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https://www.readbyqxmd.com/read/28929079/spontaneous-recurrent-csf-rhinorrhoea-a-rare-case-and-review-of-literature
#1
Nishit Shah, C E Deopujari, Sunita Chhapola Shukla
Cerebrospinal fluid (CSF) rhinorrhoea is the leakage of CSF through the communication between the subarachnoid space and the nasal cavity. Surgical repair is indicated in all cases of spontaneous leaks, recurrent leaks, leaks that do not stop after conservative management and cases with history of meningitis. We present a rare case of spontaneous (delayed onset post traumatic) CSF rhinorrhoea with multiple defect sites, which was treated with an endonasal endoscopic repair. The patient was asymptomatic for 9 years after surgery, and then presented with a spontaneous left frontal recess CSF leak, which was closed using endonasal approach...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28927211/a-pivotal-randomized-clinical-trial-evaluating-the-safety-and-effectiveness-of-a-novel-hydrogel-dural-sealant-as-an-adjunct-to-dural-repair
#2
Michael J Strong, G Alexander West, Henry Woo, Daniel E Couture, John A Wilson, Lorenzo F Munoz, Charles L Rosen, Jeremy D Greenlee, Harry R van Loveren, Mark Iantosca, Clinton J Baird, Mark Smith, Matt McGirt, Jonathan Parish, Anthony L Asher
BACKGROUND: A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. OBJECTIVE: To evaluate the safety and efficacy of a novel hydrogel, Adherus Dural Sealant, when compared with control, DuraSeal Dural Sealant System, as an adjunct to standard methods of dural repair. METHODS: In this 17-center, prospective, randomized clinical trial designed as a noninferiority, single-blinded study, 124 patients received Adherus Dural Sealant (test sealant) and 126 received DuraSeal (control)...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28916976/preoperative-risk-factors-for-postoperative-complications-in-endoscopic-pituitary-surgery-a-systematic-review
#3
REVIEW
Daniel J Lobatto, Friso de Vries, Amir H Zamanipoor Najafabadi, Alberto M Pereira, Wilco C Peul, Thea P M Vliet Vlieland, Nienke R Biermasz, Wouter R van Furth
BACKGROUND: The ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery. METHODS: We conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines...
September 15, 2017: Pituitary
https://www.readbyqxmd.com/read/28913667/microsurgical-versus-endoscopic-transsphenoidal-resection-for-acromegaly-a-systematic-review-of-outcomes-and-complications
#4
REVIEW
Ching-Jen Chen, Natasha Ironside, I Jonathan Pomeraniec, Srinivas Chivukula, Thomas J Buell, Dale Ding, Davis G Taylor, Robert F Dallapiazza, Cheng-Chia Lee, Marvin Bergsneider
PURPOSE: The aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly. METHODS: A literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Data extracted from each study included surgical technique, perioperative complications, biochemical remission criteria, and long-term remission outcomes...
September 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28887281/cerebrospinal-fluid-leak-rhinorrhea-after-systemic-erlotinib-chemotherapy-for-metastatic-lung-cancer-a-familiar-problem-from-an-unfamiliar-culprit
#5
Blake Priddy, Douglas A Hardesty, André Beer-Furlan, Bradley Otto, Daniel M Prevedello
BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea after medical therapy for pituitary prolactinoma is a rare but well-described phenomenon. To our knowledge, no CSF leaks have been reported after targeted medical treatment of pituitary or anterior skull base metastases. We report this unusual case to raise awareness of spontaneous CSF leaks in the setting of skull base metastatic disease. CASE PRESENTATION: A 66-year-old woman presented with EGFR-mutant Stage IV adenocarcinoma of the lung...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882714/combined-minimally-invasive-supraciliary-and-transfacial-approach-for-large-tumors-with-skull-base-and-sinonasal-involvement
#6
Pal Barzo, Zsolt Zador, Mihaly Bodosi, Zsolt Bella, Daniel Jambor, Bela Fulop, Jeno Czigner
BACKGROUND: Tumors invading both the anterior skull base and the sinonasal area have been traditionally accessed via largely invasive open craniofacial approaches. Minimally invasive extended endoscopic endonasal approaches have recently become increasingly available, but have anatomical limitations and require incremental experience and thus high patient volume. Our objective was to assess the applicability of a novel combination of the minimally invasive supraciliary incision and the limited maxillofacial osteotomy as a combined surgical approach for large tumors invading both the anterior skull base and the sinonasal area...
