP) nasal polyps. A less common third type is allergic fungal sinusitis, which often presents with polyps and, not infrequently, skull base erosion. Most patients are successfully managed with maximal medical therapy or endoscopic approaches. There are currently no reports of CRSwNPs resulting in fibro-osseous thickening and proptosis in the English literature. As such, the authors report a case of a 33-year-old man who underwent a craniofacial resection with drilling of the hyperostosed bone, which led to resolution of the proptosis and nasal symptoms...
June 2016: Journal of Craniofacial Surgery
Tristan Klosterman, Sherard Tatum
The authors present a patient of a neonate with a skull base extragonadal germ cell tumor requiring a modified facial translocation approach for resection. A 1-week-old female presented with right proptosis, eyelid edema, and nasal obstruction. Imaging revealed a 3-cm right-sided skull base mass involving the right maxillary, ethmoid, sphenoid sinuses, orbit, infratemporal fossa, and cavernous sinus via skull base erosion. The lesion was refractory to chemotherapy and required surgical excision. A modified facial translocation approach with preservation of anterior maxillary bone vascularization was used to remove the tumor, which was found to be teratoma with yolk-sac features...
May 2016: Journal of Craniofacial Surgery
Ramandeep Singh, Britty Baby, Natesan Damodaran, Vinkle Srivastav, Ashish Suri, Subhashis Banerjee, Subodh Kumar, Prem Kalra, Sanjiva Prasad, Kolin Paul, Sneh Anand, Sanjeev Kumar, Varun Dhiman, David Ben-Israel, Kulwant Singh Kapoor
BACKGROUND: Box trainers are ideal simulators, given they are inexpensive, accessible, and use appropriate fidelity. OBJECTIVE: The development and validation of an open-source, partial task simulator that teaches the fundamental skills necessary for endonasal skull-base neuro-endoscopic surgery. METHODS: We defined the Neuro-Endo-Trainer (NET) SkullBase-Task-GraspPickPlace with an activity area by analyzing the computed tomography scans of 15 adult patients with sellar suprasellar parasellar tumors...
February 2016: World Neurosurgery
M Májovský, D Netuka, V Masopust, V Beneš
INTRODUCTION: Clivus is a central structure of the skull base located in the vicinity of the brainstem and vital brain vessels. Clival fractures are usually caused by a high-energy trauma. Cerebrospinal fluid leak is one of the most common complications. CASE REPORT: A middle-aged male sustained a mild head trauma, followed by a nasal cerebrospinal fluid leak. CT scan revealed the massive pneumocephalus and the fracture of the clivus in the posterior wall of the sphenoidal sinus...
July 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Karen Buch, Thanh Nguyen, Eric Mahoney, Brandon Libby, Paul Calner, Peter Burke, Alex Norbash, Asim Mian
INTRODUCTION: Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. MATERIALS AND METHODS: With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010...
February 2016: European Radiology
Angel E Rivera-Barrios, Satara Brown, Christopher M Reid, Aladdin H Hassanein, Raul Coimbra, Marek Dobke, Fernando A Herrera
BACKGROUND: A multicenter, retrospective study was conducted to determine the frequency and distribution of craniofacial fractures sustained from all terrain vehicle (ATV) accidents. METHODS: Medical records of all patients presenting to 2 trauma centers with ATV-related craniofacial trauma from 2001 to 2013 were reviewed. Patient notes and radiographic images were analyzed for detailed craniofacial injury data. The identified fractures were classified as: frontal/skullbase, naso-orbital, maxilla/zygoma, and mandible...
June 2015: Annals of Plastic Surgery
Henry W S Schroeder
OBJECTIVE: To describe the decision-making and the surgical strategy in the resection of anterior skullbase meningiomas. METHODS: Details of the microsurgical and endoscopic approach to anterior skullbase meningiomas are presented. RESULTS: Small and midsize olfactory groove, planum sphenoidale, and tuberculum sellae meningiomas can be removed via an endonasal endoscopic approach, an alternative option to the transcranial microsurgical approach...
