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Skull base surgery

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https://www.readbyqxmd.com/read/28716213/imaging-of-endoscopic-approaches-to-the-anterior-and-central-skull-base
#1
REVIEW
I M Schmalfuss
Sinonasal endoscopy for treatment of benign sinonasal diseases is a well-established procedure. Recent advances in endoscope technology have substantially expanded its application with many institutions now offering resection of skull base lesions and sinonasal malignancies via the endoscopic approach. Its minimally invasive nature leads to faster recovery time, better cosmetic results, and fewer complications. Unfortunately, not all lesions involving the sinonasal region and skull base are accessible to sinonasal endoscopy...
July 14, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28716164/collagen-matrix-as-an-inlay-in-endoscopic-skull-base-reconstruction
#2
G M Oakley, J M Christensen, M Winder, B P Jonker, A Davidson, T Steel, C Teo, R J Harvey
BACKGROUND: Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described. METHODS: A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined...
July 18, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28713744/access-osteotomy-in-the-maxillofacial-skeleton
#3
REVIEW
K Kamalpathey, Maj Gen N K Sahoo, Col P K Chattopadhyay, Maj Yuvraj Issar
Surgical accesses for the facial skeleton are based on the concept of modular osteotomies. Various techniques and combination of osteotomies facilitate access to the most inaccessible tumors of craniomaxillofacial region. Most appropriate surgical access is determined by considering size, location, extension of the tumor, and experience of the surgical team. These are primarily used for tumors in the nasopharynx or the skull base. The aim of this paper is to review surgical accesses that aid in removal of inaccessible tumors of craniomaxillofacial region with series of cases operated in the Department of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune, India, between July 2008 and June 2010...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28707807/accuracy-of-computer-assisted-navigation-significant-augmentation-by-facial-recognition-software
#4
Jordan T Glicksman, Christine Reger, Arjun K Parasher, David W Kennedy
BACKGROUND: Over the past 20 years, image guidance navigation has been used with increasing frequency as an adjunct during sinus and skull base surgery. These devices commonly utilize surface registration, where varying pressure of the registration probe and loss of contact with the face during the skin tracing process can lead to registration inaccuracies, and the number of registration points incorporated is necessarily limited. The aim of this study was to evaluate the use of novel facial recognition software for image guidance registration...
July 14, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28700740/navigation-accuracy-after-automatic-and-hybrid-surface-registration-in-sinus-and-skull-base-surgery
#5
Tanja Daniela Grauvogel, Paul Engelskirchen, Wiebke Semper-Hogg, Juergen Grauvogel, Roland Laszig
OBJECTIVE: Computer-aided-surgery in ENT surgery is mainly used for sinus surgery but navigation accuracy still reaches its limits for skull base procedures. Knowledge of navigation accuracy in distinct anatomical regions is therefore mandatory. This study examined whether navigation accuracy can be improved in specific anatomical localizations by using hybrid registration technique. STUDY DESIGN: Experimental phantom study. SETTING: Operating room...
2017: PloS One
https://www.readbyqxmd.com/read/28692497/the-safety-and-accuracy-of-surgical-navigation-technology-in-the-treatment-of-lesions-involving-the-skull-base
#6
Bin Wei, Guowen Sun, Qingang Hu, Enyi Tang
OBJECTIVE: As compared with the normal anatomy, structures of the skull base and its surroundings have been dramatically altered of the lesion near the skull base. How to remove the lesion at the skull base was mainly depending on surgeon's personal experience during past years. In this study, the authors explored the safety and accuracy of the surgical navigation system in resecting lesions near the skull base. METHODS: The surgical cases consisted of 15 patients who underwent surgery involving the skull base with the using of surgical navigation technology...
