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Endoscopic skull base surgery

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https://www.readbyqxmd.com/read/28230588/how-to-expose-the-entire-sella-floor-with-minimal-manipulation-during-an-endoscopic-endonasal-transsphenoidal-approach
#1
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Yong Jin Park, Soo Whan Kim, Jin Hee Cho, Boo-Young Kim, Sung Won Kim
OBJECTIVE: A method of opening the posterior ethmoid air cells with minimal manipulation is important for adequate exposure of the sella floor and minimal nasal morbidity. METHODS: Between February 2009 and August 2016, 373 patients with skull-base tumors underwent surgery via endoscopic endonasal transsphenoidal approach with the 2-nostrils/4-hands technique using this technique. RESULTS: A linear incision was made laterally toward one-third of the superior turbinate along the superior border of the sphenoid sinus ostium...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28228324/extended-maxillotomy-for-skull-base-access-in-contemporary-management-of-chordomas-rationale-and-technical-aspect
#2
Muhammad Fahmi Abdul Jalil, Rowan D Story, Myron Rogers
Minimally invasive approaches to the central skull base have been popularized over the last decade and have to a large extent displaced 'open' procedures. However, traditional skull base surgery still has its role especially when dealing with a large clival chordoma where maximal surgical resection is the principal goal to maximize patient survival. In this paper, we present a case of a 25year-old male patient with chordoma in the inferior clivus which was initially debulked via a transnasal endoscopic approach...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28227655/development-of-a-snake-like-dexterous-manipulator-for-skull-base-surgery
#3
Suat Coemert, Anzhu Gao, John P Carey, Mattias F Traeger, Russell H Taylor, Tim C Lueth, Mehran Armand, Suat Coemert, Anzhu Gao, John P Carey, Mattias F Traeger, Russell H Taylor, Tim C Lueth, Mehran Armand, Anzhu Gao, Russell H Taylor, Mattias F Traeger, Mehran Armand, Suat Coemert, Tim C Lueth, John P Carey
Petrous apex lesions constitute considerable surgical challenges due to their location in the skull base and close relationship with critical structures such as inner ear, carotid arteries, facial nerves and jugular bulb. These lesions often cannot be treated completely with rigid tools due to the limited accessibility. We are aiming to develop a snake-like manipulator to assist surgeons with the infralabyrinthine treatment of petrous apex lesions with increased dexterity. This snake-like dexterous manipulator (SDM) with 3...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28219164/-a-combination-use-of-endoscope-and-microscope-in-cerebral-pontine-angle-surgery
#4
Z Y Wang, H Jia, J Yang, H Y Tan, H Wu
Objective: To evaluate the application of combination use of microscope and endoscope in cerebral pontine angle (CPA) surgery. Methods: A total of 72 patients undergone lateral skull base surgeries via endoscope under microscopic control from January 2006 to January 2015 was reviewed respectively. The patients including 35 males and 37 females were composed of 22 cases of vestibular swannnomas, 45 cases of cranial neuropathy and 5 cases of CPA chelesteatoma. Twenty cases of vestibular swannnomas, 15 cases of cranial neuropathy and 2 cases of CPA chelesteatoma undergone the surgery via retrosigmoid approach, while other cases undergone the surgery via retrolabyrinthine approach...
February 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28207197/changing-the-surgical-dogma-in-frontal-sinus-trauma-transnasal-endoscopic-repair
#5
Jessica W Grayson, Hari Jeyarajan, Elisa A Illing, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. METHODS: Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed...
