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Lateral skull base

Joseph Y Shen, Neal D Futran, Maya G Sardesai
Craniofacial Actinomyces osteomyelitis progression is rare, as patients are soon treated. A 56-year-old male smoker presented with sinusitis and was managed medically. This patient failed to follow up and presented 1 year later with erosive bony disease. He was managed medically and surgically; however, his disease evolved to include his midface, skull base, and cranium. He underwent staged debridement and free tissue reconstruction. His disease is controlled but not cured. The literature includes case reports and small series describing limited disease treated successfully with surgical and medical management...
February 2018: Radiology Case Reports
Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: The variety of diagnostic characteristics associated with neurocysticercosis have been well studied, however, its potential to be implicated in other differential diagnosis has not been well demonstrated. CASE DESCRIPTION: We report the case of a 55-year-old Hispanic man who underwent a Chiari decompression surgery, which was complicated with hydrocephalus. Despite a ventriculoperitoneal (VP) shunt placement, he continued to have headaches and was soon found to have several skull base subarachnoid lesions, which were later diagnosed as the sequelae of an active neurocysticercosis infection...
March 12, 2018: World Neurosurgery
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Vladimir Nakov, Toma Spiriev, Evgeni Stavrev
BACKGROUND: Vertebrobasilar junction aneurysms occur rarely, but have a higher rupture rate than supratentoral aneurysms, and higher morbidity and mortality. Their location ventral to the neuroaxis makes them a challenging surgical lesion. METHODS: In this paper, we share our experience with the surgical technique for the management of these complex aneurysms. CONCLUSION: An in-depth understanding of the anatomy of these aneurysms, careful preoperative planning, and a meticulous surgical technique, including knowledge of every detail of the procedure-positioning, an advanced skull base technique, and careful aneurysm dissection and clipping-is essential for a successful outcome of the surgery...
March 14, 2018: Acta Neurochirurgica
Thomas Coquet, Michel Lefranc, Louis Chenin, Pascal Foulon, Éric Havet, Johann Peltier
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Rubens Spin-Neto, Louise H Matzen, Lars W Schropp, Thomas S Sørensen, Ann Wenzel
OBJECTIVES: To assess the impact of head motion artefacts and an automated artefact-correction system on CBCT image quality and interpretability for simulated diagnostic tasks. METHODS: A partially dentate human skull was mounted on a robot simulating four types of head movement (antero-posterior translation, nodding, lateral rotation, and tremor), at three distances (0.75, 1.5, and 3 mm) based on two movement patterns (skull returning/not returning to the initial position)...
March 14, 2018: Dento Maxillo Facial Radiology
Long Wang, Li Cai, Shuaibin Lu, Hai Qian, Michael T Lawton, Xiang'en Shi
Internal maxillary artery (IMA) bypass has gain momentum in the last 5 years for the treatment of complex cerebrovascular disorders and skull base tumors. However, some issues regarding this treatment modality have been proposed. As one of the most experienced neurosurgical team to perform internal maxillary artery bypass in the world (>100 clinical cases), we reviewed literature in aspects of basic anatomy of maxillary artery with its variations to the lateral pterygoid muscle, initial anastomosis modalities and subsequent exposure techniques in cadaver studies, pre-operative arterial evaluation methods, optimal interposed graft selections and surgical outcome in the management of complex aneurysms, skull base tumors and steno-occlusive disorders...
March 7, 2018: World Neurosurgery
Ana I L Namburete, Weidi Xie, Mohammad Yaqub, Andrew Zisserman, J Alison Noble
Methods for aligning 3D fetal neurosonography images must be robust to (i) intensity variations, (ii) anatomical and age-specific differences within the fetal population, and (iii) the variations in fetal position. To this end, we propose a multi-task fully convolutional neural network (FCN) architecture to address the problem of 3D fetal brain localization, structural segmentation, and alignment to a referential coordinate system. Instead of treating these tasks as independent problems, we optimize the network by simultaneously learning features shared within the input data pertaining to the correlated tasks, and later branching out into task-specific output streams...
