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Endoscopic skull base

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https://www.readbyqxmd.com/read/28328602/intracranial-anatomic-landmarks-for-endoscopic-endonasal-transcribriform-approach-to-anterior-skull-base
#1
Pinghua Wu, Huikun Zeng, Ying Guan, Ligen Mo, Danke Su
OBJECTIVES: To help surgeons locating anatomic landmarks when performing endoscopic endonasal transcribriform approach to anterior skull base. METHODS: High-resolution axial computed tomography (CT) images at thickness of 0.6 mm, and reconstructed 0.41-mm thick gapless sagittal and coronal CT images were taken from 123 subjects. Using mimics software, first located elementary points and line: nasal spine, midpoint of posterior hard palate and the line between them; then located measured points right/left posterior and anterior points; measured distances between measured points and from measured points to nasal spine and angles between lines connecting measured points to nasal spine and the basic line...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28325634/emerging-roles-of-coblation-in-rhinology-and-skull-base-surgery
#2
REVIEW
Garret W Choby, Peter H Hwang
Coblation is a technology that incorporates bipolar radiofrequency energy to ablate tissue at relatively low temperatures. Its use for sinonasal surgery is actively being investigated, including applications for turbinate reduction, sinus surgery, skull base surgery, and adenoidectomy. Potential benefits include reduction in blood loss, improved endoscopic surgical visualization, and reduction in postoperative pain. The main drawbacks are its relatively high cost, potential adverse effects on functional epithelium, and relative paucity of long-term outcomes...
March 18, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28324181/trigeminocardiac-reflex-during-endoscopic-juvenile-nasopharyngeal-angiofibroma-surgery-an-appraisal
#3
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#4
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#5
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321377/single-layer-repair-of-large-anterior-skull-base-defects-without-vascularized-mucosal-flap
#6
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28317322/cerebrospinal-fluid-leaks-during-endoscopic-sinus-surgery-in-thirty-two-patients
#7
Georg J Ledderose, Klaus Stelter, Christian S Betz, Anna S Englhard, Carola Ledderose, Andreas Leunig
The inadvertent cerebrospinal fluid (CSF) leak is a very rare but potentially hazardous complication in endoscopic sinus surgery. We performed a systematic review of a series of 32 cases of CSF leaks occurring during sinus surgery. We identified surgical inexperience and impaired orientation in the surgical field as the main risk factors for iatrogenic CSF leaks. The lateral lamella of the cribriform plate and the anterior ethmoid roof are predilection sites for CSF leaks in the anterior skull base. We determined suitable methods of repair based on the location of the leak and found high success rates after endoscopic leak closure...
March 20, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28314403/management-of-cavernous-sinus-involvement-in-sinonasal-and-ventral-skull-base-malignancies
#8
REVIEW
Amol Raheja, William T Couldwell
Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28314401/combined-endoscopic-and-open-approaches-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#9
REVIEW
James K Liu, Anni Wong, Jean Anderson Eloy
Combined transcranial and endoscopic endonasal approaches remain useful in the treatment of ventral skull base malignancies. The extended bifrontal transbasal approach provides wide access to the anterior ventral skull base and paranasal sinuses without transfacial incisions. In more extensive lesions, the bifrontal transbasal approach can then be combined with an endoscopic endonasal approach (EEA) from below. This article reviews the indications, surgical technique, and operative nuances of combined transbasal and EEA (cranionasal) approaches for the surgical management of ventral skull base malignancies...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28314400/endoscopic-resection-of-clival-malignancies
#10
REVIEW
Adam J Folbe, Peter F Svider, James K Liu, Jean Anderson Eloy
Surgical management of clival lesions presents numerous therapeutic challenges because of the close proximity of surrounding critical structures. With a detailed understanding of the endoscopic endonasal approach and relevant considerations, appropriate lesions can be removed in a safe and minimally invasive manner. Use of this technique as a primary approach represents the standard of care for many lesions at leading skull base centers, although adjunct techniques may be necessary in extensive lesions and those with significant lateral extension...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28299444/the-ethmoidal-arteries-a-cadaveric-study-based-on-cone-beam-computed-tomography-and-endoscopic-dissection
#11
Marco Ferrari, Luca Pianta, Andrea Borghesi, Alberto Schreiber, Marco Ravanelli, Davide Mattavelli, Vittorio Rampinelli, Francesco Belotti, Luigi Fabrizio Rodella, Roberto Maroldi, Piero Nicolai
PURPOSE: To describe the anatomical variability of the ethmoidal arteries (EAs). To evaluate the reliability of cone beam computed tomography (CBCT) in preoperative assessment of EAs. METHODS: Fourteen cadaver heads underwent CBCT and endoscopic dissection. The following anatomical features were evaluated for anterior (AEA), middle (MEA), and posterior (PEA) EAs: presence, cranio-caudal position, antero-posterior position, and dehiscence of the bony canal. Accuracy of radiological assessment was calculated...
