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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/29452829/cribriform-plate-width-is-highly-variable-within-and-between-subjects
#1
Daniel H Coelho, Taylor S Pence, Mostafa Abdel-Hamid, Richard M Costanzo
OBJECTIVE: All successful endonasal surgery, including functional endoscopic sinus surgery (FESS), depends on knowledge of both anatomy and the specific variations that can occur between and within patients. Familiarity with these structures is a critical component in preventing complications from these procedures, and failure to understand subtle variation can have disastrous results. The aim of this study was to characterize the anatomical variations (if any) of the cribriform plate using a large cadaveric sample set...
February 13, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29451456/clival-meningocele-causing-bilateral-hearing-loss-in-a-child-due-to-superficial-siderosis-of-the-central-nervous-system-case-report
#2
Stephen J Johans, Kevin N Swong, Daniel J Burkett, Michael P Wemhoff, Sean M Lew, Chirag R Patel, Anand V Germanwala
Superficial siderosis (SS) of the CNS is a rare and often unrecognized condition. Caused by hemosiderin deposition from chronic, repetitive hemorrhage in the subarachnoid space, it results in parenchymal damage in the subpial layers of the brain and spinal cord. T2-weighted MRI shows the characteristic hypointensity of hemosiderin deposition, classically occurring around the cerebellum, brainstem, and spinal cord. Patients present with progressive gait ataxia and sensorineural hearing impairment. Although there have been several studies, case reports, and review articles over the years, the clear pathophysiology of subarachnoid space hemorrhage remains to be elucidated...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29442163/accuracy-and-feasibility-of-a-dedicated-image-guidance-solution-for-endoscopic-lateral-skull-base-surgery
#3
Christoph Rathgeb, Lukas Anschuetz, Daniel Schneider, Cilgia Dür, Marco Caversaccio, Stefan Weber, Tom Williamson
OBJECTIVE: We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. MATERIALS AND METHODS: The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table...
February 13, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29421841/-endonasal-endoscopic-surgery-of-choanal-atresia-long-term-results
#4
Laura Holtmann, Kerstin Stähr, Julian Kirchner, Stephan Lang, Stefan Mattheis
INTRODUCTION:  Choanal atresia is a rare abnormality. As neonates depend on transnasal respiration, bilateral choanal atresia causes an acute emergency. Transnasal endoscopic resection of congenital choanal atresia is a well-established therapy. However, the surgical technique has not yet been standardized. METHODS:  A retrospective chart review was performed with a follow-up examination between 9 to 87 months after surgery. 11 patients (7 with unilateral atresia, 4 with bilateral atresia) were included...
February 8, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29405836/expanded-transcanal-transpromontorial-approach-a-novel-surgical-technique-for-cerebellopontine-angle-vestibular-schwannoma-removal
#5
Daniele Marchioni, Marco Carner, Davide Soloperto, Luca Bianconi, Andrea Sacchetto, Luca Sacchetto, Barbara Masotto, Livio Presutti
Objective Vestibular schwannoma (VS) is a benign tumor of the lateral skull base. Different microscopic surgical techniques are described in literature: the retrosigmoid and translabyrinthine approaches are used to treat big tumors located in the cerebellopontine angle, and the middle cranial fossa approach is utilized for small tumors with good hearing preservation. The expanded transcanal transpromontorial (ExpTT) approach is a combined microscopic-endoscopic technique previously indicated for Koos stage I and II VS and now proposed for larger VS, up to 3 cm in diameter, with linear progression into the cerebellopontine angle and touching the brainstem...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29405833/evidence-based-use-of-perioperative-antibiotics-in-otolaryngology
#6
Priyesh N Patel, Asitha D L Jayawardena, Rachel L Walden, Edward B Penn, David O Francis
Objective To identify and clarify current evidence supporting and disputing the effectiveness of perioperative antibiotic use for common otolaryngology procedures. Data Sources PubMed, Embase (OVID), and CINAHL (EBSCO). Review Methods English-language, original research (systematic reviews/meta-analyses, randomized control trials, prospective or retrospective cohort studies, case-control studies, or case series) studies that evaluated the role of perioperative antibiotic use in common otolaryngology surgeries were systematically extracted using standardized search criteria by 2 investigators independently...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29404249/extended-endoscopic-endonasal-approach-for-suprasellar-craniopharyngioma
#7
D Locatelli, F Pozzi, G Agresta, S Padovan, A Karligkiotis, P Castelnuovo
