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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/29226334/early-stage-olfactory-neuroblastoma-and-the-impact-of-resecting-dura-and-olfactory-bulb
#1
Ashley C Mays, Diana Bell, Renata Ferrarotto, Jack Phan, Dianna Roberts, Clifton D Fuller, Steven J Frank, Shaan M Raza, Michael E Kupferman, Franco DeMonte, Ehab Y Hanna, Shirley Y Su
OBJECTIVE: Compare outcomes of patients with olfactory neuroblastoma (ONB) without skull base involvement treated with and without resection of the dura and olfactory bulb. METHODS: Retrospective review of ONB patients treated from 1992 to 2013 at the MD Anderson Cancer Center (The University of Texas, Houston, Texas, U.S.A.). Primary outcomes were overall and disease-free survival. RESULTS: Thirty-five patients were identified. Most patients had Kadish A/B...
December 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29210717/quality-of-life-outcomes-after-endoscopic-approaches-to-intracranial-tumors
#2
Madeleine R Schaberg
PURPOSE OF REVIEW: To review the literature on quality of life (QOL) in endoscopic approaches to anterior and central intracranial skull-base disease. As endoscopic surgical techniques have gained widespread acceptance and complications and morbidity remain low and comparable with microscopic and open approaches, a shift to focusing on patients' perception of their own well being as an important outcome parameter has been made. In addition to the traditional measurements of surgical outcomes (extent of resection, recurrence rate, morbidity, survival, and complication rate), the success of a surgery can now be assessed using QOL measures...
November 27, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29209853/3d-endoscopic-ear-surgery-a-clinical-pilot-study
#3
Daniele Bernardeschi, Ghizlene Lahlou, Daniele De Seta, Francesca Yoshie Russo, Isabelle Mosnier, Olivier Sterkers
OBJECTIVE: To evaluate the feasibility and efficacy of a new high-resolution 3D endoscope in endoscopic ear and lateral skull base surgery. METHODS: Eight patients, five women and three men, were included in this clinical pilot prospective study. Their age was 38 ± 17.3 years (mean ± SD, range 17-54 years). The right side was involved in five cases, and the left side in three cases. There were three cases of chronic otitis, one case of cholesteatoma of the external auditory canal, one case of otosclerosis, one case of cochlear implant surgery, and two cases of stage 2 vestibular schwannoma operated on with a retrosigmoid approach to preserve hearing...
December 5, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29194274/a-stratified-algorithm-for-skull-base-reconstruction-with-endoscopic-endonasal-approach
#4
Zhen Li, Tao Ji, Guo-Dong Huang, Jian Guo, Ji-Hu Yang, Wei-Ping Li
The authors presented our institutional experience with skull base reconstruction techniques and developed a stratified algorithm for different causes of cerebrospinal fluid (CSF) leak. This is a retrospective review of patients who were diagnosed as CSF leak treated with skull base reconstruction or who underwent endoscopic transsphenoidal surgery for sellar and parasellar lesions at our department from August 2012 to April 2017. The authors totally identified 57 (59 operations in total) patients who were divided into 3 groups according to the causes of CSF leak and different reconstruction techniques...
November 20, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29194254/anterior-skull-base-tumors-the-role-of-transfacial-approaches-in-the-endoscopic-era
#5
Leandro Infantini Dini, Gustavo Rassier Isolan, Evelise Flores, Eduardo Madruga Lombardo, Cláiton Heitz
The basis of craniofacial tumor surgery is complete surgical extirpation, preferably en bloc or with free borders. Craniofacial techniques are the gold standard and primary strategies in the treatment of anterior skull base tumors. In the last decade, the reports favoring results of endoscopic techniques have increased. One could conclude that the classical transfacial approaches might become useless, but, in fact, there is little research comparing these techniques.In this article, the authors present their experience with combined craniofacial resection of anterior craniofacial skull base tumors in 9 consecutive patients between January 2013 and July 2015...
November 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29174229/repair-of-cerebrospinal-fluid-leakage-using-a-transfrontal-radial-adipofascial-flap-an-individual-approach-supported-by-3d-printing-for-surgical-planning
#6
Stefan Grau, Stephanie Kellermann, Michael Faust, Moritz Perrech, Dirk Beutner, Alexander Drzezga, Joachim Zöller
BACKGROUND: Leakage of cerebrospinal fluid (CSF) due to large prolactinomas represents a complex issue. Due to limited anatomical space, often multiple leakage sites and scarce locally available tissue for repair, surgical possibilities are limited. We report an initial case of using a radial fasciocutaneous flap applied sub-frontally to cover a large skull base defect, supported by preoperative 3D-printing for surgical planning. CASE DESCRIPTION: A 29 year old female developed severe nuchal pain which was caused by destruction of large parts of her skull base by a prolactinoma...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29166425/anatomy-of-the-sphenopalatine-artery-and-its-implications-for-transnasal-neurosurgery
#7
M Eordogh, A Grimm, I Gawish, L Patonay, R Reisch, H R Briner, G Baksa
BACKGROUND: The knowledge of sinonasal vasculature is inevitable in transnasal neurosurgery. We performed an anatomical study on the sphenopalatine artery from the perspective of skull base procedures. METHODOLOGY: To analyse the anatomical landmarks of the sphenopalatine artery, arterial skull corrosion casts (26 head halves) underwent endoscopic transnasal phantom surgery. Furthermore, we performed microsurgical dissection on formaldehyde-fixated cadavers with arterial perfusion (14 head halves) as well as studied Cone Beam CT-scans of anonymised patients and cadavers (115 head sides)...
