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https://www.readbyqxmd.com/read/29455409/how-i-do-it-endoscopic-endonasal-approach-to-the-inferior-third-of-the-clivus
#1
Eugenio Cárdenas Ruiz-Valdepeñas, Ariel Kaen, Gustavo Pérez Prat, Jesus Ambrosiani Fernandez
BACKGROUND: Nowadays, endoscopic endonasal expanded approach targeting for the clival lower third is well described in literature. Nonetheless, great variations can be found among surgical groups, specially during the earlier stages of this procedure. METHOD: We present a step by step description of the clival lower third approach until entering the dural space, setting its bony limits. We describe the basipharyngeal flap tailoring as a helpful option for latter reconstruction...
February 17, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29454123/cardiac-metastasis-from-clivus-chordoma-a-case-report
#2
Jun Won Kim, Chang-Ki Hong, Yoon Jin Cha, Se Hoon Kim, Chang-Ok Suh, Kyu-Sung Lee
BACKGROUND: Chordomas are rare tumors showing locally aggressive nature and high rates of local recurrences. Distant metastases are infrequently reported and cardiac metastases are extremely rare. CASE DESCRIPTION: A 32-year-old woman had been diagnosed with a large chordoma involving the clivus. She received a total removal of the tumor and adjuvant intensity-modulated radiotherapy. Four and a half years after the surgery, she presented with multifocal lesions in the ventricles and the right atrium, although an open thoracotomy revealed chronic inflammation...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433179/walk-the-line-the-surgical-highways-to-the-craniovertebral-junction-in-endoscopic-approaches-a-historical-perspective
#3
Massimiliano Visocchi, Domenico Gerardo Iacopino, Francesco Signorelli, Alessandro Olivi, Rosario Maugeri
BACKGROUND: We compiled a comprehensive literature review on the anatomic and clinical results of endoscopic approaches to the craniocervical junction (CVJ) to better contribute to identify the best strategy. METHODS: An updated literature review was performed in the PubMed, OVID, and Google Scholar medical databases, using the terms "Craniovertebral junction," "Transoral approach," "Transnasal approach," "Transcervical approach," "Endoscopic endonasal approach," "Endoscopic transoral approach," "Endoscopic transcervical approach...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29405184/-forensic-medical-determination-of-the-age-based-on-the-analysis-of-ct-scanograms-of-the-skull-and-the-craniovertebral-region-in-the-sagittal-projection
#4
A V Kovalev, M D Ametrin, G V Zolotenkova, A N Gerasimov, D V Gornostaev, M P Poletaeva
The objective of the present study was to determine the biological age of the unrecognized individuals based on the analysis of CT-scanograms of the skull and the craniovertebral region in the sagittal projection. We investigated the structure of the spongy substance of the clinoid plate of the sella turcica and the clivus of the cranium, involution of the vertebrae configuration in the medial atlantoaxial articulation, frontal and sphenoidal sinuses. A total of 80 skulls of Caucasoid individuals at the age ranging from 4 to 84 years belonging to an Eastern Slavonic population (free from the pathological lesions in the above cranial structures) were available for the examination...