February 21, 2018: Medical Image Analysis
Akshay V Patel, Jason E Thuener, Kate Clancy, Mustafa Ascha, Nauman F Manzoor, Chad A Zender
OBJECTIVES: The submental artery island flap (SIF) has recently been described in temporal bone defects. At our institution we have broadened the application of the SIF and modified the harvest technique for complex lateral facial and skull base defects. Our primary aim is to evaluate the outcomes of patients undergoing complex lateral facial soft tissue, parotidectomy, and temporal bone defects who are reconstructed with the SIF to a similar cohort undergoing free tissue transfer reconstruction...
March 2018: Oral Oncology
Silky Chotai, Yi Liu, Songtao Qi
The lesions involving cavernous sinus (CS) and lateral sellar region includes tumors, vascular lesions, infection, inflammation, and trauma. Tumors associated with CS cause significant distortion of the microanatomy posing an additional surgical challenge to the neurosurgeons. The surgical approach and microsurgical anatomy with respect to the origin and growth of the tumor within the CS region have not been comprehensively described in recent years. We conducted a review of literature concerning CS and associated tumors, complied through MEDLINE/OVID and using cross-references of articles on PubMed with the keywords cavernous sinus, CS tumors, pituitary adenoma, meningioma, schwannoma, chordoma, CS hemangiomas, extradural, interdural, intradural, skull base, gamma knife radiosurgery, endoscopic endonasal approach...
January 2018: Asian Journal of Neurosurgery
Brandon Lucke-Wold, Erik C Brown, Justin S Cetas, Aclan Dogan, Sachin Gupta, Timothy E Hullar, Timothy L Smith, Jeremy N Ciporen
Cerebrospinal fluid (CSF) leaks occur in approximately 10% of patients undergoing a translabyrinthine, retrosigmoid, or middle fossa approach for vestibular schwannoma resection. Cerebrospinal fluid rhinorrhea also results from trauma, neoplasms, and congenital defects. A high degree of difficulty in repair sometimes requires repetitive microsurgical revisions-a rate of 10% of cases is often cited. This can not only lead to morbidity but is also costly and burdensome to the health care system. In this case-based theoretical analysis, the authors summarize the literature regarding endoscopic endonasal techniques to obliterate the eustachian tube (ET) as well as compare endoscopic endonasal versus open approaches for repair...
March 2018: Neurosurgical Focus
Justin Michel, Thomas Radulesco, Jade Graziani, Martin Penicaud, Patrick Dessi
Endoscopic or transfacial external frontal sinus approaches do not provide good monitoring of the frontal sinus lateral extent. Moreover, endoscopic or transfacial external approaches remain associated with numerous complications or therapeutic failure, e.g. frontal sinus drainage pathway synechia, healing problems or residual hypoesthesia. We propose a rapid, easy-to-perform, 5-step procedure called the transpalpebral approach which is indicated in case of sequestered disease within the lateral extent of the frontal sinus...
February 26, 2018: Clinical Otolaryngology
Pengfei Wu, Roberto Colasanti, Jungshun Lee, Alba Scerrati, Serdar Ercan, Jun Zhang, Mario Ammirati
BACKGROUND: Several far lateral approaches have been proposed to deal with cranio-vertebral junction (CVJ) tumors including the basic, transcondylar, and supracondylar far lateral approaches (B-FLA, T-FLA, and S-FLA). However, the indications on when to use one versus the other are not well systematized yet. Our purpose is to evaluate in an experimental cadaveric setting which approach is best suited to remove tumors of different sizes. METHODS: We implanted at the CVJ, using a transoral approach, tumor models of different sizes (five 1-cm3 and five 3-cm3 tumors) in ten embalmed cadaveric heads...
