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https://www.readbyqxmd.com/read/28214636/a-case-of-evolving-bilateral-sphenoidal-meningoencephalocoeles-case-report-and-review-of-literature
#1
Varun Aggarwal, Pankaj Shivhare, E R Jayadevan, Vinod Felix, Mathew Abraham, Suresh Nair, Prakash Nair
The evolution of sphenoid sinus meningoencephalocoeles and cerebrospinal fluid (CSF) rhinorrhoea is poorly understood. We present a case demonstrating the gradual evolution of encephalocoeles from both the lateral walls of a previously normal sphenoid sinus in a patient with dural arteriovenous fistula (DAVF), the CSF leak which developed following staged embolisation of the DAVF was managed by an endoscopic endonasal transpterygoid approach. Our findings suggest that over a period of time, chronic elevation of intracranial pressure (ICP) results in gradual erosion of the lateral wall of the sphenoid with development of meningoencephalocoeles and CSF leaks...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28210022/csf-related-complications-after-intradural-spinal-tumor-surgery-utility-of-an-autologous-fat-graft
#2
Kenan I Arnautovic, Marko Kovacevic
OBJECT: The incidence of cerebrospinal fluid (CSF)-related complications after intradural spinal tumor (IST) surgery is high and reported in up to 18% of patients. However, no efficient way to prevent those complications has been reported so far. Treating these complications may require prolonged bed rest, re-exploration, external lumbar drain, use of antibiotics, and possible precipitation of other complications. To alleviate the risk of CSF-related complications, we prospectively adopted the intraoperative use of autologous fat grafting after IST surgery...
December 2016: Medical Archives
https://www.readbyqxmd.com/read/28192268/spontaneous-intracranial-hypotension-a-review-and-introduction-of-an-algorithm-for-management
#3
REVIEW
Benjamin Davidson, Farshad Nassiri, Alireza Mansouri, Jetan H Badhiwala, Christopher D Witiw, Mohammed F Shamji, Philip W Peng, Richard I Farb, Mark Bernstein
Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid (CSF) volume and pressure caused by a leak of CSF through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, as they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. Herein, we review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#4
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185972/optimizing-sellar-reconstruction-after-pituitary-surgery-with-free-mucosal-graft-results-in-the-first-50-consecutive-patients
#5
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/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#6
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/28171738/analysis-of-audiometric-outcomes-following-combined-middle-cranial-fossa-transmastoid-approaches-for-spontaneous-cerebrospinal-fluid-otorrhea
#7
Shawn M Stevens, Ryan Crane, Myles L Pensak, Ravi N Samy
Outcome Objectives To (1) explore audiometric outcomes following use of a combined transmastoid/middle cranial fossa (TM-MCF) approach in the treatment of spontaneous cerebrospinal fluid (CSF) otorrhea and (2) determine the influence of dehiscence location and reconstructive methodology on audiometric outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults with spontaneous CSF otorrhea were reviewed from 2007 to 2016 if they underwent combined TM-MCF. Definitive audiometric evaluations were performed at least 3 months postoperatively...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28163520/penetrating-anterior-skull-base-fracture-inflicted-by-a-cow-s-horn
#8
Adomas Bunevicius, Karolis Bareikis, Laimutis Kalasauskas, Arimantas Tamasauskas
Farm workers are at increased risk for animal-inflicted head injuries that are associated with significant morbidity and occasionally may be fatal. These injuries may cause permanent eye damage with or without concomitant skull base fracture. Here, we present a male farmer who suffered a cow attack that resulted in perforating orbital injury with comminuted frontobasal cranial fracture caused by a cow's horn. The next day, the patient developed nasal and orbital cerebrospinal fluid (CSF) leak. Computed Tomography cisternography revealed CSF leakage to frontal and maxillary sinuses...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28162204/-evidence-based-clinical-practice-guidelines-for-the-treatment-of-dural-tears-and-the-consequent-cerebrospinal-fluid-leak-during-spine-surgery
#9
(no author information available yet)
Dural tears (DT) and the consequent cerebral spinal fluid (CSF) leak are not rare in spine surgeries. CSF leak can be troublesome, leading to pseudomeningocele, cutaneous CSF fistula, and meningitis. Revision surgery is unavoidable in some cases. The reported incidences of DT and CSF leak are different according to the various pathologies. Ossification of the posterior longitudinal ligament, revision spine surgery and multi-segment laminectomy have higher risks for DT. Various techniques have been described to manage this complication, such as bed rest, repair with dural substitutes, fibrin glue, gelatin sponge, lumbar drain, muscle flap, etc...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#10
Egidio Del Fabbro
: 102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28134637/experiences-in-performing-posterior-calvarial-distraction
#11
Kevin McMillan, Mark Lloyd, Martin Evans, Nicholas White, Hiroshi Nishikawa, Desiderio Rodrigues, Melanie Sharp, Pete Noons, Guirish Solanki, Stephen Dover
The use of posterior calvarial distraction (PCD) for the management of craniosynostosis is well recognized. The advantages of using this technique include increased cranial volume, decreased intracranial pressure, relief of posterior fossa crowding, improved cerebrospinal fluid (CSF) circulation at the cranio-cervical junction with cessation, and possible resolution of syrinx.The authors retrospectively review their first 50 patients who have undergone PCD under the senior author's care in our unit.The demographics, diagnoses, intraoperative approach with techniques in distractor placement and outcomes of each patient were obtained through an electronic craniofacial database and written patient records...