Objectives  We illustrate a suprasellar craniopharyngiomas treated with an extended endoscopic endonasal approach (EEEA). Design  Case report of a 43-year-old male affected by cerebral lesion located in suprasellar region involving the third ventricle and compressing the neurovascular structures, causing an anterosuperior dislocation of the chiasma. There is a complete disruption of the pituitary stalk that can explain the clinical finding of partial anterior hypopituitarism and hyperprolactinemia. The lesion is characterized by a solid and cystic component...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404244/skull-base-reconstruction-in-the-pediatric-patient
#8
REVIEW
Irit Duek, Alon Pener-Tessler, Ravit Yanko-Arzi, Arik Zaretski, Avraham Abergel, Ahmad Safadi, Dan M Fliss
Introduction  Pediatric skull base and craniofacial reconstruction presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Objectives  To suggest an algorithm for skull base reconstruction in children and adolescents after tumor resection. Materials and Methods  Comprehensive literature review and summary of our experience...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404243/pediatric-craniopharyngiomas-a-primer-for-the-skull-base-surgeon
#9
REVIEW
Christopher Salvatore Graffeo, Avital Perry, Michael J Link, David J Daniels
Pediatric craniopharyngioma is a rare sellar-region epithelial tumor that, in spite of its typically benign pathology, has the potential to be clinically devastating, and presents a host of formidable management challenges for the skull base surgeon. Strategies in craniopharyngioma care have been the cause of considerable controversy, with respect to both philosophical and technical issues. Key questions remain unresolved, and include optimizing extent-of-resection goals; the ideal radiation modality and its role as an alternative, adjuvant, or salvage treatment; appropriate indications for expanded endoscopic endonasal surgery as an alternative to transcranial microsurgery; risks and benefits of skull base techniques in a pediatric population; benefits of and indications for intracavitary therapies; and the preferred management of common treatment complications...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404240/open-approaches-to-the-anterior-skull-base-in-children-review-of-the-literature
#10
REVIEW
Oshri Wasserzug, Ari DeRowe, Barak Ringel, Gadi Fishman, Dan M Fliss
Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404239/nasoseptal-flap-for-skull-base-reconstruction-in-children
#11
REVIEW
Oded Ben-Ari, Anat Wengier, Barak Ringel, Narin N Carmel Neiderman, Zvi Ram, Nevo Margalit, Dan M Fliss, Avraham Abergel
Objective  The endoscopic endonasal approach is being increasingly used for the resection and reconstruction of anterior skull base (ASB) lesions. Vascularized nasoseptal flaps (NSF) have become the workhorse for the reconstruction of ASB defects, resulting in a significant decrease in the incidence of cerebrospinal fluid (CSF) leaks. The objective of this study was to investigate the efficacy and safety of NSF in children. Methods  This is a retrospective analysis of the medical records of all patients under the age of 18 years who underwent endoscopic repair of ASB lesions with the use of NSF at our tertiary medical center between 1/2011 and 8/2016...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404238/fibro-osseous-lesions-of-the-skull-base-in-the-pediatric-population
#12
REVIEW
Meghan Wilson, Carl Snyderman
Fibro-osseous lesions of the skull base include a variety of lesions with different biologic behavior. The most common lesions include fibrous dysplasia, osteoma, aneurysmal bone cyst, and juvenile ossifying fibroma. The diagnosis can usually be established with radiographic imaging. In the absence of symptoms, slow-growing lesions can often be observed. When surgery is indicated for relief of symptoms, endoscopic endonasal techniques are well suited for all age groups.
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404235/developmental-considerations-in-pediatric-skull-base-surgery
#13
REVIEW
Melissa A LoPresti, Jonathan N Sellin, Franco DeMonte
Objectives  To review developmental surgical anatomy and technical nuances related to pediatric skull base surgery. Design  Retrospective, single-center case series with literature review. Setting  MD Anderson Cancer Center. Participants  Patients undergoing pediatric skull base surgery. Main Outcome Measures  Review developmental anatomy of the pediatric skull base as it relates to technical nuance of various surgical approaches and insight gained from a 25-year institutional experience with this unique patient population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29379240/imaging-review-of-cerebrospinal-fluid-leaks
#14
Naga V Vemuri, Lakshmi S P Karanam, Venkatesh Manchikanti, Srinivas Dandamudi, Sampath K Puvvada, Vineet K Vemuri
Cerebrospinal fluid (CSF) leak occurs due to a defect in the dura and skull base. Trauma remains the most common cause of CSF leak; however, a significant number of cases are iatrogenic, and result from a complication of functional endoscopic sinus surgery (FESS). Early diagnosis of CSF leak is of paramount importance to prevent life-threatening complications such as brain abscess and meningitis. Imaging plays a crucial role in the detection and characterization of CSF leaks. Three-dimensional, isotropic, high resolution computed tomography (HRCT) accurately detects the site and size of the bony defect...