September 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28876688/management-of-myelomeningocele-in-the-province-of-kwazulu-natal-south-africa
#7
M N Mnguni, B Enicker, T E Madiba
BACKGROUND: Spina bifida is the most common of congenital anomalies of the central nervous system that are compatible with life. The most frequent form is myelomeningocele. METHOD: Setting: Neurosurgery Unit, Inkosi Albert Luthuli Central Hospital. Patients: Consecutive children with diagnosis myelomeningocele who were managed at from January 2006 to December 2014. Design: Retrospective analysis of children with myelomeningocele. Multiple logistic regression analysis identified clinical, demographic and surgical variables that were associated with outcome...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875123/costs-and-perioperative-outcomes-associated-with-open-versus-endoscopic-resection-of-sinonasal-malignancies-with-skull-base-involvement
#8
Terence S Fu, Eric Monteiro, Ian Witterick, Allan Vescan, Gelareh Zadeh, Fred Gentili, John R de Almeida
Objective  To compare financial and perioperative outcomes between endoscopic and open surgical approaches in the surgical management of sinonasal malignancies. Design  Retrospective chart review. Setting  Tertiary care hospital. Participants  Patients undergoing surgical resection of a sinonasal malignancy from January 2000 to December 2014. Main Outcome Measures  In-hospital costs, complications, and length of stay (LOS). Results  Of 106 patients, 91 received open surgery (19 free flap and 72 non-free flap) and 15 were treated with purely endoscopic approaches...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#9
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28872159/cerebrospinal-fluid-rhinorrhoea-following-transsphenoidal-surgery-for-pituitary-adenoma-experience-in-a-chinese-centre
#10
C Zhang, X Ding, Y Lu, L Hu, G Hu
The aim of this study was to elucidate the risk factors for cerebrospinal fluid (CSF) rhinorrhoea following transsphenoidal surgery and discuss its prevention and treatments. We retrospectively reviewed 474 consecutive cases of pituitary adenoma treated with 485 transsphenoidal surgical procedures from January 2008 to December 2011 in our department. We analysed the incidence of intra- and post-operative CSF leakage and outcomes of various repair strategies. Intra-operative CSF leakage was encountered in 85 cases (17...
August 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28871507/delayed-post-operative-tension-pneumocephalus-and-pneumorrhachis
#11
D C Kieser, D T Cawley, C Tavolaro, T Cloche, I Obeid, V Pointillart, J M Vital, O Gille
INTRODUCTION: The incidence of pneumocephalus and pneumorrhachis after spinal surgery is unknown, with a paucity of literature on this complication. MATERIALS AND METHODS: We present the first published case of delayed onset tension pneumocephalus and pneumorrhachis associated with spinal surgery. RESULTS: This complication occurred from a cerebro-spinal fluid (CSF) leak after posterior instrumentation removal and was successfully treated with emergent wound debridement and the formation of a CSF fistula...
September 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28867316/endoscopic-endonasal-surgery-for-treatment-of-pituitary-apoplexy-16-years-of-experience-in-a-specialized-pituitary-center-endoscopic-surgery-for-pituitary-apoplexy
#12
Jackson A Gondim, Lucas Alverne F de Albuquerque, Joao Paulo Almeida, Tania Bulcao, Erica Gomes, Michele Schops, Raquel Vasconcelos, Flora da Paz, Sergio Botelho Guimarães
OBJECTIVE: Symptomatic pituitary apoplexy is a rare but life-threatening condition caused by sudden hemorrhage or infarction of a pituitary adenoma. In the current study, we aim to evaluate the clinical presentation, management and clinical outcomes in a cohort of patients who were treated for this condition in our center in the last 16 years. METHODS: We performed a retrospective analysis of all patients who underwent endoscopic endonasal surgery for treatment of symptomatic pituitary apoplexy between 2001 and 2016 in our center...