November 22, 2017: Rhinology
https://www.readbyqxmd.com/read/29134171/endoscopic-endonasal-repair-of-internal-carotid-artery-injury-during-endoscopic-endonasal-surgery
#8
Irit Duek, Gill E Sviri, Moran Amit, Ziv Gil
Background  Injury to the cavernous portion of the internal carotid artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication that can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success. Objectives  We provide a detailed technical description of an operative technique for endoscopic management of carotid artery injury. Methods  A case of ICA injury during endoscopic skull base surgery is presented...
October 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29134165/an-innovate-robotic-endoscope-guidance-system-for-transnasal-sinus-and-skull-base-surgery-proof-of-concept
#9
D T Friedrich, F Sommer, M O Scheithauer, J Greve, T K Hoffmann, P J Schuler
Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29134164/visual-outcomes-after-endoscopic-pituitary-surgery-in-patients-presenting-with-preoperative-visual-deficits
#10
Felipe Fredes, Gabriel Undurraga, Pablo Rojas, Felipe Constanzo, Carolina Lazcano, Jaime Pinto, Thomas Schmidt
Introduction  Pituitary adenomas represent 15% of primary brain tumors. Visual disturbance is a common clinical manifestation of these neoplasms due, among other factors, to local mass effect on the optic system. Objective  To evaluate changes of the visual fields in patients undergoing endoscopic endonasal approach (EEA) for pituitary adenomas and to find predictive factors for successful visual field outcome. Material and Methods  This is a cross-sectional study. A review was conducted of medical records of consecutive patients with tumors of the sellar region undergoing EEA between January 2008 and December 2012 at the Skull Base Unit of Guillermo Grant Benavente Hospital, University of Concepción, Concepción, Chile, and who had undergone pre- and postoperative visual field evaluation...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29125446/suprasellar-and-recurrent-pediatric-craniopharyngiomas-expanding-indications-for-the-extended-endoscopic-transsphenoidal-approach
#11
Andrew F Alalade, Elizabeth Ogando-Rivas, Jerome Boatey, Mark M Souweidane, Vijay K Anand, Jeffrey P Greenfield, Theodore H Schwartz
OBJECTIVE The expanded endonasal endoscopic transsphenoidal approach has become increasingly used for craniopharyngioma surgery in the pediatric population, but questions still persist regarding its utility in younger children, in recurrent and irradiated tumors, and in masses primarily located in the suprasellar region. The narrow corridor, incomplete pneumatization, and fear of hypothalamic injury have traditionally relegated this approach to application in older children with mostly cystic craniopharyngiomas centered in the sella...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29109836/pedicle-flaps-contribute-to-endoscopic-skull-base-surgery-and-facial-soft-tissue-repair-the-diuturnity-of-johannes-fredericus-samuel-esser-1877-1946
#12
Richard A Pollock, M Douglas Gossman
Pedicle flaps based on the external maxillary (facial) artery were introduced during the World War I, precisely a century ago. Today they remain effective tools in facial soft-tissue repair. Recently, pedicle flaps based on the internal maxillary (sphenopalatine) artery have been chosen to reliably close dural defects after endoscopic skull-base surgery. Pedicle flaps, "biologic" to the extent they are based on a defined arterial blood supply, are the lasting contributions-the diuturnity-of Johannes ("Jan") Fredericus Samuel Esser (1877-1946) of Leiden, Holland, and Chicago (IL)...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29105367/early-experience-with-a-patient-specific-virtual-surgical-simulation-for-rehearsal-of-endoscopic-skull-base-surgery
#13
Tae-Bin Won, Peter Hwang, Jae Hyun Lim, Sung-Woo Cho, Sun Ha Paek, Steven Losorelli, Yona Vaisbuch, Sonny Chan, Kenneth Salisbury, Nikolas H Blevins
BACKGROUND: With the help of contemporary computer technology it is possible to create a virtual surgical environment (VSE) for training. This article describes a patient-specific virtual rhinologic surgical simulation platform that supports rehearsal of endoscopic skull-base surgery. We also share our early experience with select cases. METHODS: A rhinologic VSE was developed, featuring a highly efficient direct 3-dimensional (3D) volume renderer with simultaneous stereoscopic feedback during surgical manipulation of the virtual anatomy, as well as high-fidelity haptic feedback...
