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https://www.readbyqxmd.com/read/28633408/risk-factors-for-readmission-with-cerebrospinal-fluid-leakage-within-30-d-of-vestibular-schwannoma-surgery
#1
Ali A Alattar, Brian R Hirshman, Brandon A McCutcheon, Clark C Chen, Thomas Alexander, Jeffrey Harris, Bob S Carter
BACKGROUND: Cerebrospinal fluid (CSF) leak is a well-recognized complication after surgical resection of vestibular schwannomas and is associated with a number of secondary complications, including readmission and meningitis. OBJECTIVE: To identify risk factors for and timing of 30-d readmission with CSF leak. METHODS: Patients who had undergone surgical resection of a vestibular schwannoma from 1995 to 2010 were identified in the California Office of Statewide Health Planning and Development database...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28625902/obesity-in-neurosurgery
#2
REVIEW
Mendel D Castle-Kirszbaum, Jin W Tee, Patrick Chan, Martin K Hunn
Obesity is an important consideration in neurosurgical practice. 28.3% of Australian adults are obese and it is estimated that over two-thirds of Australia's population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures demonstrated that, in patients undergoing spinal surgery, an increased BMI is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery and increased financial cost...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28620574/complications-of-advanced-kadish-stage-esthesioneuroblastoma-single-institution-experience-and-literature-review
#3
Sheri K Palejwala, Saurabh Sharma, Christopher H Le, Eugene Chang, Michael Lemole
INTRODUCTION: In esthesioneuroblastoma, greater disease extent and Kadish staging correlate with greater recurrence, complications, and mortality. These advanced stage malignancies require extensive resections and aggressive adjuvant therapy. This increases the risk of complications such as cerebrospinal fluid leak, neurologic deficits, and osteomyelitis. We present our case series and then analyze the literature to ascertain whether advanced stage tumors corresponds to greater rates of complications...
May 12, 2017: Curēus
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#4
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/28595773/endoscopic-endonasal-management-of-esthesioneuroblastoma-a-retrospective-multicenter-study
#5
Takayuki Nakagawa, Satoru Kodama, Masayoshi Kobayashi, Tetsuji Sanuki, Shuho Tanaka, Nobuhiro Hanai, Toyoyuki Hanazawa, Hiroko Monobe, Hidenori Yokoi, Motohiko Suzuki, Masaru Yamashita, Koichi Omori
OBJECTIVE: The aim of the present study was to illustrate the safety and utility of the endoscopic endonasal approach (EEA) for the treatment of esthesioneuroblastomas (ENB). METHODS: We retrospectively reviewed patients with a diagnosis of ENB between March 2008 and February 2016 at 10 tertiary referral hospitals in Japan, and assessed demographic data, stage of disease, surgical approach, outcomes and postoperative complications. RESULTS: A total of 22 patients (10 males and 12 females; mean age at presentation, 49...
June 5, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28589319/the-transotic-approach-for-vestibular-schwannoma-indications-and-results
#6
Yin Xia, Wenyang Zhang, Yi Li, Xiaobo Ma, Qiang Liu, Jinghua Shi
To analyze retrospectively the indications and the results obtained with the transotic approach in a series of patients with vestibular schwannoma. The study included 36 patients from 2007 to 2013 with a vestibular schwannoma that was removed with a transotic approach. All patients underwent preoperative pure tone audiometry, evaluation of facial function and CT and MR imaging. All patients having (1) a hearing loss of more than 50 dB, (2) an average tumor size of 2.7 cm (range 0.5-5.0 cm) and (3) signs of a contracted mastoid (high jugular bulb, anteriorly located sigmoid sinus, low middle cranial fossa, or reduced pneumatization) were selected...
