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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/28808799/transorbital-endoscopic-approach-for-exposure-of-the-sylvian-fissure-middle-cerebral-artery-and-crural-cistern-an-anatomical-study
#1
João Paulo Almeida, Armando S Ruiz-Treviño, Sathwik R Shetty, Sacit B Omay, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The availability of minimal access instrumentation and endoscopic visualization has revolutionized the field of minimally invasive skull base surgery. The transorbital endoscopic approach using an eyelid incision has been proposed as a new minimally invasive technique for the treatment of skull base pathology, mostly extradural tumors. Our study aims to evaluate the anatomical aspects and potential role of the transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern...
August 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28799867/endoscope-assisted-repair-of-csf-otorrhea-and-temporal-lobe-encephaloceles-via-keyhole-craniotomy
#2
Pamela C Roehm, Derrick Tint, Norman Chan, Ryan Brewster, Vishad Sukul, Kadir Erkmen
OBJECTIVE Temporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. Standard middle fossa craniotomy exposes patients to dural retraction, which can lead to postoperative neurological complications. Endoscopic and minimally invasive techniques have been used in other surgeries to minimize brain retraction, and so these methods were applied to repair the lateral skull base...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28765065/reconstructive-outcome-of-intraoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-surgery-for-tumors-involving-skull-base
#3
Chi-Man Jeon, Sang Duk Hong, Ho Jun Seol, Jung-Il Lee, Do-Hyun Nam, Yoon Jung Hwang, Doo-Sik Kong
Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28764208/assessing-the-viability-of-hadad-flap-by-postoperative-contrast-enhanced-magnetic-resonance-imaging
#4
Hegde Jyotirmay, Sunil Kumar Saxena, A S Ramesh, K Nagarajan, Shreshta Bhat
INTRODUCTION: The Expanded Endonasal Approaches (EEAs) have been widely used for various skull base lesions. The reconstruction of the skull base defects is of vital importance to prevent postoperative complications. The vascular pedicled-nasoseptal flap (Hadad-Bassagasteguy flap) is used as a workhorse in reconstruction of majority of the defects. AIM: The purpose of this study was: (a) To assess the postoperative MRI appearance of vascularised pedicled nasoseptal flap for its viability; (b) To determine the variations in MRI that may suggest potential flap failure...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761532/skull-base-bony-lesions-management-nuances-a-retrospective-analysis-from-a-tertiary-care-centre
#5
Amit Kumar Singh, Arun Kumar Srivastava, Jayesh Sardhara, Kamlesh Singh Bhaisora, Kuntal Kanti Das, Anant Mehrotra, Rabi Narayan Sahu, Awadhesh Kumar Jaiswal, Sanjay Behari
BACKGROUND: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability in the involvement of important local structure. Through this retrospective analysis from a Tertiary Care Centre, we are summarizing the details of skull base bony lesions and its management nuances...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28758183/neuronavigation-guided-endoscopic-endonasal-excision-of-schwannoma-like-chordoma-of-the-meckel-s-cave-a-case-report
#6
Ali Akay, Sercan Göde, M Sedat Çağli
Chordomas are locally aggressive malignant tumors due to their recurrence potential, originating from the embryonic notochord remnants. Chordomas can originate anywhere on the axial skeleton. They are extradural and are spread by bone destruction. Chordomas are locally aggressive tumors which invade the dura mater, and may also present with secondary intradural growth. The Meckel's cave location of chordomas has been very rarely reported in the literature. Chordomas located in the Meckel's cave can be radiologically confused with trigeminal schwannomas...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28748855/clinical-characteristics-and-endoscopic-endonasal-removal-of-foreign-bodies-within-sinuses-orbit-and-skull-base
#7
Yi-Hui Wen, Wei-Jian Hou, Wen-Bin Lei, Feng-Hong Chen, Xiao-Lin Zhu, Zhang-Feng Wang, Ren-Qiang Ma, Wei-Ping Wen
BACKGROUND: Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS. METHODS: We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center...
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28742240/role-of-tissue-eosinophils-in-chronic-rhinosinusitis-associated-olfactory-loss
#8
Leah J Hauser, Rakesh K Chandra, Ping Li, Justin H Turner
BACKGROUND: Olfactory dysfunction is 1 of the hallmark symptoms of chronic rhinosinusitis (CRS). Eosinophilic inflammation has been implicated as a potential causative factor. However, prior studies have been limited by retrospective study designs, concomitant use of systemic corticosteroids, and other confounding factors. METHODS: CRS and healthy non-CRS control subjects undergoing endoscopic sinus or skull-base surgery were prospectively enrolled and completed olfactory testing utilizing the 40-item Smell Identification Test (SIT) immediately prior to surgery...