July 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#7
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#8
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28688556/pediatric-langerhans-cell-histiocytosis-of-the-lateral-skull-base
#9
Ananya Majumder, Cameron C Wick, Rebecca Collins, Timothy N Booth, Brandon Isaacson, J Walter Kutz
OBJECTIVE: Describe the presentation, imaging characteristics, management, and outcomes of pediatric patients with Langerhans cell histiocytosis (LCH) of the temporal bone. METHODS: A retrospective chart review was performed between 2000 and 2014 at a single tertiary care children's hospital. Fourteen patients were identified with a diagnosis of LCH and involvement of the temporal bone. RESULTS: Ten patients were female and ten were Caucasian...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28686110/role-of-endoscopic-transnasal-surgery-for-skull-base-chondrosarcoma-a-retrospective-analysis-of-19-cases-at-a-single-institution
#10
Hirotaka Hasegawa, Masahiro Shin, Kenji Kondo, Shunya Hanakita, Akitake Mukasa, Taichi Kin, Nobuhito Saito
OBJECTIVE Skull base chondrosarcoma is one of the most intractable tumors because of its aggressive biological behavior and involvement of the internal carotid artery and cranial nerves (CNs). One of the most accepted treatment strategies for skull base chondrosarcoma has been surgical removal of the tumor in conjunction with proactive extensive radiation therapy (RT) to the original tumor bed. However, the optimal strategy has not been determined. The goal of this study was to evaluate the early results of endoscopic transnasal surgery (ETS)...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28680389/post-mortem-validation-of-mri-identified-veins-on-the-surface-of-the-cerebral-cortex-as-potential-landmarks-for-neurosurgery
#11
Günther Grabner, Thomas Haider, Mark Glassner, Alexander Rauscher, Hannes Traxler, Siegfried Trattnig, Simon D Robinson
Background and Objective: Image-guided neurosurgery uses information from a wide spectrum of methods to inform the neurosurgeon's judgement about which tissue to resect and which to spare. Imaging data are registered to the patient's skull so that they correspond to the intraoperative macro- and microscopic view. The correspondence between imaging and optical systems breaks down during surgery, however, as a result of cerebro-spinal fluid drain age, tissue resection, and gravity-based brain shift. In this work we investigate whether a map of surface veins, automatically segmented from MRI, could serve as additional reference system...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28677936/impact-of-optic-canal-decompression-on-visual-outcome-in-subtotal-resected-skull-base-meningiomas
#12
Meike Unteroberdörster, Oliver Müller, Neriman Özkan, Daniela Pierscianek, Martin Hadamitzky, Bernadette Kleist, Ulrich Sure, Nicolai El Hindy
BACKGROUND: Visual impairment (VI) due to neoplastic infiltration of the optic canal (OC) is frequently seen in skull base meningiomas representing a significant restriction in patients` quality of life. However, the delicate anatomy of this region often prevents gross total tumor resection. The aim of the present study was to evaluate the impact of intradural OC decompression and postoperative oncological procedure on preservation of visual acuity in subtotal resected skull base meningiomas...
July 4, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28673886/newly-diagnosed-sellar-tumors-in-cancer-patients-a-diagnostic-challenge-and-management-dilemma
#13
Carlos R Goulart, Smita Upadhyay, Leo F S Ditzel Filho, Andre Beer-Furlan, Ricardo L Carrau, Luciano M Prevedello, Daniel M Prevedello
OBJECTIVE: The use of PET CT for staging in cancer patients and the widespread use of MRI led to an increased incidence of incidental sellar mass detection. The imaging findings can be suggestive of a benign pituitary tumor but metastasis can never be completely ruled out with non-invasive work-up. Appropriate diagnosis of these sellar masses is critical as the treatment paradigm might change in the presence of a pituitary metastasis. Moreover, definitive tissue diagnosis might prevent unnecessary radiotherapy to the skull base or even the need for systemic treatment when benign pituitary disease is confirmed...
June 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28667597/stereotactic-radiotherapy-as-primary-definitive-or-postoperative-treatment-of-intracranial-meningioma-of-who-grade-ii-and-iii-leads-to-better-disease-control-than-stereotactic-radiotherapy-of-recurrent-meningioma
#14
Dorota Lubgan, Sandra Rutzner, Ulrike Lambrecht, Karl Rössler, Michael Buchfelder, Ilker Eyüpoglu, Rainer Fietkau, Sabine Semrau
The aim of this study was to evaluate long-term clinical outcome, prognostic factors and quality of life after adjuvant or definitive fractionated stereotactic radiotherapy (SRT) of meningioma WHO grade II and III or at recurrence. 131 patients with 138 meningioma (64 WHO grade II, 16 WHO grade III, 58 without histology) of the skull base, falx and convexity were treated between 01/2002 and 01/2015 at the Erlangen University Hospital by fractionated stereotactic radiotherapy (SRT) as primary treatment (adjuvant or definitive) and at recurrence...
