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Cranial base endoscopic surgery

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https://www.readbyqxmd.com/read/28433845/clinical-outcome-after-extended-endoscopic-endonasal-resection-of-craniopharyngiomas-two-institution-experience
#1
Hye Ran Park, Varun R Kshettry, Christopher J Farrell, Jae Meen Lee, Yong Hwy Kim, Tae Bin Won, Doo Hee Han, Hyunwoo Do, Gurston Nyguist, Marc Rosen, Dong Gyu Kim, James J Evans, Sun Ha Paek
BACKGROUND: The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. OBJECTIVE: We present clinical experience and outcomes utilizing EEA for craniopharyngiomas. METHODS: A total of 116 patients in two remote institutions were enrolled in this retrospective study. Surgical, endocrinological and ophthalmological outcomes were assessed. RESULTS: The mean follow-up was 35 months (range, 1-115)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28409727/clival-chordomas-considerations-after-16-years-of-endoscopic-endonasal-surgery
#2
Matteo Zoli, Laura Milanese, Rocco Bonfatti, Marco Faustini-Fustini, Gianluca Marucci, Giovanni Tallini, Corrado Zenesini, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28391532/outcome-of-a-graduated-minimally-invasive-facial-reanimation-in-patients-with-facial-paralysis
#3
Laura C Holtmann, Anja Eckstein, Kerstin Stähr, Minzhi Xing, Stephan Lang, Stefan Mattheis
Peripheral paralysis of the facial nerve is the most frequent of all cranial nerve disorders. Despite advances in facial surgery, the functional and aesthetic reconstruction of a paralyzed face remains a challenge. Graduated minimally invasive facial reanimation is based on a modular principle. According to the patients' needs, precondition, and expectations, the following modules can be performed: temporalis muscle transposition and facelift, nasal valve suspension, endoscopic brow lift, and eyelid reconstruction...
April 8, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28362929/metastatic-liposarcoma-of-the-skull-base-a-case-report-and-review-of-literature
#4
Nirmeen Zagzoog, Greta Ra, Alex Koziarz, John Provias, Doron Sommer, Saleh A Almenawer, Kesava Reddy
BACKGROUND AND IMPORTANCE: Myxoid liposarcoma is not an uncommon form of sarcoma. However, it usually affects the lower extremity long bones. Scapular involvement is extremely rare, as is a metastasis to the parasellar region. We present a case of liposarcoma of the skull base originating in the scapular region and metastasizing to the sellar and parasellar regions and provide a review of the pertinent literature. CLINICAL PRESENTATION: A 43-year-old female patient diagnosed with left scapular myxoid liposarcoma was treated with surgical resection...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28359922/first-application-of-7t-magnetic-resonance-imaging-in-endoscopic-endonasal-surgery-of-skull-base-tumors
#5
Thomas F Barrett, Hadrien A Dyvorne, Francesco Padormo, Puneet S Pawha, Bradley N Delman, Raj K Shrivastava, Priti Balchandani
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. METHODS: Images were acquired at 7T on 11 patients with skull base lesions...
March 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28291218/-endoscopic-transnasal-surgery-for-giant-fibrous-dysplasia-of-the-skull-base-spreading-to-the-right-orbital-cavity-and-nasopharynx-a-case-report-and-literature-review
#6
A N Shkarubo, A Yu Lubnin, E Yu Bukharin, L V Shishkina, D N Andreev, K V Koval', I V Chernov, V V Karnaukhov
BACKGROUND: An extended endoscopic endonasal approach is increasingly used in surgical treatment of space-occupying skull base lesions. The international literature reports only 20 cases of surgical treatment for fibrous dysplasia (PD) of the skull base using the endoscopic endonasal approach. We present our experience with the endoscopic endonasal approach in surgical treatment for giant fibrous dysplasia of the skull base, spreading to the right orbital cavity and nasopharynx. CLINICAL CASE: A 26-year-old male patient presented with cranial pain, Vth nerve dysfunction on the right, right keratopathy...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28279556/management-options-of-non-syndromic-sagittal-craniosynostosis
#7
REVIEW
Bryan S Lee, Lee S Hwang, Gaby D Doumit, Joseph Wooley, Francis A Papay, Mark G Luciano, Violette M Recinos
There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options...
