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Endoscopic skull base

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https://www.readbyqxmd.com/read/29456964/anatomical-correlation-between-nasal-vascularisation-and-the-design-of-the-endonasal-pedicle-flaps
#1
Juan R Gras-Cabrerizo, Elena García-Garrigós, Joan R Montserrat-Gili, Juan R Gras-Albert, Rosa Mirapeix-Lucas, Humbert Massegur-Solench, Miquel Quer-Agusti
Arteries that supply the nasal septum and the lateral nasal wall include vessels that originate from the external carotid artery and from the internal carotid artery. A variety of local endonasal pedicle flaps can be used in different anatomical areas for endoscopic skull base reconstruction. The main flaps are based on terminal branches of the sphenopalatine artery and on anterior ethmoidal artery. This study will describe the anatomy of these vessels and their relationship with the main flaps.
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29455219/endoscopic-transsphenoidal-approach-to-skull-base-lesions-a-clinical-prospective-study
#2
Moneer K Faraj, Wissam J Sagban
OBJECTIVE: To review the patients operated by endoscopic transphenoidal approach for skull base lesions. All the clinical data including age, gender, type of pathology, surgical outcome and surgical complications were studied. METHODS: A clinical prospective study was conducted on 94 cases with skull base lesion that were treated in Neuroscience Hospital in Baghdad, Iraq between October 2011 and December 2016. We followed each patient for an average of 2 years after surgery to determine most common lesion involving the skull base, age and gender distribution, surgical outcome, complications and hospital accommodation...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29452829/cribriform-plate-width-is-highly-variable-within-and-between-subjects
#3
Daniel H Coelho, Taylor S Pence, Mostafa Abdel-Hamid, Richard M Costanzo
OBJECTIVE: All successful endonasal surgery, including functional endoscopic sinus surgery (FESS), depends on knowledge of both anatomy and the specific variations that can occur between and within patients. Familiarity with these structures is a critical component in preventing complications from these procedures, and failure to understand subtle variation can have disastrous results. The aim of this study was to characterize the anatomical variations (if any) of the cribriform plate using a large cadaveric sample set...
February 13, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29451456/clival-meningocele-causing-bilateral-hearing-loss-in-a-child-due-to-superficial-siderosis-of-the-central-nervous-system-case-report
#4
Stephen J Johans, Kevin N Swong, Daniel J Burkett, Michael P Wemhoff, Sean M Lew, Chirag R Patel, Anand V Germanwala
Superficial siderosis (SS) of the CNS is a rare and often unrecognized condition. Caused by hemosiderin deposition from chronic, repetitive hemorrhage in the subarachnoid space, it results in parenchymal damage in the subpial layers of the brain and spinal cord. T2-weighted MRI shows the characteristic hypointensity of hemosiderin deposition, classically occurring around the cerebellum, brainstem, and spinal cord. Patients present with progressive gait ataxia and sensorineural hearing impairment. Although there have been several studies, case reports, and review articles over the years, the clear pathophysiology of subarachnoid space hemorrhage remains to be elucidated...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29444558/limitations-of-the-endoscopic-endonasal-transcribriform-approach
#5
Neil Majmundar, Naveed Kamal, Renuka Reddy, Jean A Eloy, James K Liu
The endoscopic endonasal transcribriform approach (EETA) has become a useful strategy in the treatment of various anterior skull base pathology, including meningoencephaloceles, olfactory groove meningiomas, schwannomas, esthesioneuroblastomas, and other sinonasal malignancies. However, not all pathologies are optimally treated through this approach due to tumor size, extent of the lesion, vascular involvement, and the presence of intact olfaction. One must be prepared to use a transcranial approach if the EETA is not favorable...
February 13, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29444557/limits-of-the-endoscopic-transnasal-trans-tubercular-approach
#6
Verena Gellner, Peter V Tomazic
INTRODUCTION: The endoscopic transnasal transsphenoidal transtubercular approach has become a standard alternative approach to neurosurgical transcranial routes for lesions of the anterior skull base in particular pathologies of the anterior tubercle, sphenoid plane, and midline lesions up to the interpeduncular cistern. For both the endoscopic and the transcranial approach indications must strictly be evaluated and tailored to the patients' morphology and condition. The purpose of this review is to evaluate the evidence in literature of the limitations of the endoscopic transtubercular approach...
February 13, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29442163/accuracy-and-feasibility-of-a-dedicated-image-guidance-solution-for-endoscopic-lateral-skull-base-surgery
#7
Christoph Rathgeb, Lukas Anschuetz, Daniel Schneider, Cilgia Dür, Marco Caversaccio, Stefan Weber, Tom Williamson
OBJECTIVE: We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. MATERIALS AND METHODS: The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table...
