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Endoscopic endonasal surgery

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https://www.readbyqxmd.com/read/28736350/antibiotic-prophylaxis-in-endoscopic-endonasal-pituitary-and-skull-base-surgery
#1
Laura Milanese, Matteo Zoli, Giacomo Sollini, Chiara Martone, Corrado Zenesini, Carmelo Sturiale, Paolo Farneti, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study is to assess the efficacy of our intraoperative antibiotic prophylaxis, analyzing the risk factors of postoperative meningitis in our series. METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days have been included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction, no postoperative administrations have been performed after 2005...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#2
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28720745/-a-case-of-intradural-retroclival-chordoma
#3
Hiroki Takahashi, Yasuyuki Kinoshita, Satoshi Usui, Koji Arihiro, Shuji Kimura, Takafumi Mitsuhara, Kaoru Kurisu
A 67-year-old woman was referred to our department with a retroclival lesion including a cyst on MRI. MRI revealed a lesion appearing as an isointense region on a diffusion-weighted image(DWI). Gadolinium(Gd)-DTPA T1-WI showed heterogeneous enhancement of the lesion in the prepontine cistern. Computed tomography(CT)revealed an isodense lesion with no invasion into the clival bone. Based on a preoperative diagnosis of retroclival chordoma, extended trans-sphenoidal surgery(TSS)was performed by a direct endoscopic endonasal approach via the left nostril...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28705702/recurrent-pituicytoma-with-pseudoaneurysm-report-of-a-challenging-case
#4
Stefano Peron, Jaime Mandelli, Nicola Galante, Stefano Colombo, Davide Locatelli
BACKGROUND: Pituicytoma is a rare tumor originating from glial cells of the adult neurohypophysis and infundibulum. Surgical removal is the treatment of choice for this neoplasm. In recent years the endoscopic endonasal approach has proven to be a viable and effective alternative to standard craniotomy. CASE DESCRIPTION: We report a case of a patient submitted to surgical treatment for a recurrence of pituicytoma, which was operated on transcranially at another hospital approximately five years previously...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#5
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28687446/preservation-of-hormonal-function-by-identifying-pituitary-gland-at-endoscopic-surgery
#6
Stefan Linsler, Renate Hero-Gross, Bettina Friesenhahn-Ochs, Salman Sharif, Frank Lammert, Joachim Oertel
OBJECTIVE: The endonasal endoscopic approach has been established for perisellar tumor surgery with a higher resection rate and reduced complications. We analyzed the potential to identify the pituitary gland under endoscopic view, at surgery and see its relation to postoperative hormonal insufficiency in endonasal endoscopic procedures. METHODS: Between January 2011 and January 2014, 70 cases of pituitary adenomas with preoperative intact pituitary function underwent endoscopic endonasal transsphenoidal procedures for intrasellar pathologies...
July 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28676464/endonasal-endoscopic-odontoidectomy-in-ventral-pathologies-of-the-cranio-cervical-junction-results-of-a-multicenter-experience
#7
Salvatore Chibbaro, Helene Cebula, Sorin Aldea, Bertrand Baussart, Leonardo Tigan, Julien Todeschi, Antonio Romano, Mario Ganau, Christian Debry, Franco Servadei, Francois Proust, Stephane Gaillard
