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Cerebrospinal fluid leak

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https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#1
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29135804/surgical-management-of-tumors-involving-meckel-s-cave-and-cavernous-sinus-role-of-an-extended-middle-fossa-and-lateral-sphenoidectomy-approach
#2
Daniel Q Sun, Arnold H Menezes, Matthew A Howard, Bruce J Gantz, David M Hasan, Marlan R Hansen
OBJECTIVE: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). STUDY DESIGN: Retrospective patient series. SETTING: Tertiary referral center. PATIENTS: Twenty-two consecutive patients (mean age: 45 yr, range: 16-76) who underwent transzygomatic, extended middle fossa approaches for tumors involving MC and CS...
November 13, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29127655/the-endoscopic-endonasal-approach-is-not-superior-to-the-microscopic-transcranial-approach-for-anterior-skull-base-meningiomas-a-meta-analysis
#3
Ivo S Muskens, Vanessa Briceno, Tom L Ouwehand, Joseph P Castlen, William B Gormley, Linda S Aglio, Amir H Zamanipoor Najafabadi, Wouter R van Furth, Timothy R Smith, Rania A Mekary, Marike L D Broekman
OBJECT: In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. METHODS: A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values...
November 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29122086/endonasal-endoscopic-management-of-frontal-sinus-cerebrospinal-fluid-leak
#4
Javaneh Jahanshahi, Mehdi Zeinalizadeh, Hasan Reza Mohammadi, Seyed Mousa Sadrehosseini
BACKGROUND: A frontal sinus leak is uncommon and is seen in ∼15% of cases of patients with cerebrospinal fluid (CSF) rhinorrhea. Now, endonasal endoscopic techniques have been reported to reconstruct skull base defects in the frontal sinus with a favorable outcome. OBJECTIVE: To review our experience in the repair of frontal sinus CSF leaks through an endonasal endoscopic approach. METHODS: Twenty-four patients with a frontal sinus leak who underwent endonasal endoscopic repair entered the study...
November 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29122079/sinonasal-t-cell-expression-of-cytotoxic-mediators-granzyme-b-and-perforin-is-reduced-in-patients-with-chronic-rhinosinusitis
#5
Sarah E Smith, Rodney J Schlosser, James R Yawn, Jose L Mattos, Zachary M Soler, Jennifer K Mulligan
BACKGROUND: CD8+ T cells and natural killer (NK) cells are cytotoxic cells that use granzyme B (GrB) and perforin. Defective cytotoxic function is known to play a role in dysregulated immune response as seen in chronic sinusitis, also referred to as chronic rhinosinusitis (CRS). However, to our knowledge, in the United States, neither GrB or perforin expression has been reported in patients with CRS. OBJECTIVE: The aim of this study was to investigate sinonasal cytotoxic cells, their mediators, and cell-specific distribution of these mediators in patients with CRS with nasal polyp (CRSwNP) and in patients with CRS without nasal polyp (CRSsNP)...
November 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29122076/a-systematic-review-of-secondary-cerebrospinal-fluid-leaks
#6
Neeraja Konuthula, Mohemmed N Khan, Anthony Del Signore, Satish Govindaraj, Raj Shrivastava, Alfred M Iloreta
BACKGROUND: Secondary cerebrospinal leaks (CSF) are leaks that recur after an initial endoscopic repair of CSF leaks. Identification of characteristics that could predict secondary leaks may allow surgeons to plan repairs with the knowledge that these defects are more likely to fail. OBJECTIVE: To identify characteristics that could predict secondary CSF leaks. METHODS: A search of all studies that reported outcomes after endoscopic repair of CSF leaks was conducted by using medical literature data bases...
November 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#7
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29114899/in-reference-to-intervention-for-elevated-intracranial-pressure-improves-success-rate-after-repair-of-spontaneous-cerebrospinal-fluid-leaks
#8
João Mangussi-Gomes, Leonardo L Balsalobre, Marcos Q T Gomes, Eduardo A S Vellutini, Aldo E C Stamm, André Beer-Furlan
No abstract text is available yet for this article.
November 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29104156/endoscopic-approach-to-clival-chordomas-the-northwestern-experience
#9
Rudy J Rahme, Omar M Arnaout, Olabisi R Sanusi, Kartik Kesavabhotla, James P Chandler
INTRODUCTION: Chordomas are rare primary bone tumors with a low-grade histology but an aggressive clinical behavior characterized by local invasion and recurrence. When occurring in the skull base, their treatment is limited by proximity to critical neurovascular structures. Open surgical approaches can carry high morbidity making the development of alternative approaches desirable. We describe our experience with endoscopic endonasal approaches to clival chordomas over 13 years. MATERIALS AND METHOD: We performed a retrospective chart review of patients diagnosed with clival chordomas and treated with an endoscopic endonasal approach between the years 2003 and 2015 at Northwestern Memorial Hospital...
November 2, 2017: World Neurosurgery
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
#10
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/29098278/cranioplasty-using-a-mixture-of-biologic-and-nonbiologic-agents
#11
Demetri Arnaoutakis, Arash Bahrami, Jason E Cohn, Jesse E Smith
Importance: A surgeon faces challenges with cranioplasty techniques to achieve a successful result with relatively few complications. Objective: To describe a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty with favorable outcomes and low occurrence of complications. Design, Setting, and Participants: A retrospective medical records review of all 26 patients who underwent primary cranioplasty procedure with a modified technique between January 2011 and December 2015 at a high-volume head and neck oncologic reconstructive practice was conducted; data analysis was also performed during that period...