2018: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/29404235/developmental-considerations-in-pediatric-skull-base-surgery
#5
REVIEW
Melissa A LoPresti, Jonathan N Sellin, Franco DeMonte
Objectives To review developmental surgical anatomy and technical nuances related to pediatric skull base surgery. Design Retrospective, single-center case series with literature review. Setting MD Anderson Cancer Center. Participants Patients undergoing pediatric skull base surgery. Main Outcome Measures Review developmental anatomy of the pediatric skull base as it relates to technical nuance of various surgical approaches and insight gained from a 25-year institutional experience with this unique patient population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29403363/a-retrospective-2d-morphometric-analysis-of-adult-female-chiari-type-i-patients-with-commonly-reported-and-related-conditions
#6
Maggie S Eppelheimer, James R Houston, Jayapalli R Bapuraj, Richard Labuda, Dorothy M Loth, Audrey M Braun, Natalie J Allen, Soroush Heidari Pahlavian, Dipankar Biswas, Aintzane Urbizu, Bryn A Martin, Cormac O Maher, Philip A Allen, Francis Loth
Purpose: Researchers have sought to better understand Chiari type I malformation (CMI) through morphometric measurements beyond tonsillar position (TP). Soft tissue and bone structures within the brain and craniocervical junction have been shown to be different for CMI patients compared to healthy controls. Yet, several morphological characteristics have not been consistently associated with CMI. CMI is also associated with different prevalent conditions (PCs) such as syringomyelia, pseudotumor, Ehlers-Danlos syndrome (EDS), scoliosis, and craniocervical instability...
2018: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29393814/extended-middle-fossa-approach-to-lateralized-pontine-cavernomas-in-children
#7
Robert C Rennert, Reid Hoshide, Mark Calayag, Joanna Kemp, David D Gonda, Hal S Meltzer, Takanori Fukushima, John D Day, Michael L Levy
OBJECTIVE Treatment of hemorrhagic cavernous malformations within the lateral pontine region demands meticulous surgical planning and execution to maximize resection while minimizing morbidity. The authors report a single institution's experience using the extended middle fossa rhomboid approach for the safe resection of hemorrhagic cavernomas involving the lateral pons. METHODS A retrospective chart review was performed to identify and review the surgical outcomes of patients who underwent an extended middle fossa rhomboid approach for the resection of hemorrhagic cavernomas involving the lateral pons during a 10-year period at Rady Children's Hospital of San Diego...
February 2, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29384905/central-nervous-system-leukemia-in-a-patient-with-concurrent-nasopharyngeal-carcinoma-and-acute-myeloid-leukaemia-a-case-report
#8
Jun-Qing Liu, Wen-Yuan Mai, Si-Ben Wang, Yin-Jun Lou, Sen-Xiang Yan, Jie Jin, Wei-Lai Xu
RATIONALE: Concurrent case of nasopharyngeal carcinoma (NPC) and acute myeloid leukemia (AML) has not been reported. Here, we report a case of NPC, who was concurrently suffered from AML one mother after the NPC diagnosis. PATIENT CONCERNS: The patient was a 45-year-old male who presented with a mass on his right side neck. DIAGNOSES: The patient was diagnosed with Epstein-Barr virus negative type-2 non-keratinizing carcinoma with clivus involvement and unilateral metastasis to the cervical lymph node...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29310398/an-unusual-case-of-oropharyngeal-chordoma-a-case-report-and-literature-review
#9
Xiang Li, Yufan Wang, Feng Wang, Bowen Li, Shuai Sun, Hongyu Yang
RATIONALE: Chordomas are rare malignant neoplasms derived from incomplete regression of notochordal tissue along the cranio-coccygeal axis. Chordomas that develop in an atypical position are called ectopic chordomas, such as oropharyngeal chordomas (OCs). OCs are exceedingly rare; only 11 cases have been reported to date. Preoperative diagnosis is challenging, and an accurate diagnosis thus is based on postoperative pathologic examination findings and immunohistochemistry. Although surgical therapy and radiotherapy is performed in some patients, the 5-year survival rate is low...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29237926/endoscopic-approach-to-remove-intra-extracranial-tumors-in-various-skull-base-regions-10-year-experience-of-a-single-center
#10
Qiu-Hang Zhang, Zhen-Lin Wang, Hong-Chuan Guo, Feng Kong, Bo Yan, Ming-Chu Li, Ge Chen, Jian-Tao Liang, Yu-Hai Bao, Feng Ling
BACKGROUND: Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base. Herein, we described a pure endoscopic transnasal or transoral approach (ETA) for the removal of intra-extracranial tumors in various skull base regions. METHODS: Retrospectively, clinical data, major surgical complications, pre- and postoperative images, and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed...