December 2014: World Neurosurgery
J Yokoyama, S Ohba, M Fujimaki, T Anzai, M Kojima, K Ikeda, M Suzuki, H Yoshimoto, K Inoue
BACKGROUND: The most significant problem of intra-arterial chemotherapy for advanced paranasal sinus carcinomas and residual cancers supplied by internal carotid artery (ICA) and involving the skull base is the lack of salvage therapies. OBJECTIVE: The objective of the study was to evaluate the usefulness of intra-arterial chemotherapy including ICA infusion for treating advanced paranasal sinus carcinomas, which have invaded the skull base. METHODS: Forty-six patients with advanced paranasal sinus carcinomas supplied by ICA were treated by intra-arterial chemotherapy using CDDP and sodium thiosulphate (STS) as a neutraliser of CDDP toxicity...
December 9, 2014: British Journal of Cancer
Abdul Rahman Al-Shudifat, Babar Kahlon, Peter Höglund, Ahmed Y Soliman, Kristoffer Lindskog, Peter Siesjo
AIMS: The aim of the present study was to identify predictive factors for outcome after surgery of vestibular schwannomas. DESIGN: This is a retrospective study with partially collected prospective data of patients who were surgically treated for vestibular schwannomas at a single institution from 1979 to 2000. Patients with recurrent tumours, NF2 and those incapable of answering questionnaires were excluded from the study. The short form 36 (SF36) questionnaire and a specific questionnaire regarding neurological status, work status and independent life (IL) status were sent to all eligible patients...
January 2014: Journal of Neurology, Neurosurgery, and Psychiatry
S A R Nouraei, A Hudovsky, J S Virk, P Chatrath, G S Sandhu
OBJECTIVES: To audit the accuracy of clinical coding in otolaryngology, assess the effectiveness of previously implemented interventions, and determine ways in which it can be further improved. DESIGN: Prospective clinician-auditor multidisciplinary audit of clinical coding accuracy. PARTICIPANTS: Elective and emergency ENT admissions and day-case activity. MAIN OUTCOME MEASURES: Concordance between initial coding and the clinician-auditor multi-disciplinary teams (MDT) coding in respect of primary and secondary diagnoses and procedures, health resource groupings health resource groupings (HRGs) and tariffs...
December 2013: Clinical Otolaryngology
Scharukh Jalisi, Brian O'Gara, Gentian Toshkezi, Lawrence Chin
OBJECTIVE: The purpose of this study was to describe the effectiveness of local vascularized flaps for the repair of various skull base defects. METHODS: We analyzed a cohort of 138 patients undergoing skull base surgery in a retrospective review of all head and neck surgical oncology cases done at a major tertiary care center between 2005 and 2008. RESULTS: Eighteen patients met our inclusion criteria, requiring local vascularized flap or free graft reconstruction...
January 2015: World Neurosurgery
William J Parkes, Howard Krein, Ryan Heffelfinger, Joseph Curry
Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT) as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up...
2011: Plastic Surgery International
Forhad H Chowdhury, Mohammod R Haque, Khandkar A Kawsar, Shamim Ara, Quazi Deen Mohammod, Mainul H Sarker, Atul H Goel
AIM: Endonasal transsphenoidal approaches are getting rapidly popular in removing many midline skullbase lesions from crista galli to foramen magnum. For safe removal of these lesions, familiarity with endoscopic endonasal anatomy of circle of Willis is very important. Furthermore, for safe development of this approach in vascular neurosurgery in the near future, endoscopic endonasal exposure of circle of Willis is a fundamental step. The goals in this study were to dissect the circle of Willis completely through the endoscopic endonasal approach and to become more familiar with the views and skills associated with the technique by using fresh cadaveric specimens...
2012: Turkish Neurosurgery
Christopher R Grindle, Joseph M Curry, Melissa D Kang, James J Evans, Marc R Rosen
OBJECTIVE: Despite the increasing utilization of image-guided surgery, no radiology protocols for obtaining magnetic resonance (MR) imaging of adequate quality are available in the current literature. At our institution, more than 300 endonasal cranial base procedures including pituitary, extended pituitary, and other anterior skullbase procedures have been performed in the past 3 years. To facilitate and optimize preoperative evaluation and assessment, there was a need to develop a magnetic resonance protocol...
