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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/29657933/relationship-between-height-of-ethmoid-skull-base-and-length-of-lateral-lamella-by-sectional-coronal-computed-tomography-scan-before-endoscopic-sinus-surgery
#1
Seyyed Mustafa Hashemi, Nezamoddin Berjis, Hamidreza Ebrahimi
Background: Damage to ethmoid skull base (ESB) and lateral lamella (LL) during endoscopic sinus surgery (ESS) causes penetration into the brain. This study is aimed to determine the relationship between the height of ESB and length of LL by sectional coronal computed tomography (CT) scans before ESS. Materials and Methods: In a cross-sectional study, 100 patients admitted to ENT clinic of Al-Zahra Hospital, filled the consents regarding the use of CT scan stereotype...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29619106/an-analysis-of-anatomic-variations-of-the-sphenoid-sinus-and-its-relationship-to-the-internal-carotid-artery
#2
Myrian Marajó Dal Secchi, Ricardo Landini Lutaif Dolci, Reginaldo Teixeira, Paulo Roberto Lazarini
Introduction  The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective  To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods  Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively)...
April 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29617919/combined-nasoseptal-and-inferior-turbinate-flap-for-reconstruction-of-large-skull-base-defect-after-expanded-endonasal-approach-operative-technique
#3
Julien Boetto, Moujahed Labidi, Kentaro Watanabe, Shunya Hanakita, Schahrazed Bouazza, Thibault Passeri, Anne-Laure Bernat, Sebastien Froelich
BACKROUND: Increasing indications for endoscopic endonasal approaches have led neurosurgeons to develop new reconstruction techniques for larger skull base defects. Vascularized grafts have been a great adjunction to reduce the rate of cerebrospinal fluid leak and can also be used to cover exposed critical structures such as the internal carotid artery. The nasoseptal flap and the inferior or middle turbinate flap are thus widely used in endoscopic skull base surgery, but may be insufficient for very large defects...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29588905/endoscopic-endonasal-resection-of-a-suprasellar-pituitary-adenoma-mimicking-tuberculum-sellae-meningioma-in-a-patient-with-an-intrasellar-persistent-trigeminal-artery
#4
Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Mostafa Shahein, E Antonio Chiocca, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588903/endoscopic-endonasal-transoculomotor-triangle-approach-for-the-resection-of-a-pituitary-adenoma-with-ambient-cistern-extension
#5
Georgios Andrea Zenonos, Eric Wesley Wang, Juan C Fernandez-Miranda
Objectives  The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588901/endoscopic-endonasal-transtuberculum-sellae-approach-for-the-resection-of-suprasellar-intrainfundibular-epidermoid-cyst
#6
Alaa S Montaser, Juan M Revuelta Barbero, Mostafa Shahein, Alexandre B Todeschini, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 49-year-old female presented with intense headaches of 3 months duration. Brain magnetic resonance imaging (MRI) was performed and showed a sellar-suprasellar lesion extending into the third ventricle. A presumptive diagnosis of a craniopharyngioma was made. Since the patient did not have any visual deficits, she opted for conservative management. Four months later, she started to have progressive deterioration of vision; thus, surgery was indicated. The patient underwent endoscopic endonasal resection of the lesion through a transtuberculum sellae approach...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588890/endoscopic-transsphenoidal-salvage-surgery-for-symptomatic-residual-cystic-craniopharyngioma-after-radiotherapy
#7
Enzo Emanuelli, Giuliana Frasson, Diego Cazzador, Daniele Borsetto, Luca Denaro
Objectives  Ideal treatment of craniopharyngiomas is still controversial. Radiotherapy (RT) is considered effective for recurrences or after subtotal tumor removal (STR). About 40 to 50% of patients may experience tumor cyst expansion soon after RT; in these cases, the role of salvage surgery is debated. Design  Operative video. Setting  Tertiary care center. Participants  An 11-year-old boy diagnosed with persistent craniopharyngioma. In 2015, the patient underwent right frontotemporal craniotomy for STR at another center, complicated by panhypopituitarism...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588886/endoscopic-endonasal-transplanum-transtuberculum-approach-for-the-resection-of-a-large-suprasellar-craniopharyngioma
#8
João Mangussi-Gomes, Eduardo A Vellutini, Huy Q Truong, Felix H Pahl, Aldo C Stamm
