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Endoscopic endonasal surgery

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https://www.readbyqxmd.com/read/28433845/clinical-outcome-after-extended-endoscopic-endonasal-resection-of-craniopharyngiomas-two-institution-experience
#1
Hye Ran Park, Varun R Kshettry, Christopher J Farrell, Jae Meen Lee, Yong Hwy Kim, Tae Bin Won, Doo Hee Han, Hyunwoo Do, Gurston Nyguist, Marc Rosen, Dong Gyu Kim, James J Evans, Sun Ha Paek
BACKGROUND: The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. OBJECTIVE: We present clinical experience and outcomes utilizing EEA for craniopharyngiomas. METHODS: A total of 116 patients in two remote institutions were enrolled in this retrospective study. Surgical, endocrinological and ophthalmological outcomes were assessed. RESULTS: The mean follow-up was 35 months (range, 1-115)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433840/the-unusual-presentation-of-a-myxoma-within-the-sphenoid-sinus-case-report-and-review-of-the-literature
#2
Julian V Clarke, Aditi H Mandpe, Peter B Weber, Hannes Vogel, Lewis Z Leng
BACKGROUND: We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. CASE DESCRIPTION: A 72 year old female was diagnosed with an incidental sphenoid sinus tumor and left sphenoid wing meningioma during work-up for left sided proptosis and diplopia. Biopsies of the sphenoid wing and sphenoid sinus tumors were obtained. After undergoing surgical resection of the meningioma, the patient then underwent definitive resection of the sphenoid sinus myxoma via endoscopic endonasal skull base approach...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28413768/surgical-resection-of-an-optic-nerve-sheath-meningioma-relevance-of-endoscopic-endonasal-approaches-to-the-optic-canal
#3
Patrick J Hunt, Franco DeMonte, Rosa A Tang, Shirley Y Su, Shaan M Raza
Optic nerve sheath meningiomas (ONSMs) account for less than 2% of meningiomas and 1.7% of orbital tumors. Although rare, the management of these tumors is important as unilateral blindness often results in untreated cases. Radiotherapy has emerged as the preferred treatment. However, therapies for ONSMs are controversial due to the variable natural history of the disease and limitations of surgical and radiotherapy options. A 60-year-old woman presented with monocular left diminished color perception and blurred vision...
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28412879/quantitative-analysis-of-transnasal-anterior-skull-base-approach-report-of-technology-for-intraoperative-assessment-of-instrument-motion
#4
Angelique M Berens, Richard Alex Harbison, Yangming Li, Randall A Bly, Nava Aghdasi, Manuel Ferreira, Blake Hannaford, Kris S Moe
OBJECTIVE: To develop a method to measure intraoperative surgical instrument motion. This model will be applicable to the study of surgical instrument kinematics including surgical training, skill verification, and the development of surgical warning systems that detect aberrant instrument motion that may result in patient injury. DESIGN: We developed an algorithm to automate derivation of surgical instrument kinematics in an endoscopic endonasal skull base surgery model...
April 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#5
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28409727/clival-chordomas-considerations-after-16-years-of-endoscopic-endonasal-surgery
#6
Matteo Zoli, Laura Milanese, Rocco Bonfatti, Marco Faustini-Fustini, Gianluca Marucci, Giovanni Tallini, Corrado Zenesini, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28403108/analyses-and-treatments-of-postoperative-nasal-complications-after-endonasal-transsphenoidal-resection-of-pituitary-neoplasms
#7
You Cheng, Fei Xue, Tian-You Wang, Jun-Feng Ji, Wei Chen, Zhi-Yi Wang, Li Xu, Chun-Hua Hang, Xin-Feng Liu
In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392496/preoperative-evaluation-of-the-interface-between-tuberculum-sellae-meningioma-and-the-optic-nerves-on-fast-imaging-with-steady-state-acquisition-for-extended-endoscopic-endonasal-transsphenoidal-surgery
#8
Yasuhiko Hayashi, Daisuke Kita, Issei Fukui, Yasuo Sasagawa, Masahiro Oishi, Osamu Tachibana, Fumiaki Ueda, Mitsutoshi Nakada
INTRODUCTION: Endoscopic endonasal transsphenoidal surgery (EETS) is increasingly applied to treat tuberculum sellae meningiomas. However, if the tumor adheres firmly to the optic nerve, dissection of the interface between both structures should be prudent to preserve visual function. The purpose of this study was to investigate whether tumor adhesion to the optic nerve can be predicted preoperatively by fast imaging with steady-state acquisition (FIESTA). METHODS: Twenty-two patients with tuberculum sellae meningioma treated with EETS were retrospectively identified...
April 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28389053/non-functioning-pituitary-adenoma-underwent-surgery-a-multicenter-retrospective-study-over-the-last-four-decades-1977-2015
#9
Pedro Iglesias, Karina Arcano, Vanessa Triviño, Paula García-Sancho, Juan José Díez, Fernando Cordido, Carles Villabona
OBJECTIVE: To assess clinical features, diagnostic procedures, therapies and outcomes in patients with clinically non-functioning pituitary adenomas (NFPAs) surgically treated over the last four decades. DESIGN AND METHODS: A multicenter retrospective study in NFPA patients periodically followed up in specialized neuroendocrinology units who underwent surgery in the period 1977-2015 was performed. RESULTS: A total of 131 patients were studied [66 women (50...
