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Cranial base endoscopic surgery

Juan Luis Gómez-Amador, Luis Alberto Ortega-Porcayo, Isaac Jair Palacios-Ortíz, Alexander Perdomo-Pantoja, Felipe Eduardo Nares-López, Alfredo Vega-Alarcón
Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem...
October 21, 2016: Journal of Neurosurgery
Rolfe M Radcliffe, Yasmine Messiaen, Nita L Irby, Thomas J Divers, Curtis W Dewey, Katharyn J Mitchell, Lauren V Schnabel, Abraham J Bezuidenhout, Peter V Scrivani, Norm G Ducharme
OBJECTIVE: To report a transnasal, endoscopically guided ventral surgical approach for accessing the cranial and caudal segments of the sphenopalatine sinus for mass removal in a horse. STUDY DESIGN: Case report. ANIMAL: Adult horse with acute onset blindness referable to a soft tissue mass within the sphenopalatine sinus. CLINICAL REPORT: A 7-year-old Warmblood gelding presented with a history of running into a fence and falling...
October 12, 2016: Veterinary Surgery: VS
Omur Gunaldi, Hakan Kina, Osman Tanriverdi, Uzay Erdogan, Lütfi Şinasi Postalci
OBJECTIVE: In recent years, endoscope started to be used for the excision of the brainstem lesions or those localized in the anterior part of the brainstem. In this paper a case of clival meningioma resected through endoscopic endonasal transclival route has been presented with illustrations, live surgery videos demonstrating the surgery step by step. CASE REPORT: A 35-year-old male patient consulted to us with dysphagia,and impaired consciousness. MR imaging detected a mass lesion with a wide base localized clivus and anterior part of brainstem...
May 25, 2016: Turkish Neurosurgery
T Marshak, W K Yun, C Hazout, R Sacks, R J Harvey
BACKGROUND: Vidian neurectomy has been proposed as a surgical option for rhinitis refractory to medical treatment. However, the evidence base for its benefit remains controversial. METHODS: A systematic review was performed. Studies reporting original data on patients with rhinitis treated by vidian neurectomy were included. Patient-reported outcome measures were the primary outcome investigated; specific peri-operative morbidities were the secondary outcome. RESULTS: A total of 1012 articles fulfilled the search criteria, 32 of which were included in the study...
July 2016: Journal of Laryngology and Otology
Matthew M Dedmon, Garrett D Locketz, Kyle J Chambers, Matthew R Naunheim, Derrick T Lin, Stacey T Gray
OBJECTIVE: To collect data on skull base surgery training experiences and practice patterns of otolaryngologists that recently completed fellowship training. DESIGN: A 24-item survey was disseminated to physicians who completed otolaryngology fellowships in rhinology, head and neck oncology, or neurotology between 2010 and 2014. RESULTS: During a typical year, 50% of rhinologists performed more than 20 endoscopic anterior skull base cases, 83% performed fewer than 20 open cases, and were more confident performing advanced transplanum (p = 0...
August 2016: Journal of Neurological Surgery. Part B, Skull Base
Matthew Piazza, John Y K Lee
The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope...
July 2016: Neurosurgery Clinics of North America
Parviz Dolati, Daniel Eichberg, Alexandra Golby, Amir Zamani, Edward Laws
BACKGROUND: Transsphenoidal surgery (TSS) is the most common approach for the treatment of pituitary tumors. However, misdirection, vascular damage, intraoperative CSF leakage, and optic nerve injuries are all well-known complications, and the risk of adverse events is more likely in less experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation coupled with neuronavigation in localization of neurovascular structures during TSS. METHODS: Twenty-five patients with pituitary tumors underwent preoperative 3TMRI and Images loaded into the navigation platforms were used for segmentation and pre-operative planning...
