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Lateral skull base

Cameron C Wick, Daniel E Killeen, Michael Clark, Joe Walter Kutz, Brandon Isaacson
OBJECTIVE: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa. STUDY DESIGN: Retrospective case review. SETTING: Tertiary university hospital. PATIENTS: Adult patients from 2005 to 2015 who underwent surgical repair of a spontaneous lateral skull base CSF leak with intraoperative confirmation of a posterior fossa leak source...
October 14, 2016: Otology & Neurotology
Rolfe M Radcliffe, Yasmine Messiaen, Nita L Irby, Thomas J Divers, Curtis W Dewey, Katharyn J Mitchell, Lauren V Schnabel, Abraham J Bezuidenhout, Peter V Scrivani, Norm G Ducharme
OBJECTIVE: To report a transnasal, endoscopically guided ventral surgical approach for accessing the cranial and caudal segments of the sphenopalatine sinus for mass removal in a horse. STUDY DESIGN: Case report. ANIMAL: Adult horse with acute onset blindness referable to a soft tissue mass within the sphenopalatine sinus. CLINICAL REPORT: A 7-year-old Warmblood gelding presented with a history of running into a fence and falling...
October 12, 2016: Veterinary Surgery: VS
Daniele Starnoni, Roy Thomas Daniel, Mercy George, Mahmoud Messerer
BACKGROUND: Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare entities and their peculiar location represent a surgical challenge due to the importance of a wide exposure and skull base reconstruction. They are thought to arise from congenital base defect of the lateral sphenoid or in some cases have been postulated to represent a rare manifestation of altered CSF dynamics. We report the first case in literature of a Chiari malformation type I and a lateral sphenoid encephaloceles revising the theoretical etiology and surgical technique of endoscopic repair...
October 8, 2016: World Neurosurgery
Joseph Frankl, Cassi Grotepas, Baldassare Stea, G Michael Lemole, Alexander Chiu, Rihan Khan
BACKGROUND: Chordoma is a rare invasive bone tumor that may occur anywhere along the neuraxis. A total of three primary histological varieties have been identified: conventional, chondroid, and dedifferentiated. CASE PRESENTATION: We report a case of an 8-year-old white girl who presented with conventional chordoma, was treated with surgical resection and mixed proton and photon beam therapy, and had a recurrence in the resection cavity 2.5 years later with dedifferentiated morphology...
October 12, 2016: Journal of Medical Case Reports
Yi Wang, Yi Deng, Zhi Li, Xu Li, Chen-Yuan Zhang, Zhen Jin, Ming-Xia Fan, Michael T Compton, Eric F C Cheung, Kelvin O Lim, Raymond C K Chan
Minor physical anomalies (MPAs) are subtle signs of fetal developmental abnormalities that have been considered to be among the most replicated risk markers for schizophrenia-spectrum disorders. However, quantitative approaches are needed to measure craniofacial MPAs. The present study adopted an imaging-based quantitative approach to examine craniofacial MPAs across the spectrum of schizophrenia and affective disorders, to address their sensitivity and specificity. We sampled 31 patients with schizophrenia, 30 of their unaffected relatives, and 30 individuals with schizotypal personality traits, as well as 37 non-schizotypal controls...
October 8, 2016: PsyCh Journal
Xin Wang, Falk Poenisch, Narayan Sahoo, Ronald X Zhu, MingFwu Lii, Michael T Gillin, Jing Li, David Grosshans
This is a real case study to minimize the neutron dose equivalent (H) to a fetus using spot scanning proton beams with favorable beam energies and angles. Minimum neutron dose exposure to the fetus was achieved with iterative planning under the guidance of neutron H measurement. Two highly conformal treatment plans, each with three spot scanning beams, were planned to treat a 25-year-old pregnant female with aggressive recurrent chordoma of the base of skull who elected not to proceed with termination. Each plan was scheduled for delivery every other day for robust target coverage...
2016: Journal of Applied Clinical Medical Physics
Julia E Noel, Caroline C Jeffery, Edward Damrose
OBJECTIVE: Imaging plays a critical role in the evaluation of patients presenting with unilateral vocal fold paresis or paralysis of unknown etiology. In those with idiopathic unilateral vocal fold paralysis (iUVFP), there is no consensus regarding the need or timing of repeat imaging. This study seeks to establish the rate of delayed detection of alternate etiologies for these patients to determine if and when imaging should be repeated. METHODS: Retrospective chart review was conducted identifying patients at our institution with vocal fold movement impairment between 1998 and 2014...
September 26, 2016: Annals of Otology, Rhinology, and Laryngology
Hiroto Ichishima
A cribriform plate, a perpendicular plate, and two lateral masses are major components of the ethmoid bone of mammals. Notwithstanding the noticeable bone, virtually sitting in the center of the skull, extensive modifications of the skull of modern cetaceans, especially odontocetes (toothed whales), and the lack of clarity as to what characteristics delimit each element of the ethmoid has made the problem of the nature of the cetacean ethmoid more complicated and elusive than in other, less modified mammals...