October 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29378388/limits-of-endoscopic-endonasal-transpterygoid-approach-to-cavernous-sinus-and-meckel-s-cave
#15
Douglas A Hardesty, Alaa S Montaser, Ricardo L Carrau, Daniel M Prevedello
The endoscopic endonasal approach (EEA) to the ventral skull base has greatly increased in popularity over the last two decades. So-called expanded EEA have opened corridors to pathology off-midline, including lesions within the cavernous sinus and Meckel's cave. A standard EEA exposure into the sphenoid sinus allows visualization of the medial cavernous sinus; a transpterygoid approach allows for surgical manipulation of the lateral cavernous sinus and Meckel's cave contents. Pituitary adenomas, meningiomas, and schwannomas are the most common pathologies in this region...
January 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29373206/aggressive-ossifying-fibroma-of-right-ethmoidal-sinus-a-case-report
#16
Yazeed Alghonaim, Salwa ALRashed ALHumaid, Abdullah Arafat
BACKGROUND: Ossifying fibroma is a rare benign fibro-osseous lesion seen in the bones of the head and neck area. It is mostly found in the mandible followed by the maxilla and rarely in the paranasal sinuses along with the orbit and skull bones. CASE PRESENTATION: A 30-year-old male patient presented with headache and incidental finding of a right ethmoidal sinus ossifying fibroma by paranasal-sinuses CT scan and MRI of the face. A flexible fiber-optic nasal endoscopy examination revealed a right side fullness...
December 26, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29350272/endoscopic-endonasal-approach-for-trigeminal-schwannomas-our-experience-of-39-patients-in-10-years
#17
Lu Yang, Li Hu, Weidong Zhao, Huankang Zhang, Quan Liu, Dehui Wang
BACKGROUND: The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. METHODS: A retrospective review of patients with TSs was undertaken to assess the outcome of endoscopic surgery from 2006 to 2016...
March 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29339322/endoscopic-endonasal-craniofacial-surgery-for-recurrent-skull-base-meningiomas-involving-the-pterygopalatine-fossa-the-infratemporal-fossa-the-orbit-and-the-paranasal-sinus
#18
Masahiro Shin, Masaaki Shojima, Kenji Kondo, Hirotaka Hasegawa, Shunya Hanakita, Akihiro Ito, Taichi Kin, Nobuhito Saito
OBJECT: Skull base meningiomas carry a non-negligible risk of recurrence. In particular, those arising from the sphenoid wings or middle cranial fossa penetrate into extracranial regions, uncommonly showing massive expansion into the craniofacial regions on recurrence. The role of endoscopic endonasal surgery for those intractable lesions remains unclear. METHODS: We performed endoscopic endonasal craniofacial surgery for 8 recurrent meningiomas invading into the pterygopalatine fossa, infratemporal fossa, nasopharynx, paranasal sinus, or orbit, comprising 2 meningothelial and 1 fibrous meningiomas (WHO grade I), 3 atypical and 1 clear cell meningiomas (grade II), and 1 anaplastic meningioma (grade III)...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29336295/transnasal-endoscopic-resection-of-pediatric-orbital-cyst-how-i-do-it
#19
Jingying Ma, Zhenxiao Huang, Bing Zhou
BACKGROUND: An orbital cystic lesion is a common orbital disease and has classically been approached via external incision. The introduction of endoscopic surgery has revolutionized the management of sinus and skull base disorders. Similarly, endoscopic techniques have been increasingly used to access intraorbital lesions with excellent outcomes, especially in pediatric patients. OBJECTIVE: We described, in detail, the surgical technique of the endoscopic approach to treat a pediatric orbital cyst...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29336291/extent-of-surgery-in-endoscopic-transsphenoidal-skull-base-approaches-and-the-effects-on-sinonasal-morbidity
#20
Vincent Wu, Michael D Cusimano, John M Lee
BACKGROUND: Endoscopic transsphenoidal skull base surgery (ETSS) is now considered the criterion standard approach for resection of pituitary adenomas and other midline anterior skull base lesions. Normal sinonasal structures are resected during ETSS, which raises concerns for nasal morbidity and patient-based outcome. OBJECTIVE: To perform a surgical outcome assessment by examining whether the extent of ETSS approaches affected patient-specific sinonasal quality of life as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22)...
January 1, 2018: American Journal of Rhinology & Allergy
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