June 11, 2016: World Neurosurgery
A N Shkarubo, A A Ogurtsova, D A Moshchev, A Yu Lubnin, D N Andreev, K V Koval', I V Chernov
INTRODUCTION: Intraoperative identification of the cranial nerves is a useful technique in removal of skull base tumors through the endoscopic endonasal approach. Searching through the scientific literature found one pilot study on the use of triggered electromyography (t-EMG) for identification of the VIth nerve in endonasal endoscopic surgery of skull base tumors (D. San-Juan, et al, 2014). AIM: The study objective was to prevent iatrogenic injuries to the cranial nerves without reducing the completeness of tumor tissue resection...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Harminder Singh, Richard W Vogel, Robert M Lober, Adam T Doan, Craig I Matsumoto, Tyler J Kenning, James J Evans
Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base...
2016: Scientifica
Yu-Hsuan Lin, Po-Chin Wang, Yaoh-Shiang Lin
Sinonasal organized hematoma (SNOH) is rarely encountered in clinical practice. The disease demonstrates a high tendency for occurrence in East Asian individuals, and in the majority of cases, is located in the maxillary sinus. The current report presents the case of an 81-year-old female who developed a space-occupying lesion, which masqueraded as a skull base malignancy, following surgery for the treatment of isolated sphenoid sinus aspergilloma. Subsequent endoscopic endonasal surgery confirmed the diagnosis of an OH of the sphenoid sinus...
June 2016: Oncology Letters
Alireza Mohebbi, Shahin Rajaeih, Mahdi Safdarian, Parisa Omidian
INTRODUCTION: The sphenoid sinus is an important structure in ventral skull base surgeries that is surrounded by several vital anatomical structures including the internal carotid arteries, optic nerve and cranial nerves inside the cavernous sinus. In addition, the foramen rotundum is a small canal deeply situated in the base of the skull, which represents the way for exit of the maxillary nerve. Understanding of the sphenoid bone anatomical relationships is central to the expanded endonasal approaches to the skull base...
May 24, 2016: Brazilian Journal of Otorhinolaryngology
Davide Locatelli, Fabio Pozzi, Mario Turri-Zanoni, Paolo Battaglia, Laura Santi, Iacopo Dallan, Paolo Castelnuovo
INTRODUCTION: Transorbital endoscopic surgery is one of the most recent fields of skull base surgery. This paper presents the emerging applications of transorbital endoscopic approaches to the skull base and their current results on the treatment of selected extradural and intradural lesions, based on a review of meta-analysis and recent clinical series. EVIDENCE ACQUISITION: A PubMed, Cochrane and Ovid search for articles published from 2000 to 2015 was performed using the search terms "endoscopic skull base surgery", "transorbital endoscopic approach", and "transorbital neuroendoscopic surgery"...
December 2016: Journal of Neurosurgical Sciences
Giuseppe Catapano, Matteo de Notaris, Domenico Di Maria, Luis Alonso Fernandez, Giuseppe Di Nuzzo, Vincenzo Seneca, Giuseppina Iorio, Iacopo Dallan
BACKGROUND: The evolution of skull base surgery over the past decade has been influenced by advancement in visualization technology. Recently, as a result of such improvements, three-dimensional (3-D) scopes have been widely used during endoscopic endonasal approaches. In the present study, we describe the use of 3-D stereoscopic endoscope for the treatment of a variety of skull base lesions. METHODS: From January 2010 to June 2015, a 3-D endoscopic endonasal approach (4 and 4...
August 2016: Acta Neurochirurgica
Richard C Allen
PURPOSE OF REVIEW: Classical orbital approaches in skull base surgery have involved large incisions with extensive bone removal resulting in prolonged recovery with associated morbidity and mortality. The purpose of this review is to explore recent advances in skull base surgery that are applicable to the orbital surgeon. RECENT FINDINGS: Transnasal endoscopic surgery provides access to the medial 180 degrees of the orbit. Access to the lateral 180 degrees may be obtained using transmaxillary and transcranial techniques...