April 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28387628/endonasal-endoscopic-pituitary-surgery-in-the-elderly
#10
Peter J Wilson, Sacit B Omay, Ashutosh Kacker, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Pituitary adenomas are benign, slow-growing tumors that cause symptoms either through mass effect or hormone overproduction. The decision to operate on a healthy young person is relatively straightforward. In the elderly population, however, the risks of complications may increase, rendering the decision more complex. Few studies have documented the risks of surgery using the endonasal endoscopic approach in a large number of elderly patients. The purpose of this study was to audit a single center's data regarding outcomes of purely endoscopic endonasal transsphenoidal resection of pituitary adenomas in elderly patients and to compare them to the current literature...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387626/the-value-of-endoscope-assistance-during-transcranial-surgery-for-tuberculum-sellae-meningiomas
#11
Sascha Marx, Stefan Clemens, Henry W S Schroeder
OBJECTIVE In tuberculum sellae meningioma (TSM) surgery, endonasal approaches are claimed to have a superior visual outcome compared with transcranial approaches. The authors question whether this is always true and analyze their series of cases of endoscope-assisted transcranial TSM surgery with special regard to the postoperative visual outcome in order to explore this issue. METHODS All surgical procedures for TSM performed between 2003 and 2015 in the Department of Neurosurgery, University Medicine Greifswald, were retrospectively analyzed...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28372812/advances-in-microdebrider-technology-improving-functionality-and-expanding-utility
#12
REVIEW
Dennis Tang, Brian C Lobo, Brian D'Anza, Troy Woodard, Raj Sindwani
Since its application in nasal surgery, the microdebrider has revolutionized the practice of endoscopic sinus surgery. As the demands and breadth of procedures performed endoscopically have increased, so has the need for improvement in the microdebrider and related technologies. This article addresses how use of the microdebrider has impacted endonasal surgery and discusses current advances, which include creation of specialty hand pieces and blades, increases in instrument rotational speed, incorporation of navigation and energy, adaptation for intracranial use, and disposable instrumentation designed for in office use...
March 31, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28368500/long-term-endocrine-outcomes-following-endoscopic-endonasal-transsphenoidal-surgery-for-acromegaly-and-associated-prognostic-factors
#13
Harish Babu, Alicia Ortega, Miriam Nuno, Aaron Dehghan, Aaron Schweitzer, H Vivien Bonert, John D Carmichael, Odelia Cooper, Shlomo Melmed, Adam N Mamelak
BACKGROUND: Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented. OBJECTIVE: To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness. METHODS: We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center...
March 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362929/metastatic-liposarcoma-of-the-skull-base-a-case-report-and-review-of-literature
#14
Nirmeen Zagzoog, Greta Ra, Alex Koziarz, John Provias, Doron Sommer, Saleh A Almenawer, Kesava Reddy
BACKGROUND AND IMPORTANCE: Myxoid liposarcoma is not an uncommon form of sarcoma. However, it usually affects the lower extremity long bones. Scapular involvement is extremely rare, as is a metastasis to the parasellar region. We present a case of liposarcoma of the skull base originating in the scapular region and metastasizing to the sellar and parasellar regions and provide a review of the pertinent literature. CLINICAL PRESENTATION: A 43-year-old female patient diagnosed with left scapular myxoid liposarcoma was treated with surgical resection...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28359922/first-application-of-7t-magnetic-resonance-imaging-in-endoscopic-endonasal-surgery-of-skull-base-tumors
#15
Thomas F Barrett, Hadrien A Dyvorne, Francesco Padormo, Puneet S Pawha, Bradley N Delman, Raj K Shrivastava, Priti Balchandani
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. METHODS: Images were acquired at 7T on 11 patients with skull base lesions...
March 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28355937/treatment-and-outcomes-of-endoscopic-surgery-and-traditional-open-resection-in-sinonasal-mucosal-melanoma
#16
Wu Cao, Bing Guan, Aimin Yu, Li Xu, Ying Wang, Saroj Kafle, Bingyi Dai
OBJECTIVE: The optimal surgical approach for sinonasal mucosal melanoma (SNM) remains under debate. We aimed to compare the therapeutic efficacy of traditional open resection and endoscopic surgery for patients with SNM treated at a single center. METHODS: Thirty-three patients diagnosed with SNM who underwent surgery between January 1995 and June 2014 at a single institution were retrospectively analyzed; 18 patients were treated using an open resection approach and 15 using an endoscopic resection approach for the primary tumor...
March 30, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28347892/transcranial-evacuation-of-atypical-progressive-supradiaphragmatic-hematoma-after-transsphenoidal-complete-resection-of-pituitary-adenoma
#17
Hussam Metwali, Rudolf Fahlbusch
OBJECTIVE: Supradiaphragmatic hematoma is a special type of hematomas after transsphenoidal resection (TS) of pituitary adenoma that required special management. METHODS: two patients suffered from symptomatic supradiaphragmatic hematomas after TS total resection of pituitary adenomas in the absence of vascular anomalies. Both patients also developed hydrocephalus at the time of diagnosis of the hematoma. The initial endoscopic endonasal inspection revealed the absence of subdiaphragmatic bleeding...
March 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28328613/endoscopic-endonasal-repair-of-isolated-medial-orbital-wall-fracture-with-balloon-technique
#18
Kazutaka Soejima, Tsutomu Kashimura, Takashi Yamaki, Hiroyuki Sakurai, Hiroaki Nakazawa
Endonasal endoscopic repair of medial orbital wall fractures is minimally invasive and benefits the patients. The authors describe the authors' modified balloon technique, which allows longer support of the orbital wall. From October 2010 through January 2016, the author repaired 9 isolated medial wall fractures by this method. Five patients were diagnosed as having enophthalmos of greater than 2 mm, and 6 patients had persistent diplopia before the operation. The herniated orbital contents that filled the anterior ethmoidal sinus were gently reduced with a 4-mm-diameter 0° sinus endoscope...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28324181/trigeminocardiac-reflex-during-endoscopic-juvenile-nasopharyngeal-angiofibroma-surgery-an-appraisal
#19
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#20
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
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