February 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28185972/optimizing-sellar-reconstruction-after-pituitary-surgery-with-free-mucosal-graft-results-in-the-first-50-consecutive-patients
#6
Maria Peris-Celda, Mark Chaskes, Daniel D Lee, Tyler J Kenning, Carlos D Pinheiro-Neto
BACKGROUND: Postoperative CSF leak after endoscopic pituitary surgery ranges from 1.9-10% in different series. Vascularized flaps have reduced the incidence of leak, however it carries nasal morbidity. This paper presents a technique for sellar reconstruction with free mucosal graft from the nasal cavity floor including inferior meatus mucosa. This technique aims to standardize sellar reconstruction without the use of the nasoseptal flap and keeping the advantage of mucosal coverage of the defect in all cases...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28180051/region-specific-objective-signatures-of-endoscopic-surgical-instrument-motion-a-cadaveric-exploratory-analysis
#7
R Alex Harbison, Angelique M Berens, Yangming Li, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives The objective of this study was to evaluate region-specific surgical instrument kinematics among novice and experienced surgeons performing endoscopic endonasal skull base surgery. Design Cadaveric experimental study. Setting Tertiary academic center. Participants Two novice and two experienced surgeons performed eight endoscopic total ethmoidectomies and sphenoidotomies using an optically tracked microdebrider. Main Outcome Measures Time-stamped Euclidian coordinates were recorded. Cumulative instrument travel, mean linear velocity and acceleration, and mean angular velocities were calculated in the anterior ethmoid, posterior ethmoid, and sphenoid sinus regions...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180047/the-pedicled-buccal-fat-pad-anatomical-study-of-the-new-flap-for-skull-base-defect-reconstruction-after-endoscopic-endonasal-transpterygoid-surgery
#8
Denis A Golbin, Nikolay V Lasunin, Vasily A Cherekaev, Georgiy A Polev
Objectives To evaluate the efficacy and safety of using a buccal fat pad for endoscopic skull base defect reconstruction. Design Descriptive anatomical study with an illustrative case presentation. Setting Anatomical study was performed on 12 fresh human cadaver specimens with injected arteries (24 sides). Internal carotid artery was exposed in the coronal plane via the endoscopic transpterygoid approach. The pedicled buccal fat pad was used for reconstruction. Participants: 12 human cadaver head specimens; one patient operated using the proposed technique...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180045/juvenile-nasal-angiofibromas-a-comparison-of-modern-staging-systems-in-an-endoscopic-era
#9
Nicholas R Rowan, Nathan T Zwagerman, Molly E Heft-Neal, Paul A Gardner, Carl H Snyderman
Objectives To compare the clinical utility of four juvenile nasal angiofibroma (JNA) staging systems in a large cohort of patients. Design Retrospective case series. Setting Tertiary referral academic center. Participants Pediatric patients undergoing surgical resection of JNAs between January 2008 and June 2015. Main Outcome Measures Intraoperative blood loss and transfusions, number of staged operations, postoperative residual disease, and recurrent disease. Results In total, 34 patients were identified; all underwent preoperative embolization followed by surgery...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180044/role-of-leukocyte-platelet-rich-fibrin-in-endoscopic-endonasal-skull-base-surgery-defect-reconstruction
#10
Liuba Soldatova, Raewyn G Campbell, Ahmad H Elkhatib, Thomas W Schmidt, Nelson R Pinto, Jaime M Pinto, Daniel M Prevedello, Leo F Ditzel Filho, Bradley A Otto, Ricardo L Carrau
Objective Advancements in endoscopic endonasal approaches have increased the extent and complexity of skull base resections, in turn demanding the development of novel techniques for skull base defect reconstruction. The objective of this pilot study was to investigate the effect of leukocyte-platelet-rich fibrin (L-PRF) on the postoperative healing after endoscopic skull base surgery. Methods Between January and May of 2015, 47 patients underwent endoscopic endonasal resection of sellar, parasellar, and suprasellar lesions with the application of L-PRF membranes during the skull base reconstruction at two surgical centers...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180037/complications-of-open-approaches-to-the-skull-base-in-the-endoscopic-era
#11
Justin D Miller, Robert J Taylor, Emily C Ambrose, Jeffrey P Laux, Charles S Ebert, Adam M Zanation
Objective It is important to characterize the developing complication profile of the open approach as it becomes reserved for more complex disease during the endoscopic era. Our objective was to characterize complication rates of current open skull base surgery. Design Retrospective chart review. Setting Tertiary care center. Participants The study group consisted of 103 patients and 117 open skull base surgeries were performed from 2008 to 2012. Main Outcome Measures Intraoperative/postoperative complications...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#12
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28162240/endoscopic-resection-of-sinonasal-and-ventral-skull-base-malignancies
#13
REVIEW
Ghassan Alokby, Roy R Casiano
The transnasal endoscopic resection of ventral skull base lesions represents a safe and effective method for the surgical management of sinonasal and ventral skull base malignancies in carefully selected cases. The goal of surgery is complete removal of all tumor with negative resection margins while maintaining the key oncological principles. Careful selection of cases along with the presence of an experienced surgeon and a fully involved multidisciplinary skull base team trained in the management of ventral skull base neoplasm are essential for excellent outcomes...
