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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/28990255/role-of-surgery-in-the-treatment-of-osteoradionecrosis-and-its-complications-after-radiotherapy-for-nasopharyngeal-carcinoma
#1
Wen Bo Huang, Stanley Thian Sze Wong, Jimmy Yu Wai Chan
BACKGROUND: The purpose of this study was to review the efficacy of surgery for patients with osteoradionecrosis (ORN) after radiotherapy for nasopharyngeal carcinoma (NPC). METHODS: Between 2000 and 2016, we identified 162 patients with skull base ORN, among which 58 patients required surgery. A retrospective medical chart review was performed and the indications and results of surgical interventions were recorded. RESULTS: All surgeries were performed for the treatment of secondary complications of ORN, including central nervous system (CNS) infection (48...
October 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28987843/the-endoscopic-buccal-fat-pad-flap-for-closure-of-skull-base-defects-a-report-of-five-cases
#2
Daniel W Flis, John F Burke, Arnau Benet, Phillip Theodosopoulos, Manish Aghi, Ivan H El-Sayed
OBJECTIVE: To demonstrate the clinical utility of the buccal fat pad to close a variety of skull base defects. METHODS: A retrospective chart review of 5 consecutive patients who underwent endoscopic cranial base surgery with endoscopic harvest of BFPF pedicled along the internal maxillary artery for reconstruction of the skull base from October 2013 until November 2014. RESULTS: All 5 patients had complete take of the BFPFs with mucosalization on post-operative follow up with no reported complications or CSF leaks...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985669/establishment-of-next-generation-neurosurgery-research-and-training-laboratory-with-integrated-human-performance-monitoring
#3
Antonio Bernardo
Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28967314/endoscopic-endonasal-pituitary-gland-hemi-transposition-for-resection-of-a-dorsum-sellae-meningioma
#4
Alaa S Montaser, Juan M Revuelta Barbero, Alexandre Todeschini, André Beer-Furlan, Russell R Lonser, Ricardo L Carrau, Daniel M Prevedello
A 69-year-old female with incidental diagnosis of a dorsum sellae meningioma had shown significant tumor growth after initial conservative management. The procedure started with a microscopic sublabial transsphenoidal approach to the sella and the suprasellar space. Due to limitations to a safe dissection and removal of the retrosellar component, the surgery was converted to a purely endoscopic endonasal approach with left hemi-transposition of the pituitary gland, followed by drilling of the dorsum sellae and removal of the left posterior clinoid process...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967307/introduction-surgical-management-of-skull-base-meningiomas
#5
Gabriel Zada, Mustafa K Başkaya, Mitesh V Shah
Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962038/site-specific-considerations-in-the-surgical-management-of-skull-base-chondrosarcomas
#6
Shaan M Raza, Paul W Gidley, Michael E Kupferman, Ehab Y Hanna, Shirley Y Su, Franco DeMonte
BACKGROUND: Numerous approaches have been reported in the management of skull base chondrosarcomas. Data are lacking for surgical outcomes by the tumor site of origin. OBJECTIVE: To provide insight into outcomes by site of origin and factors affecting resection in order to aid in surgical approach selection. METHODS: A retrospective review was conducted of 49 patients with chondrosarcoma treated at our institution. Charts were reviewed for tumor- and treatment-related factors...
September 9, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28943419/severe-cerebral-complications-secondary-to-perforation-injury-of-the-anterior-skull-base-during-sinonasal-surgery-an-underappreciated-problem
#7
Shadi Al-Afif, Elvis J Hermann, Gökce Hatipoglu Majernik, Makoto Nakamura, Peter Raab, Thomas Lenarz, Joachim K Krauss
OBJECTIVE: Functional endonasal sinus surgery (FESS) is widely practiced and is considered a generally safe procedure. Skull base injuries occur in less than 1% of procedures and are typically associated with cerebrospinal fluid leaks. Rarely, skull base injuries might result in cerebral lesions. Here we present a series of four patients with iatrogenic perforating injuries of the anterior skull base and cerebral lesions after routine FESS. METHODS: Four patients with iatrogenic perforating cerebral lesions after routine FESS performed at other institutions were referred to a tertiary neurosurgery department within a 10-year period...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28938328/bulla-down-endoscopic-sphenoidotomy
#8
Mohannad Al-Qudah
Surgical approach to the sphenoid sinus is still one of the most challenging steps in sinus surgery. The author describes a novel, simple, and safe technique to access sphenoid sinus to manage isolated sphenoid pathologies or approach skull base by removing the bulla ethmoidalis and temporarily lateralizing the middle turbinate during endoscopic sinus surgery. The current approach provides an effective method to access the sphenoid sinus without increasing morbidity and avoids unnecessary possible complications associated with turbinates' resection...