June 6, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28583494/spontaneous-csf-rhinorrhea-from-the-trigeminal-canal-in-an-adolescent
#7
Jonathan C Simmonds, Andrew R Scott
We report a case of a seventeen-year old, healthy, non-obese young woman who presented with retro-orbital headaches and metallictasting, left-sided rhinorrhea. Computed tomography revealed a defect along the medial wall of the canal of V2 within a well-pneumatized lateral recess of the left sphenoid sinus. Prior imaging obtained 4 years earlier in the context of nasal trauma showed no such defect - thus lending support for the arachnoid granulation hypothesis of spontaneous CSF leaks from the sphenoid sinus...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28575349/safety-and-efficacy-of-a-novel-self-adhering-dural-substitute-in-a-canine-supratentorial-durotomy-model
#8
Kevin M Lewis, Jenifer Sweet, Scott T Wilson, Serge Rousselle, Heinz Gulle, Bernhard Baumgartner
BACKGROUND: Cerebrospinal fluid (CSF) leaks increase postoperative risk for complication, likelihood of reoperation, and costs. OBJECTIVE: To investigate a novel, self-adhering polyethylene glycol-coated collagen pad (PCC) as a dural substitute relative to Duragen XS (DGX; Integra LifeSciences Corporation, Plainsboro, New Jersey) and as a dural sealant relative to Tachosil (Takeda Austria GmbH, Linz, Austria), a fibrinogen and thrombin-coated collagen pad (FTC)...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28574328/cerebrospinal-fluid-outflow-resistance-as-a-diagnostic-marker-of-spontaneous-cerebrospinal-fluid-leakage
#9
Jürgen Beck, Christian Fung, Christian T Ulrich, Michael Fiechter, Jens Fichtner, Heinrich P Mattle, Marie-Luise Mono, Niklaus Meier, Pasquale Mordasini, Werner J Z'Graggen, Jan Gralla, Andreas Raabe
OBJECTIVE Spinal CSF leakage causes spontaneous intracranial hypotension (SIH). The aim of this study was to characterize CSF dynamics via lumbar infusion testing in patients with and without proven spinal CSF leakage in order to explore possible discriminators for the presence of an open CSF leak. METHODS This analysis included all patients with suspected SIH who were treated at the authors' institution between January 2012 and February 2015. The gold standard for "proven" CSF leakage is considered to be extrathecal contrast accumulation after intrathecal contrast injection...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#10
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28512741/intervention-for-elevated-intracranial-pressure-improves-success-rate-after-repair-of-spontaneous-cerebrospinal-fluid-leaks
#11
William Teachey, Jessica Grayson, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
OBJECTIVES/HYPOTHESIS: Spontaneous cerebrospinal fluid (CSF) leaks are associated with increased intracranial pressure (ICP) and considered a manifestation of idiopathic intracranial hypertension. Although postoperative acetazolamide and placement of CSF shunt systems are considered valuable interventions for elevated ICP, the impact on recurrence rate remains unclear. The objective of this study was to systematically review evidence from reported literature to evaluate whether postoperative ICP management reduces recurrence rates after primary endoscopic repair...
May 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28509936/penetrating-osseous-spicules-causing-high-flow-ventral-csf-leaks-in-the-setting-of-relatively-low-bmi-a%C3%A2-preliminary-study
#12
Richard E Rosebrock, Felix E Diehn, Patrick H Luetmer, John T Wald, John I Lane, Jonathan M Morris, Vance T Lehman, Carrie M Carr, Bahram Mokri, Kent R Thielen
OBJECTIVE/BACKGROUND: We have anecdotally observed patients with high-flow ventral cerebrospinal fluid (CSF) leaks resulting from penetrating osseous spicules or calcified discs to be relatively thin. The purpose of this study was to explore the validity of this observation and determine if a potential association exists between low body mass index (BMI) and high-flow spinal ventral CSF leaks resulting from such dura-penetrating lesions. METHODS: Sixteen consecutive patients with precisely localized high-flow ventral spinal CSF leaks on dynamic myelography were identified...
May 16, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28498058/endoscopic-endonasal-resection-of-the-odontoid-process-clinical-outcomes-in-34-adults
#13
Nathan T Zwagerman, Matthew J Tormenti, Zachary J Tempel, Eric W Wang, Carl H Snyderman, Juan C Fernandez-Miranda, Paul A Gardner
OBJECTIVE Treatment of odontoid disease from a ventral corridor has consisted of a transoral approach. More recently, the endoscopic endonasal approach (EEA) has been used to access odontoid pathology. METHODS A retrospective review was conducted of patients who underwent an EEA for odontoid pathology from 2004 to 2013. During our analysis, the mean follow-up duration was 42.6 months (range 1-80 months). Patient outcomes, complications, and postoperative swallowing function were assessed either by clinic visit or phone contact...