December 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29181683/analysis-of-the-infiltrative-features-of-chordoma-the-relationship-between-micro-skip-metastasis-and-postoperative-outcomes
#11
Toru Akiyama, Koichi Ogura, Tabu Gokita, Satoshi Tsukushi, Shintaro Iwata, Tomoki Nakamura, Akihiko Matsumine, Tsukasa Yonemoto, Yoshihiro Nishida, Kazuo Saita, Akira Kawai, Seiichi Matsumoto, Takehiko Yamaguchi
BACKGROUND: Chordomas are very rare primary malignant bone tumors that arise commonly from the sacrum (50-60%) and clivus (25-35%). Chordomas have a high rate of recurrence. The authors confirmed a unique histologic infiltration pattern of chordomas that resembles a skip-metastatic lesion in normal tissue around tumor, which they named "micro-skip metastasis." This study aimed to examine the correlations between the clinicopathologic features of chordomas, including micro-skip metastasis, and the clinical outcomes, including overall survival, local recurrence-free survival, and distant metastasis-free survival...
November 27, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29174229/repair-of-cerebrospinal-fluid-leakage-using-a-transfrontal-radial-adipofascial-flap-an-individual-approach-supported-by-3d-printing-for-surgical-planning
#12
Stefan Grau, Stephanie Kellermann, Michael Faust, Moritz Perrech, Dirk Beutner, Alexander Drzezga, Joachim Zöller
BACKGROUND: Leakage of cerebrospinal fluid (CSF) due to large prolactinomas represents a complex issue. Due to limited anatomical space, often multiple leakage sites and scarce locally available tissue for repair, surgical possibilities are limited. We report an initial case of using a radial fasciocutaneous flap applied sub-frontally to cover a large skull base defect, supported by preoperative 3D-printing for surgical planning. CASE DESCRIPTION: A 29 year old female developed severe nuchal pain which was caused by destruction of large parts of her skull base by a prolactinoma...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29169050/utility-of-post-mortem-computed-tomography-in-clivus-fracture-diagnosis-case-illustration-and-literature-review
#13
S Zerbo, A Di Piazza, G Lo Re, G L Aronica, S Salerno, R Lagalla
Clivus fractures are usually associated with head blunt trauma due to traffic accident and falls. A 23 - year-old man died immediately after a smash-up while he was stopping on his motorcycle. Post-mortem Computed tomography (PMCT), performed before autopsy, revealed a complex basilar skull base fractures associated with brainstem and cranio-vertebral junction injuries, improving the diagnostic performance of conventional autopsy. Imaging data were re-assessable and PMCT offers the possibility to perform multiplanar and volume rendered reconstructions, increasing forensic medicine knowledge related to traumatic injuries...
November 16, 2017: Legal Medicine
https://www.readbyqxmd.com/read/29126120/cranial-chordoma-a-new-preoperative-grading-system
#14
Harley Brito da Silva, David Straus, Jason K Barber, Robert C Rostomily, Manuel Ferreira, Laligam N Sekhar
BACKGROUND: Chordomas are rare but challenging neoplasms involving the skull base. A preoperative grading system will be useful to identify both areas for treatment and risk factors, and correlate to the degree of resection, complications, and recurrence. OBJECTIVE: To propose a new grading system for cranial chordomas designed by the senior author. Its purpose is to enable comparison of different tumors with a similar pathology to clivus chordoma, and statistically correlate with postoperative outcomes...
