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Skull base surgery

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https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#1
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089805/surgical-outcomes-of-endoscopic-endonasal-skull-base-surgery-of-craniopharyngiomas-evaluated-according-to-the-degree-of-hypothalamic-extension
#2
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Sparing the hypothalamus following craniopharyngiomas treatment is a prerequisite to ensure a good quality of life. In this study, the functional prognosis of craniopharyngioma following Endoscopic endonasal skull base surgery (EES) was examined in function of the degree of hypothalamic extension. MATERIALS AND METHODS: Twenty cases of craniopharyngioma treated by EES were categorized according to Puget's classification using preoperative and postoperative MRI...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089417/venous-sinus-compromise-after-pre-sigmoid-transpetrosal-approach-for-skull-base-tumors-a-study-on-the-asymptomatic-incidence-and-report-of-a-rare-dural-arteriovenous-fistula-as-symptomatic-manifestation
#3
Walter C Jean, Daniel R Felbaum, Andrew B Stemer, Michael Hoa, H Jeffrey Kim
The sigmoid sinus is routinely exposed and manipulated during pre-sigmoid, transpetrosal approaches to the skull base, but there is scant data available on the incidence of venous sinus compromise after surgery. We encountered a dural arteriovenous fistula as a result of sigmoid sinus occlusion and examined the incidence of venous sinus thrombosis or narrowing after transpetrosal surgeries. We performed a retrospective analysis of a series of patients treated by the senior surgeons (WCJ, MH, HJK), who underwent either a posterior petrosectomy or translabyrinthine approach for various skull base tumors...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28074281/one-step-cad-cam-titanium-cranioplasty-after-drilling-template-assisted-resection-of-intraosseous-skull-base-meningioma-technical-note
#4
A Carolus, S Weihe, K Schmieder, C Brenke
INTRODUCTION: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery. A preoperative virtual planning of resection margins and the simultaneously fabrication of the cranioplasty could be a possibility to subsume the steps tumor resection and cosmetic restoration to a single procedure. METHODS: We present two cases of patients with complex intra-osseous spheno-orbital meningioma...
January 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28069511/in-vivo-characterization-of-magnesium-alloy-biodegradation-using-electrochemical-h2-monitoring-icp-ms-and-xps
#5
Daoli Zhao, Tingting Wang, Keaton Nahan, Xuefei Guo, Zhanping Zhang, Zhongyun Dong, Shuna Chen, Da-Tren Chou, Daeho Hong, Prashant N Kumta, William R Heineman
: The effect of widely different corrosion rates of Mg alloys on four parameters of interest for in vivo characterization was evaluated: (1) the effectiveness of transdermal H2 measurements with an electrochemical sensor for noninvasively monitoring biodegradation compared to the standard techniques of in vivo X-ray imaging and weight loss measurement of explanted samples, (2) the chemical compositions of the corrosion layers of the explanted samples by XPS, (3) the effect on animal organs by histology, and (4) the accumulation of corrosion by-products in multiple organs by ICP-MS...
January 6, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28059442/hydroxyapatite-cement-cranioplasty-following-translabyrinthine-approach-long-term-study-of-369-cases
#6
Peter G Volsky, Todd A Hillman, Kellen J Stromberg, Farrel J Buchinsky, Douglas A Chen, Neal M Jackson, Moisés A Arriaga
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm)...
January 6, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28056117/alopecia-following-bicoronal-incisions
#7
Sameep Kadakia, Arvind Badhey, Sara Ashai, Thomas S Lee, Yadranko Ducic
Importance: Multiple techniques may be used to perform bicoronal incisions, and alopecia is a known postoperative complication of this procedure. To date, no large studies exist comparing alopecia outcomes among bicoronal incision techniques with and without the use of Raney clips. Objective: To determine (1) whether postoperative alopecia is more common when bicoronal incisions are performed with monopolar cautery, Colorado microdissection tip cautery, or traditional cold steel and (2) whether this outcome is affected by the use of Raney clips...
January 5, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28049034/hypervascular-lesions-of-the-cerebellopontine-angle-the-relevance-of-angiography-as-a-diagnostic-and-therapeutic-tool-and-the-role-of-stereotactic-radiosurgery-in-management-a-comprehensive-review
#8
REVIEW
Yosef Laviv, Ajith Thomas, Ekkehard M Kasper
The cerebellopontine angle (CPA) is a narrowed skull base area, containing important cranial nerves and vessels and bordering with eloquent areas of the posterior fossa. Tumors of the CPA are a heterogeneous group and can arise extradural, intradural-extraaxial or intraaxial. Accordingly, their vascular supply changes, depending on their anatomical origin. Symptomatic, large CPA tumors require surgical resection in order to prevent irreversible, severe neurological damages. However, its tight and strategical location make surgery in the CPA very challenging and require appropriate pre-surgical planning...
December 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28045745/avoiding-complications-in-endoscopic-skull-base-surgery
#9
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
December 23, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28038480/intracranial-ameloblastoma-arising-from-the-maxilla-an-interdisciplinary-surgical-approach
#10
Johanna Quick-Weller, Felix Koch, Nazife Dinc, Stephanie Lescher, Peter Baumgarten, Patrick Harter, Friedrich Scheerer, Robert Sader, Volker Seifert, Gerhard Marquardt, Thomas Freiman
Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28034402/transoral-robotic-surgery
#11
Shokjean Yee
Transoral robotic surgery (TORS) is a technique used to treat oral, throat, and skull base cancers using a minimally invasive robotic approach through the mouth and throat. The TORS procedure allows deeper access and dissection of suspicious lesions and neoplastic growths in the oral cavity and those that extend from the throat to the base of the skull. Robotic surgery allows the surgeon to operate in tight spaces without a large open incision. This article discusses symptoms and risk factors of oral, throat, and skull base cancers; types of procedures that can be performed using the TORS approach; specialized instrumentation; patient selection; surgical advantages and disadvantages; patient benefits; and the role of the surgical team in preparing to intraoperatively care for the TORS patient...