November 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29095707/long-term-management-and-outcomes-after-repair-of-cerebrospinal-fluid-rhinorrhea-related-to-idiopathic-intracranial-hypertension
#12
Theodore A Schuman, Brent A Senior
PURPOSE OF REVIEW: To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH). RECENT FINDINGS: Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder...
October 31, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29094066/surgical-repair-of-spontaneous-cerebrospinal-fluid-csf-leaks-a-systematic-review
#13
REVIEW
Brian C Lobo, Maraya M Baumanis, Rick F Nelson
Objectives: To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources: A systematic review of English articles using MEDLINE. Review Methods: Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles by 3 authors. Results: Patients with spontaneous CSF leaks are often obese (average BMI of 38 kg/m(2)) and female (72%)...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29091245/intracranial-epidermoid-lesions-our-experience-of-38-cases
#14
Lal Rehman, Iram Bokhari, Shamim Ul Siddiqi, Veejay Bagga, Muhammad Masood Hussain
BACKGROUND: The clinical outcome following surgical resection of intracranial epidermoid lesions is not well documented. We describe a case series evaluating the clinical presentation and outcome following surgery in patients diagnosed with these lesions. MATERIALS AND METHODS: A retrospective study conducted over a 4-year period. RESULTS: A total 38 patients who underwent surgery for intracranial epidermoid lesions were identified. Of these, 20 were supertentorial and 18 were infratentorial lesions...
October 2, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29083507/complications-and-donor-site-morbidity-of-3-layer-reconstruction-with-iliotibial-tract-of-the-anterior-skull-base-retrospective-analysis-of-186-patients
#15
Davide Mattavelli, Alberto Schreiber, Andrea Bolzoni Villaret, Remo Accorona, Mario Turri-Zanoni, Alessia Lambertoni, Marco Ferrari, Paolo Castelnuovo, Piero Nicolai
BACKGROUND: Anterior skull base reconstruction after resection of sinonasal cancers may be challenging when pedicled flaps are unavailable. The purpose of the present study was to analyze the complication rate and donor site morbidity of 3-layer reconstruction with the iliotibial tract (ITT). METHODS: We retrospectively reviewed all anterior skull base reconstructions with ITT performed from 2007 to 2015. Donor site morbidity was investigated by a dedicated questionnaire...
October 30, 2017: Head & Neck
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
#16
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
https://www.readbyqxmd.com/read/29061456/multi-layered-dura-reconstruction-after-thoracoscopic-microdiscectomy-technique-and-results
#17
Erwin M J Cornips
BACKGROUND: Anterior transthoracic approaches including thoracoscopic microdiscectomy (TMD) are the preferred technique for central, broad-based, calcified thoracic disc herniations (TDHs). Dural defects due to manipulation or transdural extension may create a potentially life-threatening subarachnoid-pleural fistula. We evaluate a fast, sutureless technique to reconstruct the dura. METHODS: We analyzed 476 anterior transthoracic approaches for TDHs (437 TMDs, 31 mini-thoracotomies, 7 transaxillary approaches, one sternotomy)...
October 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29055142/the-fate-of-the-bone-graft-in-cerebrospinal-fluid-rhinorrhea-endoscopic-repair-for-idiopathic-intracranial-hypertension-a-retrospective-case-series-analysis
#18
A D Workman, R M Carey, A K Parasher, E C Kuan, J Godovchik, J T Glicksman, D W Kennedy, J N Palmer, N D Adappa
INTRODUCTION: Idiopathic intracranial hypertension (IIH) is a common cause of spontaneous cerebrospinal fluid (CSF) leaks necessitating surgical intervention, and grafting of septal, mastoid, or turbinate bone over the defect is increasingly performed to strengthen the repair of the primary defect. However, the postoperative fate of these grafted bone fragments is largely unknown. METHODOLOGY: We performed a retrospective study of patients at the University of Pennsylvania undergoing repair of spontaneous CSF leaks secondary to IIH...
October 21, 2017: Rhinology
https://www.readbyqxmd.com/read/29048111/cerebrospinal-fluid-leak-after-bone-marrow-biopsy
#19
Thomas A Fox, Rolf Jager, Kirit M Ardeshna
No abstract text is available yet for this article.
October 19, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29040677/navigation-linked-heads-up-display-in-intracranial-surgery-early-experience
#20
Justin R Mascitelli, Leslie Schlachter, Alexander G Chartrain, Holly Oemke, Jeffrey Gilligan, Anthony B Costa, Raj K Shrivastava, Joshua B Bederson
BACKGROUND: The use of intraoperative navigation during microscope cases can be limited when attention needs to be divided between the operative field and the navigation screens. Heads-up display (HUD), also referred to as augmented reality, permits visualization of navigation information during surgery workflow. OBJECTIVE: To detail our initial experience with HUD. METHODS: We retrospectively reviewed patients who underwent HUD-assisted surgery from April 2016 through April 2017...
October 10, 2017: Operative Neurosurgery (Hagerstown, Md.)
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