November 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29125445/morphometric-and-volumetric-comparison-of-102-children-with-symptomatic-and-asymptomatic-chiari-malformation-type-i
#15
Siri Sahib S Khalsa, Ndi Geh, Bryn A Martin, Philip A Allen, Jennifer Strahle, Francis Loth, Desale Habtzghi, Aintzane Urbizu Serrano, Daniel McQuaide, Hugh J L Garton, Karin M Muraszko, Cormac O Maher
OBJECTIVE Chiari malformation Type I (CM-I) is typically defined on imaging by a cerebellar tonsil position ≥ 5 mm below the foramen magnum. Low cerebellar tonsil position is a frequent incidental finding on brain or cervical spine imaging, even in asymptomatic individuals. Nonspecific symptoms (e.g., headache and neck pain) are common in those with low tonsil position as well as in those with normal tonsil position, leading to uncertainty regarding appropriate management for many patients with low tonsil position and nonspecific symptoms...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29121040/ossification-of-the-petrosphenoid-ligament-a-case-study
#16
Janusz Skrzat, Izabela Mróz, Alexandru Spulber, Michał Zarzecki, Jerzy Walocha
The current study presents a case in which a human skull revealed a partially ossified petrosphenoid ligament. The ossified ligament appears as a hooked bony trabecula emerging below the right posterior clinoid process. Another bony trabecula arises from the petrous apex and runs towards the clivus. Both trabecula face each other but do not fuse, having a small gap between their tips. Their positions clearly indicate that they must have formed an overhang above the abducens nerve. Therefore, they should be considered a part of the walls of Dorello's canal, which is a conduit for the abducens nerve and associated vascular structures...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29076464/-extended-endoscopic-endonasal-posterior-transclival-approach-to-tumors-of-the-clival-region-and-ventral-posterior-cranial-fossa-part-2-topographic-and-anatomical-aspects-and-surgical-technique
#17
A N Shkarubo, K V Koval', G F Dobrovol'skiy, M A Shkarubo, G A Polev, D N Andreev, I V Chernov, V V Karnaukhov, O A Gadzhieva
PURPOSE: to present the main topographic and anatomical features of the clivus and adjacent structures for improving and optimizing the extended endoscopic transnasal posterior (transclival) approach in removal of clival and ventral posterior cranial fossa lesions. MATERIAL AND METHODS: We performed a topographic and anatomical study of 25 cadaver heads, the vascular bed of which was filled with colored silicone using the original technique for visualizing the bed features and individual variability...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#18
REVIEW
Srikant Chakravarthi, Lior Gonen, Alejandro Monroy-Sosa, Sammy Khalili, Amin Kassam
The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF)...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29053075/machine-learning-applied-to-neuroimaging-for-diagnosis-of-adult-classic-chiari-malformation-role-of-the-basion-as-a-key-morphometric-indicator
#19
Aintzane Urbizu, Bryn A Martin, Dulce Moncho, Alex Rovira, Maria A Poca, Juan Sahuquillo, Alfons Macaya, Malena I Español
OBJECTIVE The current diagnostic criterion for Chiari malformation Type I (CM-I), based on tonsillar herniation (TH), includes a diversity of patients with amygdalar descent that may be caused by a variety of factors. In contrast, patients presenting with an overcrowded posterior cranial fossa, a key characteristic of the disease, may remain misdiagnosed if they have little or no TH. The objective of the present study was to use machine-learning classification methods to identify morphometric measures that help discern patients with classic CM-I to improve diagnosis and treatment and provide insight into the etiology of the disease...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29050071/-poorly-differentiated-chordoma-with-ini1-loss-a-clinicopathologic-study
#20
J Y Feng, L Chen, Y Y Ma, H W Yang, L Chen
Objective: To analyze the clinicopathologic characteristics of poorly-differentiated chordoma with INI1 loss in children and to discuss the differential diagnosis. Methods: The clinical, radiological, histopathological profiles and molecular pathologic characteristics of two pediatric poorly differentiated chordoma cases with INI1 loss were reviewed. Results: The patients were a girl and a boy. Both lesions involved the slope. Both patients were presented with progressive muscle weakness or neck pain. Radiological examination showed clivus bone destruction and compression of the brain stem and cervical spinal cord...
October 8, 2017: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
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