September 2016: Current Opinion in Ophthalmology
Masahiro Shin, Kenji Kondo, Shunya Hanakita, Hirotaka Hasegawa, Masanori Yoshino, Yu Teranishi, Taichi Kin, Nobuhito Saito
OBJECTIVE Reports about endoscopic endonasal surgery for skull base tumors involving the lateral part of petrous apex remain scarce. The authors present their experience with the endoscopic transsphenoidal anterior petrosal (ETAP) approach through the retrocarotid space for tumors involving the internal auditory canal, jugular fossa, and cavernous sinus. METHODS The authors performed the ETAP approach in 10 patients with 11 tumors (bilateral in 1 patient) that extensively occupied the lateral part of petrous apex, e...
April 1, 2016: Journal of Neurosurgery
Carl H Snyderman, Paul A Gardner, Bostjan Lanisnik, Janez Ravnik
OBJECTIVES/HYPOTHESIS: To assess the efficacy of a surgical telementoring program for endoscopic skull base surgery. STUDY DESIGN: Prospective case series with surveys of surgeons. METHODS: A surgical telementoring program was established for mentoring of a skull base team at the University of Maribor in Slovenia by an experienced skull base team at the University of Pittsburgh Medical Center in Pennsylvania. Two-way video and audio streaming provided real-time communication with the surgical team...
June 2016: Laryngoscope
A N Shkarubo, L V Shishkina, N K Serova, O F Tropinskaya, A Yu Lubnin, A B Kurnosov, D N Andreev, K V Koval, I V Chernov, V V Karnaukhov
AIM: The objective of the study was to develop the tactics of surgical treatment of large and giant pituitary adenomas, spreading into the posterior cranial fossa. MATERIAL AND METHODS: Patients with large hormonally inactive pituitary adenoma, extending to the right cavernous sinus and posterior cranial fossa. RESULTS: The endoscopic endonasal removal a large endo-supra-latero(D)-retrosellar pituitary tumor was conducted. Control MRI shows that the tumor was removed radically...
2015: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Shorook Na'ara, Moran Amit, Ziv Gil, Salem Billan
Objective Extramedullary plasmacytomas are rare tumors. In the current study we aim to characterize its clinical course at the skull base and define the most appropriate therapeutic protocol. Methods We conducted a meta-analysis of articles in the English language that included data on the treatment and outcome of plasmacytoma of the base of skull. Results The study cohort consisted of 47 patients. The tumor originated from the clivus and sphenoclival region in 28 patients (59.5%), the nasopharynx in 10 patients (21...
February 2016: Journal of Neurological Surgery. Part B, Skull Base
Songbai Gui, Xuyi Zong, Xinsheng Wang, Chuzhong Li, Peng Zhao, Lei Cao, Yazhuo Zhang
The aim of this study is to retrospectively analyze 161 cases of surgically treated skull base chordoma, so as to summarize the clinical classification of this tumor and the surgical approaches for its treatment via transnasal endoscopic surgery. Between August 2007 and October 2013, a total of 161 patients (92 males and 69 females) undergoing surgical treatment of skull base chordoma were evaluated with regard to the clinical classification, surgical approach, and surgical efficacy. The tumor was located in the midline region of the skull base in 134 cases, and in the midline and paramedian regions in 27 cases (extensive type)...
April 2016: Neurosurgical Review
Dimitrios Paraskevopoulos, Jonathan Roth, Shlomi Constantini
OBJECTIVE: Cranial neuroendoscopy is becoming increasingly popular. Endoscopes may be used free-hand or with endoscope holders (EH). The aim of this paper is to summarize the evolution of EH and attempt an overview of currently available devices, features, and usage, identifying weaknesses and focusing on feasibility. METHODS: A systematic review was conducted on Pubmed, OvidSP, Ebsco, and Google Scholar. Targeted search through cross-references was also implemented, followed by personal contacts, interviews, company websites, and operating manuals...
May 2016: World Neurosurgery
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