Objectives  To demonstrate an endoscopic endonasal transplanum transtuberculum approach for the resection of a large suprasellar craniopharyngioma. Design  Single-case-based operative video. Setting  Tertiary center with dedicated skull base team. Participants  A 72-year-old male patient diagnosed with a suprasellar craniopharyngioma. Main Outcomes Measured  Surgical resection of the tumor and preservation of the normal surrounding neurovascular structures. Results  A 72-year-old male patient presented with a 1-year history of progressive bitemporal visual loss...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588882/endoscopic-endonasal-approach-for-a-suprasellar-craniopharyngioma
#9
Georgios A Zenonos, Carl H Snyderman, Paul A Gardner
Objectives  The current video presents the nuances of an endoscopic endonasal approach to a suprasellar craniopharyngioma. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon, at a teaching academic institution. Participants  The case refers to a 67-year-old man who presented with vision loss and headaches, and was found to have a suprasellar mass, with imaging characteristics consistent with a craniopharyngioma...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29582975/feasibility-of-endoscopic-endonasal-approach-for-clip-application-of-cerebral-aneurysms-a-systematic-review
#10
Jonathan A Forbes, Sophie D' Herbemont, Kurt R Lehner, Diego Pineda Martinez, Ignacio P Navarro-Chávez, Diego Mendez Rosito, Theodore H Schwartz
INTRODUCTION: While open, microsurgical clipping and endovascular coiling remain the gold standards for treatment of cerebral aneurysms, a growing number of aneurysms treated via endoscopic endonasal methods have been reported in the literature. The aim of this study was to conduct a systematic review of the literature to gain a more thorough appreciation of the potential benefits and drawbacks of the endoscopic endonasal strategy in this setting. EVIDENCE ACQUISITION: We performed a detailed systematic review of the medical literature on endoscopic endonasal skull base surgery for treatment of cerebral aneurysms utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29574221/endoscopic-endonasal-clipping-of-anterior-circulation-aneurysm-surgical-techniques-and-results
#11
Li-Min Xiao, Bin Tang, Shen-Hao Xie, Guan-Lin Huang, Zhi-Gang Wang, Er-Ming Zeng, Tao Hong
OBJECTIVE: Endoscopic endonasal clipping of intracranial aneurysms may utilize the microsurgical techniques as an alternative to the transcranial approach. The aim of this manuscript is to report a series of patients who underwent endoscopic endonasal approach(EEA) for microsurgical clipping of anterior circulation aneurysms. METHOD: A retrospective chart review was conducted. All the patients who underwent standard binostril EEA for aneurysm clipping were included...
March 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29554360/evaluation-of-intranasal-flap-perfusion-by-intraoperative-indocyanine-green-fluorescence-angiography
#12
Mathew Geltzeiler, Ana Carolina Igami Nakassa, Meghan Turner, Pradeep Setty, George Zenonos, Andrea Hebert, Eric Wang, Juan Fernandez-Miranda, Carl Snyderman, Paul Gardner
BACKGROUND: Vascularized intranasal flaps are the primary reconstructive option for endoscopic skull base defects. Flap vascularity may be compromised by injury to the pedicle or prior endonasal surgery. There is currently no validated technique for intraoperative evaluation of intranasal flap viability. OBJECTIVE: To evaluate the efficacy of indocyanine green (ICG) near-infrared angiography in predicting the viability of pedicled intranasal flaps during endoscopic skull base surgery through a pilot study...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29527889/the-limits-of-the-endoscopic-endonasal-transclival-approach-for-posterior-fossa-tumors
#13
Alexandre Bossi Todeschini, Alaa S Montaser, Douglas A Hardesty, Ricardo L Carrau, Daniel M Prevedello
Endoscopic endonasal approaches (EEA) have gained popularity and acceptance in skull base surgery over the last two decades. So-called expanded EEA allow access in the sagittal plane from the frontal sinus to the odontoid process. The endoscopic endonasal transclival approach allows a unique trajectory into the midline clivus and skull base that is unachievable from traditional craniotomy approaches to lesions such as chondrosarcomas, chordomas, and posterior fossa meningiomas. In this review, we will assess the benefits and drawbacks to using an endoscopic endonasal approach versus transcranial approach to these challenging lesions, assess the anatomical limits of endoscopic endonasal transclival surgery, and discuss the published literature on the topic...