February 2, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28154960/radiological-features-for-the-approach-in-trans-sphenoidal-pituitary-surgery
#14
Victoria Twigg, Simon D Carr, Ramkishan Balakumar, Saurabh Sinha, Showkat Mirza
INTRODUCTION: In order to perform trans-sphenoidal endoscopic pituitary surgery safely and efficiently it is important to identify anatomical and pituitary disease features on the pre-operative CT and MRI scans; thereby minimising the risk to surrounding structures and optimising outcomes. We aim to create a checklist to streamline pre-operative planning. METHODS: We retrospectively reviewed pre-operative CT and MRI scans of 100 adults undergoing trans-sphenoidal endoscopic pituitary surgery...
February 2, 2017: Pituitary
https://www.readbyqxmd.com/read/28145931/endoscopic-endonasal-transsphenoidal-approach-from-the-otolaryngologist-point-of-view
#15
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Dong-Jun Lim, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, YulGyun Kim, Sung Won Kim
OBJECTIVE: In February 2009, the authors' center formed a team of neurosurgeons, otolaryngologists, endocrinologists, and radiologists to perform pituitary surgery using the endoscopic endonasal transsphenoidal approach (EETSA). This paper reviews the authors' experience with the technique, pathological outcomes, hormone profiles, and postoperative complications. METHODS: Between February 2009 and December 2015, 535 patients underwent the EETSA with 2-nostrils/4-hands surgery...
January 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28139028/combined-endoscopic-transcervical-transoral-robotic-approach-for-resection-of-parapharyngeal-space-tumors
#16
Irit Duek, Moran Amit, Gill E Sviri, Ziv Gil
BACKGROUND: Parapharyngeal space tumors (PPSTs) pose exposure challenges; they are routinely resected by the transcervical approach using blunt/blind finger dissection, increasing the risk of tumor spillage and of neurovascular injury. Large PPSTs or those located high at the skull base often require mandibulotomy or an infratemporal fossa approach, baring considerable morbidity. METHODS: The novel minimally invasive approach described, utilizes endoscopic equipment introduced transcervically for circumferential separation of the tumor from the neurovascular structures of the skull base...
January 31, 2017: Head & Neck
https://www.readbyqxmd.com/read/28125310/juvenile-psammomatoid-ossifying-fibroma-in-paranasal-sinus-and-skull-base
#17
Mingjie Wang, Bing Zhou, Shunjiu Cui, Yunchuan Li
CONCLUSION: The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. OBJECTIVES: JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. METHOD: This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014...
January 26, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28125308/endoscopic-resection-of-ossifying-fibroma-involving-paranasal-sinuses-and-the-skull-base-in-a-series-of-15-cases
#18
Ping Ye, Qian Huang, Bing Zhou
CONCLUSION: The key technical challenges in the resection of OFs are rapid removal of tumors by image-guided navigation, determining the boundary of the resection and the proper control of blood supply through the anterior or posterior ethmoidal arteries. OBJECTIVE: This study aimed to analyze the clinical data of adult patients with paranasal ossifying fibromas involving the anterior skull base and orbit. The surgical technique and indications are also discussed...
January 26, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28124657/novel-use-of-an-ultrasonic-bone-aspirator-for-extended-endoscopic-frontal-sinusotomy-a-feasibility-study
#19
Conner J Massey, Sean Bury, Jay Diamond, Ameet Singh
INTRODUCTION: Extended endoscopic frontal sinusotomy is often required for surgical management of anterior skull base pathology. Such approaches are necessary for access to pathology and maintenance of postoperative frontal sinus outflow tract drainage. Cold steel instrumentation and endoscopic high-speed microdrills are typically used for bony removal during extended frontal sinus approaches but are associated with certain drawbacks, such as thermal injury and obscuration of the surgical field with bone dust...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124655/role-of-lumbar-drains-in-contemporary-endonasal-skull-base-surgery-meta-analysis-and-systematic-review
#20
Brian D'Anza, Duc Tien, Janalee K Stokken, Pablo F Recinos, Troy R Woodard, Raj Sindwani
BACKGROUND: Historically, lumbar drains (LD) have played a prominent role in endonasal skull base surgery. Over the past few decades, advancements in techniques have augmented our ability to successfully reconstruct complex skull base defects and often obviates the need for cerebrospinal fluid (CSF) diversion. Clarity on the appropriate use of LDs is needed. OBJECTIVE: To examine the literature for the need for LDs in contemporary skull base reconstruction after resection of skull base tumors...
November 1, 2016: American Journal of Rhinology & Allergy
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