July 25, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28736350/antibiotic-prophylaxis-in-endoscopic-endonasal-pituitary-and-skull-base-surgery
#9
Laura Milanese, Matteo Zoli, Giacomo Sollini, Chiara Martone, Corrado Zenesini, Carmelo Sturiale, Paolo Farneti, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study was to assess the efficacy of our intraoperative antibiotic prophylaxis by analyzing the risk factors of postoperative meningitis in our series. METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days were included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction; no postoperative administrations were performed after 2005...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#10
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28716213/imaging-of-endoscopic-approaches-to-the-anterior-and-central-skull-base
#11
REVIEW
I M Schmalfuss
Sinonasal endoscopy for treatment of benign sinonasal diseases is a well-established procedure. Recent advances in endoscope technology have substantially expanded its application with many institutions now offering resection of skull base lesions and sinonasal malignancies via the endoscopic approach. Its minimally invasive nature leads to faster recovery time, better cosmetic results, and fewer complications. Unfortunately, not all lesions involving the sinonasal region and skull base are accessible to sinonasal endoscopy...
July 14, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28716164/collagen-matrix-as-an-inlay-in-endoscopic-skull-base-reconstruction
#12
G M Oakley, J M Christensen, M Winder, B P Jonker, A Davidson, T Steel, C Teo, R J Harvey
BACKGROUND: Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described. METHODS: A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined...
July 18, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28707807/accuracy-of-computer-assisted-navigation-significant-augmentation-by-facial-recognition-software
#13
Jordan T Glicksman, Christine Reger, Arjun K Parasher, David W Kennedy
BACKGROUND: Over the past 20 years, image guidance navigation has been used with increasing frequency as an adjunct during sinus and skull base surgery. These devices commonly utilize surface registration, where varying pressure of the registration probe and loss of contact with the face during the skin tracing process can lead to registration inaccuracies, and the number of registration points incorporated is necessarily limited. The aim of this study was to evaluate the use of novel facial recognition software for image guidance registration...
July 14, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#14
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#15
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28686110/role-of-endoscopic-transnasal-surgery-for-skull-base-chondrosarcoma-a-retrospective-analysis-of-19-cases-at-a-single-institution
#16
Hirotaka Hasegawa, Masahiro Shin, Kenji Kondo, Shunya Hanakita, Akitake Mukasa, Taichi Kin, Nobuhito Saito
OBJECTIVE Skull base chondrosarcoma is one of the most intractable tumors because of its aggressive biological behavior and involvement of the internal carotid artery and cranial nerves (CNs). One of the most accepted treatment strategies for skull base chondrosarcoma has been surgical removal of the tumor in conjunction with proactive extensive radiation therapy (RT) to the original tumor bed. However, the optimal strategy has not been determined. The goal of this study was to evaluate the early results of endoscopic transnasal surgery (ETS)...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28666364/-live-cadaver-model-for-internal-carotid-artery-injury-simulation-in-endoscopic-endonasal-skull-base-surgery
#17
Paolo Pacca, Sukhdeep S Jhawar, Daniel V Seclen, Eric Wang, Carl Snyderman, Paul A Gardner, Emad Aboud, Juan C Fernandez-Miranda
Background: Intraoperative injury of the internal carotid artery (ICA) is the most dreaded complication in endoscopic endonasal surgery (EES) of skull base. Training for ICA injury is practically impossible in live operative settings. Objective: To evaluate a pulsatile perfusion-based live cadaveric model for ICA injury simulation in a laboratory setting. The major emphasis of the study was to evaluate various means of controlling acute bleeding and evaluating the practical utility of this model for training purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28665386/-modern-diagnosis-and-treatment-in-children-with-congenital-basal-encephalocele
#18
A V Sakharov, V V Roginskiy, D N Kapitanov, A L Ivanov, E V Shelesko, S K Gorelyshev, A A Evteev, N V Lemeneva, D N Zinkevich, Yu A Kochkin, V I Ozerova, L A Satanin
Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28662972/utilization-of-sinus-stents-as-a-novel-approach-for-benign-cystic-lesions-of-the-sella
#19
Akina Tamaki, Berje Shammassian, Abhishek Ray, Warren R Selman, Kenneth Rodriguez
Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion...
June 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28645603/robotic-transnasal-endoscopic-skull-base-surgery-systematic-review-of-the-literature-and-report-of-a-novel-prototype-for-a-hybrid-system-bear
#20
Andrea Bolzoni Villaret, Francesco Doglietto, Andrea Carobbio, Alberto Schreiber, Camilla Panni, Enrico Piantoni, Giovanni Guida, Marco Maria Fontanella, Piero Nicolai, Riccardo Cassinis
BACKGROUND: Although robotics has already been applied to several surgical fields, available systems are not designed for endoscopic skull base surgery (ESBS). New-conception prototypes have been recently described for ESBS. AIM OF THE STUDY: To provide a systematic literature review of robotics for ESBS and describe a novel prototype developed at the University of Brescia. MATERIAL AND METHODS: PubMed and Scopus databases were searched using a combination of terms, including Robotics OR Robot and Surgery OR Otolaryngology OR Skull Base OR Holder...
June 20, 2017: World Neurosurgery
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