BACKGROUND: Over the past decades, supported by preliminary anatomical and clinical studies exploring its feasibility and safety, an ever growing experience was built on the use of the endoscopic endonasal approach (EEA) to ventral pathologies at the cranio-cervical junction (CCJ). PATIENTS AND METHODS: Multicenter study over a 4 years period on 14 patients managed by EEA odontoidectomy for CCJ pathologies causing irreducible atlanto-axial dislocation. The surgical set up included an IGS system based on CT and MRI images fusion, and 0° and 30° angled endoscopes with dedicated endoscopic tools...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28676314/cerebrospinal-fluid-leaks-after-transsphenoidal-surgery-effect-of-a-polyethylene-glycol-hydrogel-dural-sealant
#8
REVIEW
Erlick A C Pereira, Carly A Grandidge, Victoria A Nowak, Simon A Cudlip
To investigate cerebrospinal fluid (CSF) leak rates after mainly endoscopic endonasal transsphenoidal surgery with and without polyethylene glycol hydrogel dural sealant (DuraSeal®), we prospectively collected data from a single-centre consecutive case series over four years from January 2007 to December 2010 inclusive. 250 patients were identified (135 male, 115 female; median age 52years, range 14-83). 180 patients received DuraSeal® (72%). 85 (34%) had intra-operative dural breach and 13 (5.2%) developed post-operative CSF leaks (3 without intra-operative dural breach) requiring lumbar drainage or formal repair...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28669873/endoscopic-endonasal-surgery-for-pituitary-apoplexy-evidences-from-a-75-cases-series-from-a-tertiary-care-center
#9
Matteo Zoli, Laura Milanese, Marco Faustini-Fustini, Federica Guaraldi, Sofia Asioli, Corrado Zenesini, Alberto Righi, Giorgio Frank, Maria Pia Foschini, Carmelo Sturiale, Ernesto Pasquini, Diego Mazzatenta
BACKGROUND: The optimal management of PA remains debated. The aim of this study was to assess the outcome of TA in PA in a large surgical experience. MATERIALS: Each consecutive case of PA consecutively operated by EEA from our tertiary care center, from 1998 to 2015, were was included in this series. RESULTS: Seventy-five patients (47 males; mean age 52.4 ± 16.2 years, SD:16.2) were included. Mean follow-up was 69.3 ± 46.7 months. On admission, all patients presented with abrupt onset severe headache (100%), associated with nterior hypopituitarism in 51 patients (68%), visual disturbances in 55 (73...
June 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28666364/-live-cadaver-model-for-internal-carotid-artery-injury-simulation-in-endoscopic-endonasal-skull-base-surgery
#10
Paolo Pacca, Sukhdeep S Jhawar, Daniel V Seclen, Eric Wang, Carl Snyderman, Paul A Gardner, Emad Aboud, Juan C Fernandez-Miranda
Background: Intraoperative injury of the internal carotid artery (ICA) is the most dreaded complication in endoscopic endonasal surgery (EES) of skull base. Training for ICA injury is practically impossible in live operative settings. Objective: To evaluate a pulsatile perfusion-based live cadaveric model for ICA injury simulation in a laboratory setting. The major emphasis of the study was to evaluate various means of controlling acute bleeding and evaluating the practical utility of this model for training purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28643208/visual-outcomes-after-endoscopic-endonasal-pituitary-adenoma-resection-a-systematic-review-and-meta-analysis
#11
REVIEW
Ivo S Muskens, Amir H Zamanipoor Najafabadi, Vanessa Briceno, Nayan Lamba, Joeky T Senders, Wouter R van Furth, Marco J T Verstegen, Timothy R S Smith, Rania A Mekary, Christine A E Eenhorst, Marike L D Broekman
PURPOSE: Patients with pituitary adenomas often present with visual deficits. While the aim of endoscopic endonasal transsphenoidal surgery (EETS) is to improve these deficits, permanent worsening is a possible outcome. The aim of this meta-analysis was to evaluate the effect of EETS for pituitary adenomas on visual outcomes. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Pooled prevalence was calculated for complete recovery, improvement, and deterioration of visual field deficits, visual acuity and unspecified visual function in fixed- and random-effect models, including assessment of heterogeneity (I(2)) and publication bias (Begg's test)...