March 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28230588/how-to-expose-the-entire-sella-floor-with-minimal-manipulation-during-an-endoscopic-endonasal-transsphenoidal-approach
#8
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Yong Jin Park, Soo Whan Kim, Jin Hee Cho, Boo-Young Kim, Sung Won Kim
OBJECTIVE: A method of opening the posterior ethmoid air cells with minimal manipulation is important for adequate exposure of the sella floor and minimal nasal morbidity. METHODS: Between February 2009 and August 2016, 373 patients with skull-base tumors underwent surgery via endoscopic endonasal transsphenoidal approach with the 2-nostrils/4-hands technique using this technique. RESULTS: A linear incision was made laterally toward one-third of the superior turbinate along the superior border of the sphenoid sinus ostium...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28219164/-a-combination-use-of-endoscope-and-microscope-in-cerebral-pontine-angle-surgery
#9
Z Y Wang, H Jia, J Yang, H Y Tan, H Wu
Objective: To evaluate the application of combination use of microscope and endoscope in cerebral pontine angle (CPA) surgery. Methods: A total of 72 patients undergone lateral skull base surgeries via endoscope under microscopic control from January 2006 to January 2015 was reviewed respectively. The patients including 35 males and 37 females were composed of 22 cases of vestibular swannnomas, 45 cases of cranial neuropathy and 5 cases of CPA chelesteatoma. Twenty cases of vestibular swannnomas, 15 cases of cranial neuropathy and 2 cases of CPA chelesteatoma undergone the surgery via retrosigmoid approach, while other cases undergone the surgery via retrolabyrinthine approach...
February 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#10
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#11
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28153613/fourth-ventricle-outlet-obstruction-with-expanding-space-on-the-surface-of-cerebellum
#12
Yoshiteru Shimoda, Kensuke Murakami, Norio Narita, Teiji Tominaga
BACKGROUND: Hydrocephalus is classified as noncommunicating and communicating based on whether all ventricular and subarachnoid spaces are communicating. Although the diagnosis between the two different states is crucial, it is difficult in certain conditions. In particular, communicating hydrocephalus and noncommunicating hydrocephalus owing to fourth ventricle outlet obstruction are highly misdiagnosed. We describe a case of fourth ventricle outlet obstruction of unknown origin that was initially misdiagnosed as communicating hydrocephalus...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28125310/juvenile-psammomatoid-ossifying-fibroma-in-paranasal-sinus-and-skull-base
#13
Mingjie Wang, Bing Zhou, Shunjiu Cui, Yunchuan Li
CONCLUSION: The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. OBJECTIVES: JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. METHOD: This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014...