November 3, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29099299/perfusion-based-human-cadaveric-specimen-as-a-simulation-training-model-in-repairing-cerebrospinal-fluid-leaks-during-endoscopic-endonasal-skull-base-surgery
#14
Eisha A Christian, Joshua Bakhsheshian, Ben A Strickland, Vance L Fredrickson, Ian A Buchanan, Martin H Pham, Andrew Cervantes, Michael Minneti, Bozena B Wrobel, Steven Giannotta, Gabriel Zada
OBJECTIVE Competency in endoscopic endonasal approaches (EEAs) to repair high-flow cerebrospinal fluid (CSF) leaks is an essential component of the neurosurgical training process. The objective of this study was to demonstrate the feasibility of a simulation model for EEA repair of anterior skull base CSF leaks. METHODS Human cadaveric specimens were utilized with a perfusion system to simulate a high-flow CSF leak. Neurological surgery residents (postgraduate year 3 or greater) performed a standard EEA to repair a CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29094072/endoscopic-unilateral-transethmoid-paraseptal-approach-to-the-central-skull-base
#15
Márton Eördögh, Hans Rudolf Briner, Daniel Simmen, Nicholas Jones, Robert Reisch
Objectives: The endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach-related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restrictions in surgical manipulation and tumor resection, we introduced the unilateral transethmoidal-paraseptal approach. In this article, we analyzed the long-term results and sinonasal outcome of this technique...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29084008/delayed-complications-from-expanded-endonasal-surgery-for-intracranial-tumors
#16
Mathew N Geltzeiler, Eric W Wang
PURPOSE OF REVIEW: Delayed complications after endoscopic endonasal approaches to the skull base, defined as complications greater than 1 month postoperatively, are uncommon. These complications are divided into categories including sinonasal, neuroanatomic, endocrine and vascular. This review highlights the most up-to-date advancements and reviews the management of delayed complications for skull base patients. RECENT FINDINGS: Over the last 10 years, the field of endoscopic endonasal skull base surgery has expanded with new data highlighting the long-term patient outcomes...
October 27, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#17
REVIEW
Srikant Chakravarthi, Lior Gonen, Alejandro Monroy-Sosa, Sammy Khalili, Amin Kassam
The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF)...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29075157/open-anterior-skull-base-reconstruction-a-contemporary-review
#18
REVIEW
Daniel Kwon, Alfred Iloreta, Brett Miles, Jared Inman
Skull base extirpative and reconstructive surgery has undergone significant changes due to technological and operative advances. While endoscopic resection and reconstruction will continue to advance skull base surgery for the foreseeable future, traditional open surgical approaches and reconstructive techniques are still contemporarily employed as best practices in certain tumors or patient-specific anatomical cases. Skull base surgeons should strive to maintain a working knowledge and technical skill set to manage these challenging cases where endoscopic techniques have previously failed, are insufficient from anatomical constraints, or tumor biology with margin control supersedes the more minimally invasive approach...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29074286/endoscopic-surgery-of-the-olfactory-cleft
#19
R Jankowski, C Rumeau, P Gallet, D T Nguyen, A Russel, B Toussaint
The olfactory cleft is the specific site of development of many tumours (respiratory epithelial adenomatoid hamartoma, intestinal-type adenocarcinoma, neuroblastoma, inverted papilloma, glomangiopericytoma, etc.) and is also the site of CSF rhinorrhoea via the cribriform plate (cribri-rhinorrhoea). Olfactory cleft surgery must therefore be considered to be a specific type of surgery, complementary to ethmoidal labyrinth surgery and anterior skull base surgery. Olfactory cleft tumours can be resected according to five different surgical procedures: olfactory cleft mucosal resection, partial resection of the olfactory cleft, total resection of the olfactory cleft, unilateral endoscopic anterior skull base resection, and bilateral endoscopic anterior skull base resection...
October 23, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29066231/antibiotic-prophylaxis-and-infection-prevention-for-endoscopic-endonasal-skull-base-surgery-our-protocol-results-and-review-of-the-literature
#20
Stephen J Johans, Daniel J Burkett, Kevin N Swong, Chirag R Patel, Anand V Germanwala
Endoscopic endonasal approaches to the skull base provide minimally invasive corridors to intracranial lesions; however, enthusiasm for this new approach is always tempered by the recognition that this route requires passage through a nonsterile sinonasal corridor. Despite an increasing number of patients undergoing these surgeries, there remains no consensus on the use of perioperative antibiotics. A retrospective review of consecutive patients undergoing endoscopic endonasal skull base surgery (EESBS) at Loyola University Medical Center by the same neurosurgeon and otolaryngologist team between February 2015 and October 2016 was performed...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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