June 22, 2017: Pituitary
https://www.readbyqxmd.com/read/28643170/predictors-and-incidence-of-orthostatic-headache-associated-with-lumbar-drain-placement-following-endoscopic-endonasal-skull-base-surgery
#12
Buqing Liang, Sathwik R Shetty, Sacit Bulent Omay, Joao Paulo Almeida, Shilei Ni, Yu-Ning Chen, Armando S Ruiz-Treviño, Vijay K Anand, Theodore H Schwartz
BACKGROUND: Orthostatic headache (OH) is a potential complication of lumbar drainage (LD) usage. The incidence and risk factors for OH with the use of lumbar drainage during endoscopic endonasal procedures have not been documented. OBJECTIVE: To investigate the incidence of post-procedure OHs associated with placement of LD in patients undergoing endoscopic endonasal procedures. METHODS: We prospectively noted the placement of LDs in a consecutive series of endoscopic endonasal skull base surgeries...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28623412/long-term-follow-up-after-endoscopic-trans-sphenoidal-surgery-or-initial-observation-in-clivus-chordomas
#13
Jon Ramm-Pettersen, Radek Frič, Jon Berg-Johnsen
BACKGROUND: Resection of clivus chordomas through extensive skull base approaches is associated with high mortality and morbidity even in experienced hands. We report our experience with endoscopic trans-sphenoidal surgery, or a "wait-and-scan" strategy in selected patients. METHOD: Ten patients were diagnosed with clivus chordomas during an 8-year period. Six patients underwent primary treatment with endoscopic trans-sphenoidal surgery, followed by adjuvant proton-beam therapy in three of these patients...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28621629/endoscopic-endonasal-odontoid-resection-with-real-time-intraoperative-image-guided-computed-tomography-report-of-4-cases
#14
Harminder Singh, Sarang Rote, Ajit Jada, Evan D Bander, Gustavo J Almodovar-Mercado, Walid I Essayed, Roger Härtl, Vijay K Anand, Theodore H Schwartz, Jeffrey P Greenfield
The authors present 4 cases in which they used intraoperative CT (iCT) scanning to provide real-time image guidance during endonasal odontoid resection. While intraoperative CT has previously been used as a confirmatory test after resection, to the authors' knowledge this is the first time it has been used to provide real-time image guidance during endonasal odontoid resection. The operating room setup, as well as the advantages and pitfalls of this approach, are discussed. A mobile intraoperative CT scanner was used in conjunction with real-time craniospinal neuronavigation in 4 patients who underwent endoscopic endonasal odontoidectomy for basilar invagination...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#15
R Alex Harbison, Yangming Li, Angelique M Berens, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives  Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design  Case series. Setting  Tertiary academic center. Participants  A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures  Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28602880/intraoperative-scoring-system-to-predict-postoperative-remission-in-endoscopic-endonasal-transsphenoidal-surgery-for-growth-hormone-secreting-pituitary-adenomas
#16
Shigetoshi Yano, Naoki Shinojima, Junji Kawashima, Tatsuya Kondo, Takuichiro Hide
OBJECTIVE: This study aimed to determine the predictive factors for endocrinological remission of patients with growth hormone (GH)-secreting pituitary adenomas. METHODS: In 47 patients with GH-secreting pituitary adenomas who underwent endoscopic endonasal transsphenoidal surgery with intraoperative GH measurements from 2002 to 2011, the relationship between the intraoperative GH levels and postoperative remission was analyzed, and two items that predicted remission (GH half-life obtained 30 min or less after removal and a minimum surgical GH level less than 2...
June 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28598713/robot-assisted-endoscope-guidance-versus-manual-endoscope-guidance-in-functional-endonasal-sinus-surgery-fess
#17
Klaus Wolfgang Eichhorn, Ralf Westphal, Markus Rilk, Carsten Last, Friedrich Bootz, Friedrich Wahl, Mark Jakob, Thorsten Send
BACKGROUND: Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. METHODS: We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance...
June 9, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#18
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28593110/endoscopic-endonasal-transclival-approach-versus-dual-transorbital-port-technique-for-clip-application-to-the-posterior-circulation-a-cadaveric-anatomical-and-cerebral-circulation-simulation-study
#19
Jeremy N Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin Cetas, William Cameron
Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28591390/long-term-follow-up-of-growth-hormone-secreting-pituitary-adenomas-submitted-to-endoscopic-endonasal-surgery
#20
Caroline Martins Dos Santos Leopoldo, Felippe Martins Dos Santos Leopoldo, Américo Rubens Leite Dos Santos, José Carlos Esteves Veiga, José Viana Lima, Nilza Maria Scalissi, Paulo Roberto Lazarini, Ricardo Landini Lutaif Dolci
Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas. Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.4ng/ml after glucose load and age-adjusted IGF-1 normal at the last follow-up. Results: The overall endocrinological remission rate was 39...
May 2017: Arquivos de Neuro-psiquiatria
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