November 2011: American Journal of Otolaryngology
A Kleindienst, G Brabant, N G Morgenthaler, K C Dixit, H Parsch, M Buchfelder
The incidence of water and electrolyte disturbances following traumatic brain injury (TBI) is considerable and has been attributed to a dysregulation of the hypothalamic peptide arginine-vasopressin (AVP). Copeptin, the C-terminal part of the AVP prohormone, reflects AVP activity. In 71 TBI patients we measured copeptin in serum by a sandwich immunoassay. Injury severity was assessed by Glasgow Coma Score (GCS) and computed tomography, and recovery by Glasgow Outcome Score (GOS). Neuroendocrine and osmoregulation regulation were examined on day 0, 3 and 7, and 24 months post-injury...
2010: Acta Neurochirurgica. Supplement
Tae-Ho Yang, Seok-Young Jeong, Sun-Young Oh, Byoung-Soo Shin, Man-Wook Seo, Young-Hyun Kim, Seul-Ki Jeong
We report a case of recurrent Streptococcus Pneumoniae meningoencephalitis with a transethmoidal meningoencephalocele (TEME) but without cerebrospinal fluid (CSF) leakage.A 35-year-old man was admitted with S. pneumoniae meningitis. He had suffered from four episodes of recurrent pneumococcal meningitis during the previous 4 years. A computed tomography scan of the paranasal sinus showed the TEME protruding through a bony defect of the right frontal base. However, the patient did not have symptoms that could be attributable to CSF leakage, and radioisotope cisternography did not identify a leak...
March 2008: Journal of Clinical Neurology
Chieko Nagata, Toshiro Katsuta, Midori Kenjo, Koutarou Ukaji, Hiroyuki Nakagaki
This report describes a growing skullbase fracture in a six-year-old girl. She had a history of anterior skullbase fracture three years previously and meningitis two years later. She was referred to our hospital because of bacterial meningoencephalitis. Neuroimaging disclosed a bone defect and meningocele at the same site as the previous fracture. Although a growing skull fracture of the anterior cranial base is extremely rare, the reported cases include not only pediatric patients but also adults. Furthermore, posttraumatic pseudo-meningocele or encephalocele can be considered to be part of the same entity as growing skullbase fracture...
November 2007: Brain and Nerve, Shinkei Kenkyū No Shinpo
Takeshi Okuda, Masahiko Kitano, Mamoru Taneda
A transcranial approach is frequently employed for the closure of cerebrospinal fluid (CSF) rhinorrhea, occurring after skullbase surgery or associated with anterior skull base fracture. However, the site of CSF rhinorrhea is usually most distant from the site of craniotomy and, because securing of an adequate operative field is difficult, elimination of this type of CSF rhinorrhea tends to be insufficient. We have attempted to reconstruct the anatomical structures with an extended transsphenoidal approach for a case with CSF rhinorrhea from the planum sphenoidale, and have succeeded in achieving a more physiological and reliable elimination of CSF rhinorrhea...
November 2006: No Shinkei Geka. Neurological Surgery
Osamu Takayama, Junkichi Yokoyama, Shin Ito
Myoepithelial carcinoma is one of several new entities added to the updated classification of salivary gland tumors by the WHO in 1991. This tumor most frequently occurs in parotid gland. This is the first report presenting the tumor in floor of the mouth. It is a rare and prognostic poor cancer. Especially, there was not good therapy for recurrent cases. We treated the patient with repeated recurrences three times and presented in bilateral parapharyngeal space to skullbase in this time. We targeted function preservation and complete cure...
June 2006: Auris, Nasus, Larynx
Jan Kaminsky, Thomas Rodt, Alireza Gharabaghi, Jan Forster, Gerd Brand, Madjid Samii
The FE-modeling of complex anatomical structures is not solved satisfyingly so far. Voxel-based as opposed to contour-based algorithms allow an automated mesh generation based on the image data. Nonetheless their geometric precision is limited. We developed an automated mesh-generator that combines the advantages of voxel-based generation with improved representation of the geometry by displacement of nodes on the object-surface. Models of an artificial 3D-pipe-section and a skullbase were generated with different mesh-densities using the newly developed geometric, unsmoothed and smoothed voxel generators...
June 2005: Medical Engineering & Physics
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