January 2017: AORN Journal
https://www.readbyqxmd.com/read/28032687/transnasal-endoscopic-partial-maxillectomy-operative-nuances-and-proposal-for-a-comprehensive-classification-system-based-on-1378-cases
#12
Mario Turri-Zanoni, Paolo Battaglia, Apostolos Karligkiotis, Davide Lepera, Jacopo Zocchi, Iacopo Dallan, Maurizio Bignami, Paolo Castelnuovo
BACKGROUND: Despite the development of functional endoscopic endonasal surgery, there are still areas of the maxillary sinus that remain technically difficult to access using a standard middle meatal antrostomy as well as deep-seated skull base lesions requiring expanded transmaxillary approaches. METHODS: All patients who underwent transnasal endoscopic partial maxillectomy (TEPM) in a single institution from 2000 to 2014 were retrospectively reviewed. The TEPM was classified into 5 types according to the anatomic structures progressively removed and to the access provided...
December 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/28027059/avoiding-complications-in-endoscopic-skull-base-surgery
#13
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#14
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017748/spheno-orbital-meningiomas-a-16-year-surgical-experience
#15
Jacob L Freeman, Monica S Davern, Soliman Oushy, Stefan Sillau, D Ryan Ormond, A Samy Youssef, Kevin O Lillehei
OBJECTIVE: To examine the efficacy of spheno-orbital meningioma (SOM) resection aimed at symptomatic improvement, rather than gross total resection, followed by radiation therapy for recurrence. METHODS: A retrospective review of all patients having undergone resection by the senior author (KOL) between 2000 and 2016 was performed. Demographics, operative details, post-operative outcomes, recurrence rates and radiation treatment plans were analyzed. Statistical analysis was performed to assess for factors affecting recurrence (Fisher's exact and student's t-test), changes in exophthalmos index (student's t-test) and progression free survival (Kaplan-Meier and log rank)...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27993737/bolstering-the-nasoseptal-flap-using-sphenoid-sinus-fat-packing-a-technical-case-report
#16
Hussam Abou-Al-Shaar, Hasan A Zaidi, David J Cote, Edward R Laws
BACKGROUND: Resection of extensive skull base lesions often necessitates relatively large dural openings and arachnoid, resulting in skull base defects with the potential for a post-operative cerebrospinal fluid (CSF) leak. A nasoseptal flap (NSF) is a vascularized graft which has greatly diminished the incidence of CSF leak. Annealing of flaps against the ventral skull base can be tenuous within the first few days after surgery. We report the use of sphenoid sinus fat packing as a buttress to support the nasoseptal flap during skull base reconstruction...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989983/optical-neuronavigation-without-rigid-head-fixation-during-awake-surgery
#17
C F Freyschlag, J Kerschbaumer, W Eisner, D Pinggera, K R Brawanski, O Petr, M Bauer, A E Grams, T Bodner, M Seiz, C Thomé
INTRODUCTION: Optical neuronavigation without rigid pin fixation of the head may lead to inaccurate results due to patient's movements in case of awake surgery. The aim of this study was to report our results, using a skull-mounted reference array for optical tracking in patients undergoing awake craniotomy for eloquent gliomas. METHODS: Between March 2013 and December 2014, eighteen consecutive patients (10 male, 8 female) with (fronto-)temporal (n=16) or frontoparietal (perirolandic, n=2) lesions underwent awake craniotomy without rigid pin fixation...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989971/neurophysiological-identification-of-cranial-nerves-during-endoscopic-endonasal-surgery-of-skull-base-tumors-a-pilot-study-technical-report
#18
Alexey Nikolaevich Shkarubo, Anna Anatolievna Ogurtsova, Dmitry Aleksandrovich Moshchev, Andrew Jurievich Lubnin, Dmitry Nicolaevich Andreev, Konstantin Vladimirovich Koval, IliaValerievich Chernov
INTRODUCTION: Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, there is only a small number of published papers describing the technique of t-EMG in endoscopic endonasal removal of such tumors. OBJECTIVE: To assess the effectiveness of trigger electromyography in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. MATERIALS AND METHODS: Nine patients were operated on using the endoscopic endonasal approach within a one-year period...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27982771/comparison-of-probabilistic-and-deterministic-fiber-tracking-of-cranial-nerves
#19
Amir Zolal, Stephan B Sobottka, Dino Podlesek, Jennifer Linn, Bernhard Rieger, Tareq A Juratli, Gabriele Schackert, Hagen H Kitzler
OBJECTIVE The depiction of cranial nerves (CNs) using diffusion tensor imaging (DTI) is of great interest in skull base tumor surgery and DTI used with deterministic tracking methods has been reported previously. However, there are still no good methods usable for the elimination of noise from the resulting depictions. The authors have hypothesized that probabilistic tracking could lead to more accurate results, because it more efficiently extracts information from the underlying data. Moreover, the authors have adapted a previously described technique for noise elimination using gradual threshold increases to probabilistic tracking...
December 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27978875/-endoscopic-surgery-and-reconstruction-for-extensive-osteoradionecrosis-of-skull-base-after-radiotherapy-for-nasopharyngeal-carcinoma
#20
Z Chen, Q H Qiu, J B Zhan, Z C Zhu, Y Peng, H Liu
Objective: To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data. Results: Based on the CT and endoscopic examination, all patients had large skull base defects with bone defects averaged 7.02 cm(2) (range, 3.60 - 14...
December 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
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