February 26, 2018: Acta Neurochirurgica
Melissa M Stamates, John M Lee, Ryan T Merrell, Michael J Shinners, Ricky H Wong
In the absence of significant extracranial disease, patients with solitary brain metastases have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon, and the only described skull base involvement is limited to the pituitary gland. We report the case of a 60-year-old female with endometrial cancer who presented with weeks of right cheek pain and numbness that was accompanied by headaches. We describe the magnetic resonance imaging (MRI) findings and surgical resection of a solitary endometrial metastasis involving the infratemporal fossa, middle fossa, cavernous sinus, trigeminal nerve, and nasal sinuses...
January 2018: Journal of Neurological Surgery Reports
Alvaro Campero, Juan F Villalonga, Ramiro Lopez Elizalde, Pablo Ajler
BACKGROUND: A critical step in the far lateral approach (FLA) is the exposure of V3 segment of the vertebral artery (VA), located in the depth of the suboccipital triangle (SOT). A safe exposure of the SOT is achieved by means of a plane-by-plane dissection, which carries the risk of devascularization. A suitable alternative is to lift a cutaneous muscle flap including the 3 first muscle planes, and leave the deepest plane (SOT) attached to the skull base. To achieve this, it is necessary to have superficial anatomic repairs to help us identify our cleavage site...
February 22, 2018: World Neurosurgery
I G Stanistreet, H Stollhofen, J K Njau, P Farrugia, M C Pante, F T Masao, R M Albert, M K Bamford
Archaeological excavations at the DK site in the eastern Olduvai Basin, Tanzania, age-bracketed between ∼1.88 Ma (Bed I Basalt) and ∼1.85 Ma (Tuff IB), record the oldest lahar inundation, modification, and preservation of a hominin "occupation" site yet identified. Our landscape approach reconstructs environments and processes at high resolution to explain the distribution and final preservation of archaeological materials at the DK site, where an early hominin (likely Homo habilis) assemblage of stone tools and bones, found close to hominin specimens OH24 and OH56, developed on an uneven heterogeneous surface that was rapidly inundated by a lahar and buried to a depth of 0...
March 2018: Journal of Human Evolution
Reshma Munbodh, Jonathan P S Knisely, David A Jaffray, Douglas J Moseley
PURPOSE: We present and evaluate a fully automated 2D-3D intensity-based registration framework using a single limited field-of-view (FOV) 2D kV radiograph and a 3D kV CBCT for 3D estimation of patient setup errors during brain radiotherapy. METHODS: We evaluated two similarity measures, the Pearson correlation coefficient on image intensity values (ICC) and maximum likelihood measure with Gaussian noise (MLG), derived from the statistics of transmission images...
February 22, 2018: Medical Physics
Paul J Plummer, Jan K Shearer, Katie E Kleinhenz, Leslie C Shearer
OBJECTIVE To determine the optimal anatomic site and directional aim of a penetrating captive bolt (PCB) for euthanasia of goats. SAMPLE 8 skulls from horned and polled goat cadavers and 10 anesthetized horned and polled goats scheduled to be euthanized at the end of a teaching laboratory. PROCEDURES Sagittal sections of cadaver skulls from 8 horned and polled goats were used to determine the ideal anatomic site and aiming of a PCB to maximize damage to the midbrain region of the brainstem for euthanasia. Anatomic sites for ideal placement and directional aiming were confirmed by use of 10 anesthetized horned and polled goats...
March 2018: American Journal of Veterinary Research
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
Priscilla Savopoulos, Annukka K Lindell
Over 100 years ago Lombroso [(1876/2006). Criminal man. Durham: Duke University Press] proposed a biological basis for criminality. Based on inspection of criminals' skulls he theorized that an imbalance of the cerebral hemispheres was amongst 18 distinguishing features of the criminal brain. Specifically, criminals were less lateralized than noncriminals. As the advent of neuroscientific techniques makes more fine-grained inspection of differences in brain structure and function possible, we review criminals' and noncriminals' structural, functional, and behavioural lateralization to evaluate the merits of Lombroso's thesis and investigate the evidence for the biological underpinning of criminal behaviour...
February 15, 2018: Laterality
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