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Endoscopic skull base

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https://www.readbyqxmd.com/read/27913068/occult-infratemporal-fossa-neurofibroma-presenting-with-persistent-unilateral-tinnitus-and-middle-ear-effusion-more-than-meets-the-eye
#1
Lucas P Carlstrom, Kathryn M Van Abel, Matthew L Carlson, Eric J Moore, Janalee K Stokken
Herein, we present the case of a previously healthy 54year-old female who developed several weeks of unilateral tinnitus and aural fullness. She subsequently underwent unilateral pressure equalization tube placement at an outside institution after exam demonstrated a middle ear effusion, conductive hearing loss and normal nasopharyngoscopy. Ultimately, an MRI revealed an occult mass in the infratemporal fossa (ITF), which was successfully removed via an endoscopic transnasal ITF approach. Following resection of a histopathologically confirmed benign neurofibroma, she reported complete resolution of her symptoms...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27906848/calculation-of-an-optic-nerve-injury-risk-profile-before-sphenoid-sinus-surgery
#2
Erdem Atalay Cetinkaya, Koray Koc, Mehmet Fatih Kucuk, Pinar Koc, Nuray Bayar Muluk, Cemal Cingi
OBJECTIVES: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. METHODS: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#3
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27900036/management-of-pediatric-head-and-neck-rhabdomyosarcoma-a-case-series-of-36-patients
#4
Joanna Radzikowska, Wojciech Kukwa, Andrzej Kukwa, Anna M Czarnecka, Maciej Kawecki, Fei Lian, Cezary Szczylik, Antoni Krzeski
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric population. In 35% of cases, RMS develops in the head and neck (H&N) region, and only combined therapy is recognized as a curative treatment. However, recent advances in skull base and reconstructive surgery, along with microsurgery and endoscopic surgery, have strengthened the role of surgery as an important part of RMS treatment. In the present study, 36 pediatric RMS cases (24 males and 12 females) were analyzed after surgical treatment...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27891396/endoscopic-excision-of-symptomatic-simple-bone-cyst-at-skull-base
#5
Prashant Gunawat, Salman Tehran Shaikh, Vikram Karmarkar, Chandrashekhar Deopujari, Nishit Shah
Seizure is a classical feature of intra axial brain parenchymal lesion. Simple bone cyst is an unusual bony pathology at skull base presenting with unexpected symptoms of complex partial seizures. Skull base neuro-endoscopy has managed such lesions more effectively with reduced post-operative morbidity as compared to transcranial approach. This case report discusses a 20-year-old male who presented with 3 episodes of seizure over a time period of 10 months. MRI brain revealed T1 hypo and T2 hyper intense cystic lesion in middle cranial fossa with no enhancement on contrast administration...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890187/imaging-of-paranasal-sinuses-and-anterior-skull-base-and-relevant-anatomic-variations
#6
REVIEW
Estushi Iida, Yoshimi Anzai
This article reviews the normal anatomy and variants of the anterior skull base and sinonasal cavities that are relevant to endoscopic sinus and skull base surgery. Radiologists should be aware of sinonasal anatomy that can be impediments to surgical access and increase risk of vascular or cranial nerve injury during surgery. Imaging features of the paranasal sinuses and anterior skull base pathologies are also discussed.
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27890179/expanded-endonasal-endoscopic-approaches-to-the-skull-base-for-the-radiologist
#7
REVIEW
Christopher R Roxbury, Masaru Ishii, Ari Meir Blitz, Douglas D Reh, Gary L Gallia
The cranial base is a complex 3-D region that contains critical neurovascular structures. Pathologies affecting this region represent some of the most challenging lesions to manage due to difficulty with access and risk of significant postoperative morbidity. With the development of expanded endonasal endoscopic approaches, skull base surgeons use the nose and paranasal sinuses as a corridor to access selected ventral skull base lesions. This review discusses high-resolution imaging in the evaluation of patients with skull base lesions considered for endonasal endoscopic surgery, summarizes various expanded endonasal endoscopic approaches, and provides examples of commonly used expanded endonasal endoscopic procedures...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27879303/smooth-muscle-tumour-of-uncertain-malignant-potential-smtump-in-the-nasal-cavity-an-incidental-finding
#8
Dipak Ranjan Nayak, Asheesh Dora Ghanpur, Apoorva N Reddy, Swati Sharma
Sino-nasal smooth muscle tumours of uncertain malignant potential (SMTUMP) are very rare neoplasms of mesenchymal origin with features in between a benign leiomyoma and a leiomyosarcoma. We report a rare case of SMTUMP in a 44-year-old woman, who presented with vague symptoms of pharyngitis. Nasal endoscopy revealed a smooth mass in left nasal cavity. Contrast-enhanced CT and MRI scans showed features likely to be inverted papilloma or olfactory neuroblastoma or meningioma. Excision was planned and intraoperatively, frozen section revealed a probable spindle cell lesion...
