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https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#1
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29145656/refining-operative-strategies-for-optic-nerve-decompression-a-morphometric-analysis-of-transcranial-and-endoscopic-endonasal-techniques-using-clinical-parameters
#2
Steven L Gogela, Lee A Zimmer, Jeffrey T Keller, Norberto Andaluz
BACKGROUND: Various approaches can be considered for decompression of the intracanalicular optic nerve. Although clinical experience has been reported, no quantitative study has yet compared the extent of decompression achieved by an endoscopic endonasal versus transcranial approach. OBJECTIVE: Toward this aim, our morphometric analysis compared both approaches by quantifying the circumferential degree of optic canal decompression that is possible before any meningeal violation, which would result in cerebrospinal fluid (CSF) leak...
May 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29138073/comparision-of-results-between-posterior-fossa-decompression-with-and-without-duraplasty-for-the-surgical-treatment-of-chiari-malformation-type-i%C3%AF-a-systematic-review-and-meta-analysis
#3
REVIEW
Weiwei Lin, Guman Duan, Jinjin Xie, Jiashen Shao, Zhaoqi Wang, Baohua Jiao
BACKGROUND: Posterior fossa decompression without (PFD) or with duraplasty (PFDD) for the treatment of type 1 Chiari malformation (CM-I) is controversial. We thus did a systematic review and meta-analysis of studies to assess the effect on clinical and imaging improvement, operative time, complications and recurrence rate between PFD and PFDD in patients with CM-I. METHODS: We systematically searched PubMed, Embase, Cochrane, Web of Knowledge, and ClinicalTrials...
November 11, 2017: World Neurosurgery
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
#4
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/29125446/suprasellar-and-recurrent-pediatric-craniopharyngiomas-expanding-indications-for-the-extended-endoscopic-transsphenoidal-approach
#5
Andrew F Alalade, Elizabeth Ogando-Rivas, Jerome Boatey, Mark M Souweidane, Vijay K Anand, Jeffrey P Greenfield, Theodore H Schwartz
OBJECTIVE The expanded endonasal endoscopic transsphenoidal approach has become increasingly used for craniopharyngioma surgery in the pediatric population, but questions still persist regarding its utility in younger children, in recurrent and irradiated tumors, and in masses primarily located in the suprasellar region. The narrow corridor, incomplete pneumatization, and fear of hypothalamic injury have traditionally relegated this approach to application in older children with mostly cystic craniopharyngiomas centered in the sella...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29122086/endonasal-endoscopic-management-of-frontal-sinus-cerebrospinal-fluid-leak
#6
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/29122076/a-systematic-review-of-secondary-cerebrospinal-fluid-leaks
#7
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
#8
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/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/29102755/matriderm%C3%A2-for-the-management-of-scalp-necrosis-following-surgical-treatment-of-a-giant-parietal-encephalocele-case-report
#10
M D Vilela, Has Pedrosa, Fd Sampaio, L J Carneiro
BACKGROUND: management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, CSF leak and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge, due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant...
November 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29101074/regression-of-giant-calcified-thoracic-disc-and-spinal-cord-compression-following-thoracic-laminectomy-and-posterior-instrumented-fusion
#11
Fernando Alonso, Manish K Kasliwal
A 55 year old full time employed lady presented with urinary urgency and occasional lower extremity numbness and tingling with motor function preservation. CT and MRI revealed a 20mm x 9mm T10-T11 calcified disc (Figure A, B, C). Anterior and posterior approaches were discussed with the patient along with associated risks such as CSF leak due to possible intradural extension and small but possible risk of new onset motor deficit following disc removal. Considering her almost intact neurological function and to avoid slight albeit realistic morbidity from attempted discectomy regardless of an anterior transthoracic or posterolateral approach, a strategy consisting of a wide long segment T10-T11 laminectomy and T9-T12 posterior instrumented fusion was performed with the assumption that micro motion elimination through a fusion will eliminate dynamic compression from spinal cord draping over the anterior calcified disc fragment...
October 31, 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
#12
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/29095707/long-term-management-and-outcomes-after-repair-of-cerebrospinal-fluid-rhinorrhea-related-to-idiopathic-intracranial-hypertension
#13
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
#14
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
#15
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
#16
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/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#17
REVIEW
Srikant Chakravarthi, Lior Gonen, Alejandro Monroy-Sosa, Sammy Khalili, Amin Kassam
The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF)...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29075156/skull-base-trauma-clinical-considerations-in-evaluation-and-diagnosis-and-review-of-management-techniques-and-surgical-approaches
#18
REVIEW
Jacob S Feldman, Soroush Farnoosh, Robert M Kellman, Sherard A Tatum
Traumatic injuries to the skull base can involve critical neurovascular structures and present with symptoms and signs that must be recognized by physicians tasked with management of trauma patients. This article provides a review of skull base anatomy and outlines demographic features in skull base trauma. The manifestations of various skull base injuries, including CSF leaks, facial paralysis, anosmia, and cranial nerve injury, are discussed, as are appropriate diagnostic and radiographic testing in patients with such injuries...
November 2017: Seminars in Plastic Surgery
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
#19
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/29063272/the-learning-curve-for-endoscopic-trans-sphenoidal-resection-of-pituitary-macroadenomas-a-single-institution-experience-leeds-uk
#20
James M W Robins, Seyed A Alavi, Atul K Tyagi, Paul A Nix, Tom M Wilson, Nick I Phillips
BACKGROUND: The object of this study was to assess whether increasing operative experience results in greater endoscopic trans-sphenoidal resection of pituitary macroadenomas and lower complications. METHODS: A retrospective single institution cohort study was performed. Subjects underwent endoscopic trans-sphenoidal resection of pituitary macroadenoma between July 2009 and July 2016 by three neurosurgeons. Following data collection, statistical analysis compared percentage of tumor resection and length of hospital stay (LOS) with experience...
October 23, 2017: Acta Neurochirurgica
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