September 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28931251/managing-arterial-injury-in-endoscopic-skull-base-surgery-case-series-and-review-of-the-literature
#9
Alicia Del Carmen Becerra Romero, Jagath Lal Gangadharan, Evan D Bander, Yves Pierre Gobin, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The most feared complications following endoscopic endonasal skull base surgery are arterial vascular injuries. Previously published literature is restricted to internal carotid artery injuries. The ideal method for controlling arterial bleeding during this kind of procedure is debated, and a variety of techniques have been advocated. OBJECTIVE: To evaluate the management and outcome following intraoperative arterial injury during endoscopic endonasal skull base surgery...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922880/a-side-door-to-meckel-s-cave-anatomic-feasibility-study-for-the-lateral-transorbital-approach
#10
Blake Harrison Priddy, Cristian Ferrareze Nunes, Andre Beer-Furlan, Ricardo Carrau, Iacopo Dallan, Daniel Monte-Serrat Prevedello
BACKGROUND: In the last decade, endoscopic skull base surgery has significantly developed and generated a plethora of techniques and approaches for access to the cranial ventral floor. However, the exploration for the least-aggressive, maximally efficient approach continues. OBJECTIVE: To describe in detail an anatomical study, along with the technical nuances of a novel endoscopic approach to Meckel's Cave (MC) using a lateral transorbital (LTO) route. METHODS: Eighteen orbits of injected cadaveric specimens were operated on, using an endoscopic LTO approach to MC, middle cranial fossa, and paramedian skull base preserving the orbital rim...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922579/evaluating-real-time-effects-of-topical-1-1000-epinephrine-in-endoscopic-sinus-and-skull-base-surgery-on-hemodynamic-parameters-through-intraoperative-arterial-line-monitoring
#11
Michael T Yim, Omar G Ahmed, Masayoshi Takashima
BACKGROUND: Administration of topical 1:1000 epinephrine is commonly used in practice to achieve vasoconstriction during endoscopic sinus surgery and skull-base surgery; however, real-time effects on cardiovascular changes from systemic absorption have not been well studied. METHODS: Twenty-six patients undergoing endoscopic transsphenoidal resection of a pituitary lesion at a single institution were included into the study. Following arterial line placement by anesthesiology, 6 cottonoid pledgets soaked in 1:1000 epinephrine were placed into the bilateral nasal passages...
September 18, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28882714/combined-minimally-invasive-supraciliary-and-transfacial-approach-for-large-tumors-with-skull-base-and-sinonasal-involvement
#12
Pal Barzo, Zsolt Zador, Mihaly Bodosi, Zsolt Bella, Daniel Jambor, Bela Fulop, Jeno Czigner
BACKGROUND: Tumors invading both the anterior skull base and the sinonasal area have been traditionally accessed via largely invasive open craniofacial approaches. Minimally invasive extended endoscopic endonasal approaches have recently become increasingly available, but have anatomical limitations and require incremental experience and thus high patient volume. Our objective was to assess the applicability of a novel combination of the minimally invasive supraciliary incision and the limited maxillofacial osteotomy as a combined surgical approach for large tumors invading both the anterior skull base and the sinonasal area...
September 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28881251/registration-and-fusion-quantification-of-augmented-reality-based-nasal-endoscopic-surgery
#13
Yakui Chu, Jian Yang, Shaodong Ma, Danni Ai, Wenjie Li, Hong Song, Liang Li, Duanduan Chen, Lei Chen, Yongtian Wang
This paper quantifies the registration and fusion display errors of augmented reality-based nasal endoscopic surgery (ARNES). We comparatively investigated the spatial calibration process for front-end endoscopy and redefined the accuracy level of a calibrated endoscope by using a calibration tool with improved structural reliability. We also studied how registration accuracy was combined with the number and distribution of the deployed fiducial points (FPs) for positioning and the measured registration time...
August 3, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28875123/costs-and-perioperative-outcomes-associated-with-open-versus-endoscopic-resection-of-sinonasal-malignancies-with-skull-base-involvement
#14
Terence S Fu, Eric Monteiro, Ian Witterick, Allan Vescan, Gelareh Zadeh, Fred Gentili, John R de Almeida
Objective  To compare financial and perioperative outcomes between endoscopic and open surgical approaches in the surgical management of sinonasal malignancies. Design  Retrospective chart review. Setting  Tertiary care hospital. Participants  Patients undergoing surgical resection of a sinonasal malignancy from January 2000 to December 2014. Main Outcome Measures  In-hospital costs, complications, and length of stay (LOS). Results  Of 106 patients, 91 received open surgery (19 free flap and 72 non-free flap) and 15 were treated with purely endoscopic approaches...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28867323/endoscopic-middle-cranial-fossa-reconstruction-via-a-subtemporal-keyhole-a-technical-note
#15
Fuminari Komatsu, Masaaki Imai, Akihiro Hirayama, Naokazu Hayashi, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
BACKGROUND: Skull base reconstruction is an essential technique for repairing cerebrospinal fluid (CSF) leakage. A reliable method for middle cranial fossa (MCF) reconstruction with minimal invasiveness has not been reported. An initial case of endoscopic MCF reconstruction via a subtemporal keyhole is described. CASE DESCRIPTION: A 57-year-old man developed severe meningitis and was diagnosed with spontaneous CSF leakage from bone defects on the tegmen tympani...