March 8, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29527390/the-posterior-nasoseptal-flap-a-novel-technique-for-closure-after-endoscopic-transsphenoidal-resection-of-pituitary-adenomas
#14
James Barger, Matthew Siow, Michael Kader, Katherine Phillips, Girish Fatterpekar, David Kleinberg, David Zagzag, Chandranath Sen, John G Golfinos, Richard Lebowitz, Dimitris G Placantonakis
Background: While effective for the repair of large skull base defects, the Hadad-Bassagasteguy nasoseptal flap increases operative time and can result in a several-week period of postoperative crusting during re-mucosalization of the denuded nasal septum. Endoscopic transsphenoidal surgery for pituitary adenoma resection is generally not associated with large dural defects and high-flow cerebrospinal fluid (CSF) leaks requiring extensive reconstruction. Here, we present the posterior nasoseptal flap as a novel technique for closure of skull defects following endoscopic resection of pituitary adenomas...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29520496/endoscopic-transnasal-surgery-of-clival-lesions-our-experience
#15
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
March 8, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29498576/3d-printing-and-intraoperative-neuronavigation-tailoring-for-skull-base-reconstruction-after-extended-endoscopic-endonasal-surgery-proof-of-concept
#16
Walid I Essayed, Prashin Unadkat, Ahmed Hosny, Sarah Frisken, Marcio S Rassi, Srinivasan Mukundan, James C Weaver, Ossama Al-Mefty, Alexandra J Golby, Ian F Dunn
OBJECTIVE Endoscopic endonasal approaches are increasingly performed for the surgical treatment of multiple skull base pathologies. Preventing postoperative CSF leaks remains a major challenge, particularly in extended approaches. In this study, the authors assessed the potential use of modern multimaterial 3D printing and neuronavigation to help model these extended defects and develop specifically tailored prostheses for reconstructive purposes. METHODS Extended endoscopic endonasal skull base approaches were performed on 3 human cadaveric heads...
March 2, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29490552/minimally-invasive-endoscopic-repair-of-refractory-lateral-skull-base-cerebrospinal-fluid-rhinorrhea-case-report-and-review-of-the-literature
#17
Brandon Lucke-Wold, Erik C Brown, Justin S Cetas, Aclan Dogan, Sachin Gupta, Timothy E Hullar, Timothy L Smith, Jeremy N Ciporen
Cerebrospinal fluid (CSF) leaks occur in approximately 10% of patients undergoing a translabyrinthine, retrosigmoid, or middle fossa approach for vestibular schwannoma resection. Cerebrospinal fluid rhinorrhea also results from trauma, neoplasms, and congenital defects. A high degree of difficulty in repair sometimes requires repetitive microsurgical revisions-a rate of 10% of cases is often cited. This can not only lead to morbidity but is also costly and burdensome to the health care system. In this case-based theoretical analysis, the authors summarize the literature regarding endoscopic endonasal techniques to obliterate the eustachian tube (ET) as well as compare endoscopic endonasal versus open approaches for repair...
March 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29482118/extended-endoscopic-endonasal-approach-to-the-ventral-skull-base-lesions
#18
Murat Kutlay, Abdullah Durmaz, İlker Özer, Cahit Kural, Çağlar Temiz, Serdar Kaya, İlker Solmaz, Mehmet Daneyemez, Yusuf Izci
OBJECTIVE: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. PATIENTS AND METHODS: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions...
February 21, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29474662/radiographic-analysis-of-the-vidian-canal-and-its-utility-in-petrous-internal-carotid-artery-localization
#19
Eric C Mason, Patricia A Hudgins, Gustavo Pradilla, Nelson M Oyesiku, C Arturo Solares
BACKGROUND: Endoscopic endonasal surgery of the skull base requires expert knowledge of the anatomy and a systematic approach. The vidian canal is regarded as a reliable landmark to localize the petrous internal carotid artery (pICA) near the second genu, which can be used for orientation in deep skull base approaches. There is controversy about the relationship between the vidian canal and the pICA. OBJECTIVE: To further establish the vertical relationship between the vidian canal and the pICA to aid in surgical approaches to the skull base...
February 21, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29455219/endoscopic-transsphenoidal-approach-to-skull-base-lesions-a-clinical-prospective-study
#20
Moneer K Faraj, Wissam J Sagban
OBJECTIVE: To review the patients operated by endoscopic transphenoidal approach for skull base lesions. All the clinical data including age, gender, type of pathology, surgical outcome and surgical complications were studied. METHODS: A clinical prospective study was conducted on 94 cases with skull base lesion that were treated in Neuroscience Hospital in Baghdad, Iraq between October 2011 and December 2016. We followed each patient for an average of 2 years after surgery to determine most common lesion involving the skull base, age and gender distribution, surgical outcome, complications and hospital accommodation...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
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