May 12, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28490407/the-application-of-a-free-nasal-floor-mucoperiosteal-graft-in-endoscopic-sinus-surgery
#14
Anali Dadgostar, Christopher Okpaleke, Fahad Al-Asousi, Amin Javer
BACKGROUND: Numerous reconstructive techniques and materials have been reported for repair of skull base defects, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone, including pedicled vascularized flaps and free mucosal grafts. OBJECTIVE: This study described our technique of harvesting and transferring a free nasal floor mucoperiosteal graft and discussed our experience with the application of this technique. METHODS: A retrospective review of 19 patients (mean age, 53...
May 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28484567/clival-defect-causing-primary-spontaneous-rhinorrhea
#15
Vivek Tandon, Kanwaljeet Garg, Ashish Suri, Ajay Garg
Primary cerebrospinal fluid (CSF) rhinorrhea due to a defect in clivus is an extremely rare entity, till date only four such cases are reported in the world literature. We present a case of 55-year-old female who presented with primary spontaneous CSF rhinorrhea, for which endonasal surgery was performed about 9 years back. Patient developed recurrent CSF leak with a history of meningitis. Repeat imaging showed clival defect causing CSF leak. Transsphenoidal repair was performed under neuronavigation. In this paper, we discuss the possible mechanism of fistula formation and literature is reviewed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28481397/endoscopic-endonasal-cerebrospinal-fluid-leak-repair-on-the-ventral-midline-skull-base-a-single-neurosurgical-center-experience
#16
Cihan Isler, Merdin Lyutviev Ahmedov, Mehmet Yigit Akgun, Baris Kucukyuruk, Nurperi Gazioglu, Galip Sanus, Necmettin Tanriover
AIM: The aim of this study was to present the results of endoscopic endonasal repair of ventral midline skull base cerebrospinal fluid (CSF) leak (VMSBL) at our institution and to discuss the technique and results from a neurosurgical perspective. MATERIAL AND METHODS: A retrospective analysis of all VMSBL cases that underwent endoscopic endonasal skull base approach (EESBA) for CSF leak repair at a single tertiary neurosurgical center was performed. Twenty six patients with an average age of 44...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28480156/complex-skull-base-reconstructions-in-kadish-d-esthesioneuroblastoma-case-report
#17
Sheri K Palejwala, Saurabh Sharma, Christopher H Le, Eugene Chang, Audrey B Erman, G Michael Lemole
Introduction Advanced Kadish stage esthesioneuroblastoma requires more extensive resections and aggressive adjuvant therapy to obtain adequate disease-free control, which can lead to higher complication rates. We describe the case of a patient with Kadish D esthesioneuroblastoma who underwent multiple surgeries for infectious, neurologic, and wound complications, highlighting potential preventative and salvage techniques. Case Presentation A 61-year-old man who presented with a large left-sided esthesioneuroblastoma, extending into the orbit, frontal lobe, and parapharyngeal nodes...
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28478791/oblique-intrathecal-injection-in-lumbar-spine-surgery-a-technical-note
#18
Gordon A E Jewett, Daniel Yavin, Perry Dhaliwal, Tara Whittaker, JoyAnne Krupa, Stephan Du Plessis
OBJECTIVES: Intrathecal morphine (ITM) is an efficacious method of providing postoperative analgesia and reducing pain associated complications. Despite adoption in many surgical fields, ITM has yet to become a standard of care in lumbar spine surgery. Spine surgeons' reticence to make use of the technique may in part be attributed to concerns of precipitating a cerebrospinal fluid (CSF) leak. METHODS: Herein we describe a method for oblique intrathecal injection during lumbar spine surgery to minimize risk of CSF leak...
May 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28474582/delayed-extensive-lumbar-sub-dural-effusion-following-discectomy-clinical-imaging-and-case-report
#19
Arun-Kumar Kaliya-Perumal, Meng-Ling Lu, Fu-Cheng Kao, Chi-Chien Niu
Incidental durotomy during lumbar spine surgery is a commonly reported complication. Those presenting with cerebrospinal fluid (CSF) leak are usually recognized and repaired intraoperatively. In some circumstances, it may either be unrecognised or occur as a delayed complication. Such delayed occurrences cannot be predicted and its management remain a challenge to the surgeon, especially when it presents as a subdural effusion. We report a 55-year-old man who underwent mini open lumbar discectomy through left side for a prolapsed L4-L5 disc...
March 2017: BioMedicine
https://www.readbyqxmd.com/read/28468145/experiences-in-performing-posterior-calvarial-distraction
#20
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...
May 2017: Journal of Craniofacial Surgery
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