February 13, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29435644/innovative-real-csf-leak-simulation-model-for-rhinology-training-human-cadaveric-design
#8
Abdulaziz A AlQahtani, Abeer A Albathi, Othman M Alhammad, Abdulkarim S Alrabie
OBJECTIVE: To study the feasibility of designing a human cadaveric simulation model of real CSF leak for rhinology training. METHOD: The laboratory investigation took place at the surgical academic center of Prince Sultan Military Medical City between 2016 and 2017. Five heads of human cadaveric specimens were cannulated into the intradural space through two frontal bone holes. Fluorescein-dyed fluid was injected intracranialy, then endoscopic endonasal iatrogenic skull base defect was created with observation of fluid leak, followed by skull base reconstruction...
February 12, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29421841/-endonasal-endoscopic-surgery-of-choanal-atresia-long-term-results
#9
Laura Holtmann, Kerstin Stähr, Julian Kirchner, Stephan Lang, Stefan Mattheis
INTRODUCTION:  Choanal atresia is a rare abnormality. As neonates depend on transnasal respiration, bilateral choanal atresia causes an acute emergency. Transnasal endoscopic resection of congenital choanal atresia is a well-established therapy. However, the surgical technique has not yet been standardized. METHODS:  A retrospective chart review was performed with a follow-up examination between 9 to 87 months after surgery. 11 patients (7 with unilateral atresia, 4 with bilateral atresia) were included...
February 8, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29421455/relaxing-sphenoidal-slit-incision-to-extend-the-anterior-and-posterior-reach-of-pedicled-nasoseptal-flaps-during-endoscopic-skull-base-reconstruction-of-transcribriform-defects-technical-note-and-results-in-20-patients
#10
James K Liu, Zachary S Mendelson, Gurkirat Kohli, Jean Anderson Eloy
BACKGROUND: Reconstruction of large anterior skull base (ASB) defects after an endoscopic endonasal transcribriform approach (EEA-TC) remains a challenge despite the advent of the vascularized pedicled nasoseptal flap (PNSF). OBJECTIVE: We describe a relaxing PNSF slit incision that extends the anterior and posterior reach of the PNSF to maximize tensionless flap coverage of transcribriform ASB defects. METHODS: A retrospective chart review was conducted on 20 consecutive patients who underwent EEA-TC and subsequent PNSF reconstruction with a relaxing slit incision...
February 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29410144/endoscopic-endonasal-transrotundum-middle-fossa-exposure-technique-of-transpterygoid-maxillary-nerve-transposition
#11
Ricky H Wong
OBJECT: Middle fossa floor access can be challenging. Open skull base approaches have associated morbidity and yield suboptimal working angles around temporal lobe. Endoscopic endonasal approaches to the middle fossa are poorly described, but provide an improved angle. The author hypothesized that the length of the maxillary nerve can be transposed out of foramen rotundum in order to provide a path to expose the full width of the middle fossa floor through the anterolateral and anteromedial triangle...
February 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29406605/salvage-skull-base-reconstruction-in-the-endoscopic-era-vastus-lateralis-free-tissue-transfer
#12
Stephen Y Kang, Antoine Eskander, Ralph Abi Hachem, Enver Ozer, Theodoros N Teknos, Matthew O Old, Daniel M Prevedello, Ricardo L Carrau
BACKGROUND: When locoregional flaps fail to reconstruct the skull base, the microvascular surgeon faces several reconstructive challenges. We present our technique and results of salvage anterior skull base reconstruction utilizing the vastus lateralis free tissue transfer (VLFTT). METHODS: Four patients with anterior skull base defects after previous locoregional flap failure underwent free tissue transfer reconstruction with VLFTT. RESULTS: The success rate of free tissue transfer was 100%...