January 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28133584/preservation-of-the-myofascial-cuff-during-posterior-fossa-surgery-to-reduce-the-rate-of-pseudomeningocele-formation-and-cerebrospinal-fluid-leak-a-technical-note
#12
Daniel R Felbaum, Kyle Mueller, Amjad Anaizi, Robert B Mason, Walter C Jean, Jean M Voyadzis
INTRODUCTION:  Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. METHODS:  A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy...
December 28, 2016: Curēus
https://www.readbyqxmd.com/read/28133560/endoscopic-resection-of-skull-base-teratoma-in-klippel-feil-syndrome-through-use-of-combined-ultrasonic-and-bipolar-diathermy-platforms
#13
Justin A Edward, Alkis J Psaltis, Ryan A Williams, Gregory W Charville, Robert L Dodd, Jayakar V Nayak
Klippel-Feil syndrome (KFS) is associated with numerous craniofacial abnormalities but rarely with skull base tumor formation. We report an unusual and dramatic case of a symptomatic, mature skull base teratoma in an adult patient with KFS, with extension through the basisphenoid to obstruct the nasopharynx. This benign lesion was associated with midline palatal and cerebral defects, most notably pituitary and vertebrobasilar arteriolar duplications. A multidisciplinary workup and a complete endoscopic, transnasal surgical approach between otolaryngology and neurosurgery were undertaken...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28128699/surgical-results-and-complications-of-anterior-decompression-and-fusion-as-a-revision-surgery-after-initial-posterior-surgery-for-cervical-myelopathy-due-to-ossification-of-the-posterior-longitudinal-ligament
#14
Seiichi Odate, Jitsuhiko Shikata, Tsunemitsu Soeda, Satoru Yamamura, Shinji Kawaguchi
OBJECTIVE Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. An anterior cervical decompression and fusion (ACDF) procedure for cervical OPLL is theoretically feasible, as the lesion exists anteriorly; however, such a procedure is considered technically demanding and is associated with serious complications. Cervical laminoplasty is reportedly an effective alternative procedure with few complications; it is recognized as a comparatively safe procedure, and has been widely used as an initial surgery for cervical OPLL...
January 27, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28125308/endoscopic-resection-of-ossifying-fibroma-involving-paranasal-sinuses-and-the-skull-base-in-a-series-of-15-cases
#15
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/28124655/role-of-lumbar-drains-in-contemporary-endonasal-skull-base-surgery-meta-analysis-and-systematic-review
#16
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
https://www.readbyqxmd.com/read/28124654/outcomes-of-endoscopic-repair-of-cerebrospinal-fluid-rhinorrhea-without-lumbar-drains
#17
Austin S Adams, Paul T Russell, James A Duncavage, Rakesh K Chandra, Justin H Turner
OBJECTIVE: Lumbar drains (LD) are commonly used during endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea, either to facilitate graft healing or to monitor CSF fluid dynamics. However, the indications and necessity of LD placement remains controversial. The current study sought to evaluate endoscopic CSF leak repair outcomes in the setting of limited LD use. METHODS: Patients who underwent endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by a review of medical records...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28121970/resorbable-mesh-cranioplasty-repair-of-bilateral-cerebrospinal-fluid-leaks-following-pediatric-simultaneous-bilateral-auditory-brainstem-implant-surgery
#18
Giacomo Colletti, Marco Mandalà, Vittorio Colletti, Alberto Deganello, Fabiana Allevi, Liliana Colletti
OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI...
January 24, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28121968/outcomes-of-the-suture-pull-through-technique-for-repair-of-lateral-skull-base-csf-fistula-and-encephaloceles
#19
Brendan P O'Connell, Jacob B Hunter, Alex D Sweeney, Reid C Thompson, Lola B Chambless, George B Wanna, Alejandro Rivas
OBJECTIVE: Describe the safety profile and surgical outcomes of a combined transmastoid-middle cranial fossa suture "pull-through" technique for repair of lateral skull base defects. STUDY DESIGN: Retrospective. SETTING: Tertiary care hospital. PATIENTS: Patients undergoing surgery for cerebrospinal fluid (CSF) fistula and/or encephalocele. INTERVENTION: Combined transmastoid and middle fossa approach using suture pull-through technique...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28120070/tips-and-tricks-for-anterior-cranial-base-reconstruction
#20
Oreste de Divitiis, Alberto Di Somma, Luigi Maria Cavallo, Paolo Cappabianca
Reconstruction procedures come last in skull base surgery, but they are not the least important phase-rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i...
2017: Acta Neurochirurgica. Supplement
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