August 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28865090/sinonasal-quality-of-life-after-endoscopic-resection-of-malignant-sinonasal-and-skull-base-tumors
#16
Jordan T Glicksman, Arjun K Parasher, Steven G Brooks, Alan D Workman, Justina L Lambert, Jenna E Bergman, James N Palmer, Nithin D Adappa
OBJECTIVES: Improvement in sinonasal quality of life (QoL) following sinus surgery has been well-documented across the literature. To our knowledge, only one series has evaluated long-term QoL in patients undergoing tumor resection, and that study demonstrated no improvement in rhinologic QoL following malignant tumor resection at 2-year follow-up. The objective of the present study was to evaluate QoL in the 2 years following endoscopic malignant tumor resection. METHODS: A prospective cohort study was performed, including patients with both malignant and benign sinonasal tumors in a tertiary academic medical center...
September 2, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28859712/long-term-olfactory-outcome-after-nasoseptal-flap-reconstructions-in-midline-skull-base-surgery
#17
Michael B Soyka, Carlo Serra, Luca Regli, Eva Meier, David Holzmann
BACKGROUND: The nasoseptal flap (NSF) is a universally used surgical technique to cover defects of the skull base after extended sinonasal surgery. Long-term follow-up of complications, sequelae, and smell function is largely unknown. OBJECTIVE: The main objective of this study was to investigate monorhinal olfaction after transsphenoidal skull base surgery. METHODS: Patients who underwent skull base surgery for midline lesions (craniopharyngioma and pituitary tumors) by using a NSF, also referred to as the Haddad flap, were assessed for their long-term outcome...
September 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28844919/guidewire-breakage-during-cavernous-sinus-sampling-a-rare-complication-and-its-treatment
#18
Necmettin Tanriover, Baris Kucukyuruk, Saffet Tuzgen, Nil Comunoglu, Osman Kizilkilic, Nurperi Gazioglu
BACKGROUND: Venous sampling methods are valuable tools for the diagnosis of pituitary adenomas. However, these interventions also have their complications, which may complicate the treatment process. CASE DESCRIPTION: A forty-nine year old female pituitary adenoma patient with preliminary diagnosis of Cushing's disease underwent cavernous sinus sampling (CSS) to delineate the adenoma. The micro guidewire broke during the procedure and the distal part of the micro guidewire had to be left within the right cavernous sinus...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28838118/efficacy-of-endoscopic-fluorescein-video-angiography-in-aneurysm-surgery-novel-and-innovative-assessment-of-vascular-blood-flow-in-the-dead-angles-of-the-microscope
#19
Koji Hashimoto, Hiroyuki Kinouchi, Hideyuki Yoshioka, Kazuya Kanemaru, Masakazu Ogiwara, Takashi Yagi, Takuma Wakai, Yuichiro Fukumoto
BACKGROUND: In aneurysm surgery, assessment of the blood flow around the aneurysm is crucial. Recently, intraoperative fluorescence video angiography has been widely adopted for this purpose. However, the observation field of this procedure is limited to the microscopic view, and it is difficult to visualize blood flow obscured by the skull base anatomy, parent arteries, and aneurysm. OBJECTIVE: To demonstrate the efficacy of a new small-caliber endoscopic fluorescence video angiography system employing sodium fluorescein in aneurysm surgery for the first time...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28834622/development-of-the-endoscopic-endonasal-sinus-and-skull-base-surgery-questionnaire
#20
Ellen Ten Dam, Robert A Feijen, Minke J C van den Berge, Eelco W Hoving, Jos M Kuijlen, Bernard F A M van der Laan, Karin M Vermeulen, Paul F M Krabbe, Astrid G W Korsten-Meijer
BACKGROUND: The patients' perspective of health outcomes has become important input for assessing treatment effects. However, existing endoscopic endonasal surgery (EES) instruments are not fully aligned with the concept of health-related quality of life (HRQoL). A prospective cohort study was therefore conducted to develop a suitable quality-of-life tool to assess nasal morbidity after EES: the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q). METHODS: The study included 300 patients: 207 with sinus pathology and 93 with anterior skull base pathology...
August 23, 2017: International Forum of Allergy & Rhinology
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