June 30, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28666652/osteosarcoma-of-the-skull-base-an-analysis-of-19-cases-and-literature-review
#15
Zhifei Guo, Ke Hu, Bing Zhao, Erbao Bian, Song Ni, Jinghai Wan
BACKGROUND: Osteosarcoma of the skull base is rarely observed; most published studies comprise case reports. The clinical features and optimal treatments have not been clearly established. The purpose of this article is to present 19 cases of skull base osteosarcoma and review the literature to analyse the clinical features and treatment of skull base osteosarcoma. METHODS: The clinical data of 19 patients with skull base osteosarcoma from January 2005 to December 2016 were retrospectively analysed; pertinent English literature from 1976 to 2016 was reviewed...
June 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28666364/-live-cadaver-model-for-internal-carotid-artery-injury-simulation-in-endoscopic-endonasal-skull-base-surgery
#16
Paolo Pacca, Sukhdeep S Jhawar, Daniel V Seclen, Eric Wang, Carl Snyderman, Paul A Gardner, Emad Aboud, Juan C Fernandez-Miranda
Background: Intraoperative injury of the internal carotid artery (ICA) is the most dreaded complication in endoscopic endonasal surgery (EES) of skull base. Training for ICA injury is practically impossible in live operative settings. Objective: To evaluate a pulsatile perfusion-based live cadaveric model for ICA injury simulation in a laboratory setting. The major emphasis of the study was to evaluate various means of controlling acute bleeding and evaluating the practical utility of this model for training purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28665386/-modern-diagnosis-and-treatment-in-children-with-congenital-basal-encephalocele
#17
A V Sakharov, V V Roginskiy, D N Kapitanov, A L Ivanov, E V Shelesko, S K Gorelyshev, A A Evteev, N V Lemeneva, D N Zinkevich, Yu A Kochkin, V I Ozerova, L A Satanin
Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28662972/utilization-of-sinus-stents-as-a-novel-approach-for-benign-cystic-lesions-of-the-sella
#18
Akina Tamaki, Berje Shammassian, Abhishek Ray, Warren R Selman, Kenneth Rodriguez
Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion...
June 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28658522/platelet-activation-by-crushed-and-uncrushed-muscle-a-flow-cytometry-analysis
#19
Alistair Jukes, Dijana Miljkovic, P J Wormald, Alkis J Psaltis
BACKGROUND: Crushed autologous muscle is used in skull base surgery in the acute phase of major arterial hemorrhage to stop bleeding. The mechanism of this is not yet clear, but is thought to involve the formation of a platelet plug, which seals the vessel wall defect but still allows ongoing blood flow to the brain. METHODS: In this study we use flow cytometry to replicate the in-vivo actions of crushed muscle on platelets in whole blood. We compare the ratio of activation of platelets exposed to crushed and uncrushed muscle supernatant in control patients and in patients on antiplatelet agents...
June 28, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28658334/customized-acrylic-implants-for-reconstruction-of-extensive-skull-defects-an-exception-approach-for-selected-patients
#20
Rafael Denadai Pigozzi DA Silva, Cesar Augusto Raposo-Amaral, Marcelo Campos Guidi, Cassio Eduardo Raposo-Amaral, Celso Luiz Buzzo
Objective: to present our experience in the surgical treatment of extensive skullcap defects with customized acrylic implants. Methods: we conducted a retrospective analysis of patients with extensive skull defects undergoing acrylic cranioplasties between 2004 and 2013. We carefully selected all patients and classified surgical results based on three scales (craniofacial esthetics, improvement of facial symmetry and need for additional surgery). Results: fifteen patients underwent cranioplasty with intraoperative acrylic implants, whether manually customized (46...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
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