January 26, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27989971/neurophysiological-identification-of-cranial-nerves-during-endoscopic-endonasal-surgery-of-skull-base-tumors-pilot-study-technical-report
#14
Alexey Nikolaevich Shkarubo, Ilia Valerievich Chernov, Anna Anatolievna Ogurtsova, Dmitry Aleksandrovich Moshchev, Andrew Jurievich Lubnin, Dmitry Nicolaevich Andreev, Konstantin Vladimirovich Koval
INTRODUCTION: Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. OBJECTIVE: To assess the effectiveness of t-EMG in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. MATERIALS AND METHODS: Nine patients were operated on using the endoscopic endonasal approach within a 1-year period...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27975017/endoscopic-adipofascial-radial-forearm-flap-reconstruction-of-a-clival-defect
#15
Trevor G Hackman
Skull base surgical defects present unique challenges to anatomic and functional reconstruction. Fortunately, many endonasal skull base defects are successfully managed with a variety of local and regional reconstructive techniques. However, when prior surgery or radiotherapy eliminates the use of these local and regional reconstructive options, more elaborate free tissue transfer techniques are required. Managing endoscopic skull base defects of the anterior cranial fossa and clivus is further complicated by the limited access afforded for flap inset...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27903119/the-learning-curve-in-endoscopic-endonasal-resection-of-craniopharyngiomas
#16
Varun R Kshettry, Hyunwoo Do, Khaled Elshazly, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE There is a paucity of literature regarding the learning curve associated with performing endoscopic endonasal cranial base surgery. The purpose of this study was to determine to what extent a learning curve might exist for endoscopic endonasal resection in cases of craniopharyngiomas. METHODS A retrospective review was performed for all endoscopic endonasal craniopharyngioma resections performed at Thomas Jefferson University from 2005 to 2015. To assess for a learning curve effect, patients were divided into an early cohort (2005-2009, n = 20) and a late cohort (2010-2015, n = 23)...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903113/microscopic-versus-endoscopic-approaches-for-craniopharyngiomas-choosing-the-optimal-surgical-corridor-for-maximizing-extent-of-resection-and-complication-avoidance-using-a-personalized-tailored-approach
#17
REVIEW
James K Liu, Ilesha A Sevak, Peter W Carmel, Jean Anderson Eloy
Resection remains the mainstay of treatment for craniopharyngiomas with the goal of radical resection, if safely possible, to minimize the rate of recurrence. Endoscopic endonasal and microscopic transcranial surgical approaches have both become standard methods for the treatment for craniopharyngiomas. However, the approach selection paradigm for craniopharyngiomas is still a point of discussion. Choosing the optimal surgical approach can play a significant role in maximizing the extent of resection and surgical outcome while minimizing the risks of potential complications...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27890187/imaging-of-paranasal-sinuses-and-anterior-skull-base-and-relevant-anatomic-variations
#18
REVIEW
Estushi Iida, Yoshimi Anzai
This article reviews the normal anatomy and variants of the anterior skull base and sinonasal cavities that are relevant to endoscopic sinus and skull base surgery. Radiologists should be aware of sinonasal anatomy that can be impediments to surgical access and increase risk of vascular or cranial nerve injury during surgery. Imaging features of the paranasal sinuses and anterior skull base pathologies are also discussed.
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27890179/expanded-endonasal-endoscopic-approaches-to-the-skull-base-for-the-radiologist
#19
REVIEW
Christopher R Roxbury, Masaru Ishii, Ari Meir Blitz, Douglas D Reh, Gary L Gallia
The cranial base is a complex 3-D region that contains critical neurovascular structures. Pathologies affecting this region represent some of the most challenging lesions to manage due to difficulty with access and risk of significant postoperative morbidity. With the development of expanded endonasal endoscopic approaches, skull base surgeons use the nose and paranasal sinuses as a corridor to access selected ventral skull base lesions. This review discusses high-resolution imaging in the evaluation of patients with skull base lesions considered for endonasal endoscopic surgery, summarizes various expanded endonasal endoscopic approaches, and provides examples of commonly used expanded endonasal endoscopic procedures...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27833887/endoscopic-management-of-congenital-intranasal-meningocele-in-3-month-old-infant
#20
Gaurav Khandelwal, Manoj Sharma, Priyanka Gupta
Fronto-ethmoidal meningocoele is a rare congenital condition with protrusion of meninges through anterior cranial fossa into the facial skeleton, surgical repair should be done in order to resolve nasal obstruction, provide a watertight division between sino-nasal and intra-cranial cavities and minimise injury to any CNS contents (Maddalozzo in Issue Otolaryngol Clin N Am 2015). Open approaches may be required but endoscopic endo-nasal repairs can be done in paediatric skull-base defects. A 3 month-old infant with fronto-ethmoidal meningocele operated with endo-nasal approach...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
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