November 22, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27875509/osseous-repair-in-minimally-invasive-reconstruction-of-anterior-skull-base-defects
#9
Vijay R Ramakrishnan, Adam M Terella, Seerat Poonia, Alexander G Chiu, James N Palmer
Management of anterior skull base defects is an area of continued innovation for skull base surgeons. Various grafting materials have been advocated for the repair of skull base defects depending on needs, availability, harvest site morbidity, and surgeon preference. Spontaneous bony closure of small skull defects is known to occur in animal models without bone grafts, but this phenomenon has been unexplored in the human skull base. The objective of this study was to evaluate osseous skull base closure in patients undergoing endoscopic repair of skull base defects...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27857875/dual-endoscopic-endonasal-transsphenoidal-and-precaruncular-transorbital-approaches-for-clipping-of-the-cavernous-carotid-artery-a-cadaveric-simulation
#10
Jeremy Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin S Cetas, William E Cameron
Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27857870/persistent-trigeminal-artery-in-endonasal-resection-of-skull-base-tumors-a-systematic-review
#11
Jasper Shen, James Tourje, Elena E Chang, Adam N Mamelak, Arthur W Wu
Background Primitive persistent trigeminal artery (PTA) is an uncommon embryologic vascular communication between the carotid and basilar arteries, which can be intimately involved by skull base tumors (SBT). Owing to its rarity, skull base surgeons should familiarize themselves with the anatomical variations of PTA to avoid catastrophic complications. Objective To appraise and summarize the available evidence of PTA involved by SBTs while advocating a standardized algorithm for the surgical planning of these patients...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27846635/multilayered-closure-of-cerebrospinal-fluid-rhinorrhea-with-inlay-fascia-lata-autologous-fat-and-outlay-fascia-lata-our-experience
#12
Mehmet Akif Eryılmaz, Mitat Arıcıgil, Mehmet Akif Alan
BACKGROUND/AIMS: Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition. METHODS: In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (CSF) rhinorrhea...
November 16, 2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/27833887/endoscopic-management-of-congenital-intranasal-meningocele-in-3-month-old-infant
#13
Gaurav Khandelwal, Manoj Sharma, Priyanka Gupta
Fronto-ethmoidal meningocoele is a rare congenital condition with protrusion of meninges through anterior cranial fossa into the facial skeleton, surgical repair should be done in order to resolve nasal obstruction, provide a watertight division between sino-nasal and intra-cranial cavities and minimise injury to any CNS contents (Maddalozzo in Issue Otolaryngol Clin N Am 2015). Open approaches may be required but endoscopic endo-nasal repairs can be done in paediatric skull-base defects. A 3 month-old infant with fronto-ethmoidal meningocele operated with endo-nasal approach...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27792103/intracranial-nasal-dermoid-sinus-cyst-transnasal-endoscopic-resection-by-open-rhinoplasty-approach-with-intraoperative-video
#14
David Ulrich Seidel, Andreas M Sesterhenn
Nasal dermoid sinus cysts are rare congenital lesions that may lead to recurrent soft tissue infections and severe intracranial complications. In case of an intracranial extension, the traditional surgical approach includes a frontal craniotomy with significant morbidity. As a less invasive alternative, a transnasal endoscopic approach has been recommended.This report describes the transnasal endoscopic resection of an intracranial nasal dermoid sinus cyst via an open rhinoplasty approach, which achieved a wide surgical exposure with minimal invasivity and ideal aesthetic results...
October 27, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27773560/surgical-resection-of-sinonasal-hemangiopericytoma-involving-anterior-skull-base-case-reports-and-literature-review
#15
Jonathan C Simmonds, Elie E Rebeiz
Hemangiopericytomas are soft tissue tumors composed of pericytic cells that are characterized by their "staghorn" vascular branching and their variable clinical presentation. Fifteen to 25% of all HPC occur in the head and neck, with only 5% found in the nose or paranasal sinuses. Sinonasal hemangiopericytoma (SNHPC) is considered distinct from its soft tissue counterpart - the former showing a more uniform cellular organization, has convincing pericytic differentiation and is associated with a far better prognosis...
September 28, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27771110/image-guided-transoral-approach-in-severe-craniovertebral-junction-malformations-at-the-golden-age-of-endoscopy-regarding-2%C3%A2-cases
#16
E Mazerand, N Karmani, L Le Fournier, L Laccourreye, H-D Fournier
INTRODUCTION: The image-guided transoral approach (IGTOA) provides a safe exposure to skull base midline lesions and the ventral aspect of the craniovertebral junction (CVJ). The IGTOA has several advantages: the head being placed in the extended position, it decreases the brainstem angulation during surgery; the approach being done through the avascular median pharyngeal raphe, not only lowers the bleeding risk but also provides a direct access to the bony pathology and granulation tissue accessible only via the ventral route...
October 19, 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27767395/endoscopic-endonasal-transclival-resection-of-a-ventral-pontine-cavernous-malformation-technical-case-report
#17
Juan Luis Gómez-Amador, Luis Alberto Ortega-Porcayo, Isaac Jair Palacios-Ortíz, Alexander Perdomo-Pantoja, Felipe Eduardo Nares-López, Alfredo Vega-Alarcón
Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27766473/endoscopic-transnasal-skull-base-surgery-pushing-the-boundaries
#18
Nathan T Zwagerman, Georgios Zenonos, Stefan Lieber, Wei-Hsin Wang, Eric W Wang, Juan C Fernandez-Miranda, Carl H Snyderman, Paul A Gardner
The endoscopic endonasal approach (EEA) has significantly evolved since its initial uses in pituitary and sinonasal surgery. The literature is filled with reports and case series demonstrating efficacy and advantages for the entire ventral skull base. With competence in 'minimally invasive' parasellar approaches, larger and more complex approaches were developed to utilize the endonasal corridor to create maximally invasive endoscopic skull base procedures. The challenges of these more complex endoscopic procedures include a long learning curve and navigating in a narrow corridor; reconstruction of defects presented new challenges and early experience revealed a significantly higher risk of cerebrospinal fluid leak...
October 20, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27762178/role-of-targeted-magnetic-resonance-imaging-sequences-in-the-surgical-management-of-anterior-skull-base-pathology
#19
S Chawla, J Bowman, M Gandhi, B Panizza
BACKGROUND: The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage...
October 20, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27754596/educational-utility-of-advanced-three-dimensional-virtual-imaging-in-evaluating-the-anatomical-configuration-of-the-frontal-recess
#20
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
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