March 15, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28293965/endoscopic-approach-for-a-delayed-post-traumatic-ethmoidal-mucocele-a-technical-note
#12
Mahmoud Messerer, Giulia Cossu, Roy Thomas Daniel
OBJECTIVE: Delayed post-traumatic mucoceles are rare. We describe the surgical treatment of a post-traumatic ethmoidal mucocele with intra-orbital extension. METHOD: A uninostril endoscopic endonasal approach (EEA) was performed. The access was contralateral to the lesion to provide a wider lateral view. After a large sphenoid and ethmoid sinuses opening, the collection was drained and the optic nerve precociously identified. The orbital roof was eroded and the frontal dura mater directly visible...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291218/-endoscopic-transnasal-surgery-for-giant-fibrous-dysplasia-of-the-skull-base-spreading-to-the-right-orbital-cavity-and-nasopharynx-a-case-report-and-literature-review
#13
A N Shkarubo, A Yu Lubnin, E Yu Bukharin, L V Shishkina, D N Andreev, K V Koval', I V Chernov, V V Karnaukhov
BACKGROUND: An extended endoscopic endonasal approach is increasingly used in surgical treatment of space-occupying skull base lesions. The international literature reports only 20 cases of surgical treatment for fibrous dysplasia (PD) of the skull base using the endoscopic endonasal approach. We present our experience with the endoscopic endonasal approach in surgical treatment for giant fibrous dysplasia of the skull base, spreading to the right orbital cavity and nasopharynx. CLINICAL CASE: A 26-year-old male patient presented with cranial pain, Vth nerve dysfunction on the right, right keratopathy...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28284576/hemostasis-in-endoscopic-endonasal-skull-base-surgery-using-the-aquamantys-bipolar-sealer-technical-note
#14
Richard Bram, Susan Fiore, Daryl McHugh, Ghassan J Samara, Raphael P Davis
BACKGROUND: A major challenge during endoscopic transsphenoidal surgery is adequate intraoperative hemostasis. The Aquamantys® is a relatively new bipolar sealing device which uses radiofrequency energy and saline. This promotes hemostasis while decreasing charring and thermal spread. In this paper, we describe our experience with the Aquamantys® Mini EVS 3.4 Epidural Vein Sealer Bipolar Electrocautery System (Medtronic Advanced Energy, Portsmouth, NH, USA) during endoscopic surgery for tumors of the skull base with particular attention to ergonomic benefits and technical nuances...
March 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28279556/management-options-of-non-syndromic-sagittal-craniosynostosis
#15
REVIEW
Bryan S Lee, Lee S Hwang, Gaby D Doumit, Joseph Wooley, Francis A Papay, Mark G Luciano, Violette M Recinos
There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options...
March 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28277484/delayed-breakdown-of-an-onlay-pericranial-flap-following-endoscopic-craniofacial-resection
#16
Xu Xinni, Sein Lwin, Yew Kwang Ong
The pericranial flap is a well-vascularized, robust flap that is used to reconstruct anterior skull base defects following resection of skull base tumors. Failure of this flap is uncommon. However when it occurs, the consequences are potentially disastrous and it poses a challenge to further reconstruction. The authors report the first patient of onlay pericranial flap breakdown following endoscopic craniofacial resection. Possible contributing factors are identified and further management is discussed. With the endoscopic approach being increasingly utilized for craniofacial resection, it is imperative to be mindful of these factors to minimize the risks of onlay pericranial flap failure...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28269412/development-of-a-snake-like-dexterous-manipulator-for-skull-base-surgery
#17
Suat Coemert, Anzhu Gao, John P Carey, Mattias F Traeger, Russell H Taylor, Tim C Lueth, Mehran Armand
Petrous apex lesions constitute considerable surgical challenges due to their location in the skull base and close relationship with critical structures such as inner ear, carotid arteries, facial nerves and jugular bulb. These lesions often cannot be treated completely with rigid tools due to the limited accessibility. We are aiming to develop a snake-like manipulator to assist surgeons with the infralabyrinthine treatment of petrous apex lesions with increased dexterity. This snake-like dexterous manipulator (SDM) with 3...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28254539/video-is-part-of-the-ms-three-layer-reconstruction-with-iliotibial-tract-after-endoscopic-resection-of-sinonasal-tumors-technical-note
#18
Davide Mattavelli, Alberto Schreiber, Marco Ferrari, Remo Accorona, Andrea Bolzoni Villaret, Paolo Battaglia, Paolo Castelnuovo, Piero Nicolai
INTRODUCTION: Watertight reconstruction to separate the intradural compartment from the sinonasal cavities is crucial after endoscopic resection with transnasal craniectomy (ERTC) for naso-ethmoidal tumors. Three-layer reconstruction with the iliotibial tract (TRITT) is a safe and reliable alternative when vascularized flaps are not available. SURGICAL TECHNIQUE: The iliotibial tract graft is harvested on the lateral aspect of the thigh and divided in three portions, which are positioned in a multi-layered fashion to close the skull base defect...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28236049/analysis-of-the-venous-channel-within-the-clivus-using-multidetector-computed-tomography-digital-subtraction-venography
#19
Katsuhiro Mizutani, Masahiro Toda, Jun Kurasawa, Takenori Akiyama, Hirokazu Fujiwara, Masahiro Jinzaki, Kazunari Yoshida
PURPOSE: Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. METHODS: Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. RESULTS: Eighteen emissary veins were identified in 14 (28...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28230588/how-to-expose-the-entire-sella-floor-with-minimal-manipulation-during-an-endoscopic-endonasal-transsphenoidal-approach
#20
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Yong Jin Park, Soo Whan Kim, Jin Hee Cho, Boo-Young Kim, Sung Won Kim
OBJECTIVE: A method of opening the posterior ethmoid air cells with minimal manipulation is important for adequate exposure of the sella floor and minimal nasal morbidity. METHODS: Between February 2009 and August 2016, 373 patients with skull-base tumors underwent surgery via endoscopic endonasal transsphenoidal approach with the 2-nostrils/4-hands technique using this technique. RESULTS: A linear incision was made laterally toward one-third of the superior turbinate along the superior border of the sphenoid sinus ostium...
February 22, 2017: Journal of Craniofacial Surgery
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