February 6, 2018: Head & Neck
https://www.readbyqxmd.com/read/29405836/expanded-transcanal-transpromontorial-approach-a-novel-surgical-technique-for-cerebellopontine-angle-vestibular-schwannoma-removal
#13
Daniele Marchioni, Marco Carner, Davide Soloperto, Luca Bianconi, Andrea Sacchetto, Luca Sacchetto, Barbara Masotto, Livio Presutti
Objective Vestibular schwannoma (VS) is a benign tumor of the lateral skull base. Different microscopic surgical techniques are described in literature: the retrosigmoid and translabyrinthine approaches are used to treat big tumors located in the cerebellopontine angle, and the middle cranial fossa approach is utilized for small tumors with good hearing preservation. The expanded transcanal transpromontorial (ExpTT) approach is a combined microscopic-endoscopic technique previously indicated for Koos stage I and II VS and now proposed for larger VS, up to 3 cm in diameter, with linear progression into the cerebellopontine angle and touching the brainstem...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29405833/evidence-based-use-of-perioperative-antibiotics-in-otolaryngology
#14
Priyesh N Patel, Asitha D L Jayawardena, Rachel L Walden, Edward B Penn, David O Francis
Objective To identify and clarify current evidence supporting and disputing the effectiveness of perioperative antibiotic use for common otolaryngology procedures. Data Sources PubMed, Embase (OVID), and CINAHL (EBSCO). Review Methods English-language, original research (systematic reviews/meta-analyses, randomized control trials, prospective or retrospective cohort studies, case-control studies, or case series) studies that evaluated the role of perioperative antibiotic use in common otolaryngology surgeries were systematically extracted using standardized search criteria by 2 investigators independently...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29404256/modified-one-piece-extended-transbasal-approach-for-endoscopic-assisted-microsurgical-resection-of-tuberculum-sellae-meningioma-operative-video-and-technical-nuances
#15
James K Liu, Kentaro Watanabe
The optimal approach for surgical resection of tuberculum sellae meningiomas remains controversial. Approach selection is largely based on a variety of factors, such as tumor size, extent and location relative to the optic canal and internal carotid artery, the presence of vascular encasement, and surgeon's preference. In this operative video manuscript, the authors demonstrate the importance of an open transcranial approach when the tumor extends lateral to the optic nerve over the internal carotid artery into the opticocarotid triangle, which is a difficult region to safely access with a purely endoscopic endonasal approach...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404253/the-posterior-transpetrosal-approach-in-a-case-of-large-retrochiasmatic-craniopharyngioma-operative-video-and-technical-nuances
#16
Moujahed Labidi, Kentaro Watanabe, Marie-Pier Loit, Shunya Hanakita, Sébastien Froelich
Objectives  To discuss the use of the posterior petrosal approach for the resection of a retrochiasmatic craniopharyngioma. Design  Operative video. Results  In this case video, the authors discuss the surgical management of a large craniopharyngioma, presenting with mass effect on the third ventricle and optic apparatus. A first surgical stage, through an endoscopic endonasal transtubercular approach, allowed satisfactory decompression of the optic chiasma and nerves in preparation for adjuvant therapy...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404250/extended-endoscopic-endonasal-approach-for-craniopharyngioma-removal
#17
Mahmoud Messerer, Rodolfo Maduri, Roy Thomas Daniel
Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404249/extended-endoscopic-endonasal-approach-for-suprasellar-craniopharyngioma
#18
D Locatelli, F Pozzi, G Agresta, S Padovan, A Karligkiotis, P Castelnuovo
Objectives  We illustrate a suprasellar craniopharyngiomas treated with an extended endoscopic endonasal approach (EEEA). Design  Case report of a 43-year-old male affected by cerebral lesion located in suprasellar region involving the third ventricle and compressing the neurovascular structures, causing an anterosuperior dislocation of the chiasma. There is a complete disruption of the pituitary stalk that can explain the clinical finding of partial anterior hypopituitarism and hyperprolactinemia. The lesion is characterized by a solid and cystic component...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404248/expanded-endoscopic-endonasal-resection-of-retrochiasmatic-craniopharyngioma
#19
Justin R Davanzo, Neerav Goyal, Brad E Zacharia
This video abstract demonstrates the use of the expanded endoscopic endonasal approach for the resection of a retrochiasmatic craniopharyngioma. These tumors are notoriously difficult to treat, and many approaches have been tried to facilitate safe and effective resection. The endoscopic endonasal approach has been increasingly utilized for selected sellar/suprasellar pathology. We present the case of a 39-year-old man who was found to have a cystic, partially calcified suprasellar mass consistent with a craniopharyngioma...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404244/skull-base-reconstruction-in-the-pediatric-patient
#20
REVIEW
Irit Duek, Alon Pener-Tessler, Ravit Yanko-Arzi, Arik Zaretski, Avraham Abergel, Ahmad Safadi, Dan M Fliss
Introduction  Pediatric skull base and craniofacial reconstruction presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Objectives  To suggest an algorithm for skull base reconstruction in children and adolescents after tumor resection. Materials and Methods  Comprehensive literature review and summary of our experience...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
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