August 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28866068/treating-csf-rhinorrhea-without-dura-repair-a-case-report-of-posterior-fossa-choroid-plexus-papilloma
#13
François Lechanoine Resident, Ilyess Zemmoura, Stéphane Velut
BACKGROUND: Choroid plexus papilloma revealed by non traumatic cerebrospinal fluid (CSF) rhinorrhea had only been described five times in the literature. The challenges in this situation are to recognize CSF leak, to rapidly understand the pathophysiology of the leak, and to choose the best treatment strategy in emergency. We report an original case of posterior fossa choroid plexus papilloma revealed by CSF leak. We then discuss the surgical strategy and the pathophysiology of CSF leak, which is explained, in this case, by both hyperproduction of CSF and local skull base erosion...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28859453/comparison-of-complications-trends-and-costs-in-endoscopic-vs-microscopic-pituitary-surgery-analysis-from-a-us-health-claims-database
#14
Anthony O Asemota, Masaru Ishii, Henry Brem, Gary L Gallia
BACKGROUND: Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. OBJECTIVE: To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. METHODS: The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28846785/cerebrospinal-fluid-leak-during-stapes-surgery-gushing-leaks-and-oozing-leaks-two-different-phenomena
#15
Juan Luis Quesada, Giovanni Cammaroto, Lilla Bonanno, Francesco Galletti, Pedro Quesada
Cerebrospinal fluid (CSF) leak is an uncommon event that can occur during stapes surgery. Such leaks can be classified as gushing leaks (stapes gushers) and oozing leaks. A stapes gusher is a massive flow of CSF through the perforated footplate that fills the middle ear suddenly, while an oozing leak is a slower and less profuse flow. We conducted a retrospective, observational, multicenter study of 38 patients-23 men and 15 women, aged 23 to 71 years (mean: 47)-who had experienced a CSF leak during stapes surgery...
August 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28838875/comparison-of-porcine-and-bovine-collagen-dural-substitutes-in-posterior-fossa-decompression-for-chiari-i-malformation-in-adults
#16
Christine K Lee, Tara Mokhtari, Ian D Connolly, Gordon Li, Lawrence M Shuer, Steven D Chang, Gary K Steinberg, Melanie Hayden Gephart
BACKGROUND: Posterior fossa decompression surgeries for Chiari malformations are susceptible to post-operative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been employed to improve surgical outcomes. OBJECTIVE: This study examined whether the collagen matrix dural substitute type correlated with the incidence of post-operative complications following posterior fossa decompression in adult patients with Chiari I malformations...
August 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28838874/youtcomes-following-endoscopic-endonasal-resection-of-craniopharyngiomas-in-the-pediatric-population
#17
Vishal S Patel, Andrew Thamboo, Jennifer Quon, Jayakar V Nayak, Peter H Hwang, Michael Edwards, Zara M Patel
BACKGROUND: Craniopharyngiomas have traditionally been treated via open, transcranial approaches. More recently, endoscopic, transsphenoidal approaches have been increasingly utilized; however very few case-series exist in the pediatric population. METHODS: A retrospective review of patients (<18 years) undergoing endoscopic transsphenoidal resection of craniopharyngiomas between 1995 and 2016 was performed. Preoperative data included presenting symptoms, tumor size, location, and components...
August 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28831590/limitations-of-the-endonasal-endoscopic-approach-in-treating-olfactory-groove-meningiomas-a-systematic-review
#18
REVIEW
Sathwik Raviraj Shetty, Armando S Ruiz-Treviño, Sacit Bulent Omay, Joao Paulo Almeida, Buqing Liang, Yu-Ning Chen, Harminder Singh, Theodore H Schwartz
OBJECTIVE: To review current management strategies for olfactory groove meningioma (OGM)s and the recent literature comparing endoscopic endonasal (EEA) with traditional transcranial (TCA) approaches. METHODS: A PubMed search of the recent literature (2011-2016) was performed to examine outcomes following EEA and TCA for OGM. The extent of resection, visual outcome, postoperative complications and recurrence rates were analyzed using percentages and proportions, the Fischer exact test and the Student's t-test using Graphpad PRISM 7...
August 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28826916/surgical-treatment-of-intramedullary-ependymomas
#19
Marek Prokopienko, Przemysław Kunert, Anna Podgórska, Andrzej Marchel
OBJECT: The aims of this study were to present the results of surgery for intramedullary ependymomas (IEs), analyze complication and recurrence rates, and analyze factors that might influence outcome. METHODS: The charts of 29 consecutive patients (women - 8, men - 21; mean age - 38 years; range: 18-72) operated for IE were retrospectively analyzed. Mean follow-up was 9 years. Eighteen tumors (62%) were located in the cervical or cervicothoracic spine, and average tumor length was four spinal levels...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28790007/targeted-epidural-blood-patch-under-o-arm-guided-stereotactic-navigation-in-patients-with-intracranial-hypotension-associated-with-a-spinal-csf-leak-and-ventral-dural-defect
#20
Keisuke Takai, Makoto Taniguchi
OBJECTIVE: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention due to the insufficient coverage of injected blood. METHODS: Eight patients with intracranial hypotension due to a CSF leak diagnosed by myelographic CT and thin-cut MRI received an epidural blood patch under O-arm-guided stereotactic navigation...
August 5, 2017: World Neurosurgery
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