September 19, 2016: Journal of Morphology
Serdar Ercan, Alba Scerrati, Phengfei Wu, Jun Zhang, Mario Ammirati
OBJECTIVE The subtemporal approach is one of the surgical routes used to reach the interpeduncular fossa. Keyhole subtemporal approaches and zygomatic arch osteotomy have been proposed in an effort to decrease the amount of temporal lobe retraction. However, the effects of these modified subtemporal approaches on temporal lobe retraction have never been objectively validated. METHODS A keyhole and a classic subtemporal craniotomy were executed in 4 fresh-frozen silicone-injected cadaver heads. The target was defined as the area bordered by the superior cerebellar artery, the anterior clinoid process, supraclinoid internal carotid artery, and the posterior cerebral artery...
September 16, 2016: Journal of Neurosurgery
Charlotta Kämpfe Nordström, Göran Laurell, Helge Rask-Andersen
HYPOTHESIS: The human vestibular aqueduct (VA) shows great anatomical variations, and imaging can be difficult, so we need more data on the normal anatomy of the VA for better radiologic evaluation of large vestibular aqueduct syndrome (LVAS). BACKGROUND: The normal anatomy of the human VA was analyzed in micro-dissected human temporal bones. METHODS: The study is based on two sets of human temporal bones. One set of 32 human temporal bones was selected from a collection of 50 micro-dissected specimens...
September 14, 2016: Otology & Neurotology
Rick F Nelson, Joseph P Roche, Bruce J Gantz, Marlan R Hansen
OBJECTIVE: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial. STUDY DESIGN: Retrospective review from 2003 to 2015. SETTING: University of Iowa Hospitals and Clinics and Indiana University Health Center. PATIENTS: Those with a confirmed lateral skull base spontaneous CSF leaks and/or encephaloceles...
September 14, 2016: Otology & Neurotology
Saleem I Abdulrauf, Ahmed M Ashour, Eric Marvin, Jeroen Coppens, Brian Kang, Tze Yu Yeh Hsieh, Breno Nery, Juan R Penanes, Aysha K Alsahlawi, Shawn Moore, Hussam Abou Al-Shaar, Joanna Kemp, Kanika Chawla, Nanthiya Sujijantarat, Alaa Najeeb, Nadeem Parkar, Vilaas Shetty, Tina Vafaie, Jastin Antisdel, Tony A Mikulec, Randall Edgell, Jonathan Lebovitz, Matt Pierson, Paulo Henrique Pires de Aguiar, Paula Buchanan, Angela Di Cosola, George Stevens
INTRODUCTION: Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system. MATERIALS AND METHODS: We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography...
July 2016: Journal of Craniovertebral Junction and Spine
Debasis Sahoo, Cyril Robbe, Caroline Deck, Frank Meyer, Alexandre Papy, Remy Willinger
The main objective of this study is to develop a methodology to assess this risk based on experimental tests versus numerical predictive head injury simulations. A total of 16 non-lethal projectiles (NLP) impacts were conducted with rigid force plate at three different ranges of impact velocity (120, 72 and 55m/s) and the force/deformation-time data were used for the validation of finite element (FE) NLP. A good accordance between experimental and simulation data were obtained during validation of FE NLP with high correlation value (>0...
September 3, 2016: Injury
Haruka Miyabe, Atsuhiko Uno, Takahiro Nakajima, Natsue Morizane, Keisuke Enomoto, Masayuki Hirose, Toshinori Hazama, Yukinori Takenaka
Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction...
2016: Case Reports in Otolaryngology
Giannicola Iannella, Alessandra Manno, Emanuela Pasqualitto, Andrea Ciofalo, Diletta Angeletti, Benedetta Pasquariello, Giuseppe Magliulo
Cerebrospinal fluid (CSF) leakage of the temporal bone region is defined as abnormal communications between the subarachnoidal space and the air-containing spaces of the temporal bone. CSF leak remains one of the most frequent complications after VS surgery. Radiotherapy is considered a predisposing factor for development of temporal bone CSF leak because it may impair dural repair mechanisms, thus causing inadequate dural sealing. The authors describe the case of a 47-year-old man with a massive effusion of CSF which extended from the posterior and lateral skull base to the first cervical vertebrae; this complication appeared after a partial enucleation of a vestibular schwannoma (VS) with subsequent radiation treatment and second operation with total VS resection...
2016: Case Reports in Otolaryngology
Sumit Singh, Curtis Qin, Srikanth Medarametla, Shilpa V Hegde
We report a 14-month-old male with craniometaphyseal dysplasia (CMD). The patient presented with a history of diminishing vision and hearing loss. Cranial computed tomography scan showed diffuse calvarial and skull base hyperostosis with excessive bone narrowing the internal auditory canals and skull base foramina. A subsequent skeletal survey revealed other skeletal abnormalities, which led to the diagnosis of CMD. This was later confirmed by ANKH mutation. CMD is a rare genetic disorder that belongs to the group of craniotubular bone dysplasias...
September 2016: Radiology case reports
Markus Pirlich, Mary Tittmann, Daniela Franz, Andreas Dietz, Mathias Hofer
"CI-Wizard" is a new, three-dimensional software planning tool for cochlear implant surgery with manual and semi-automatic algorithms to visualize anatomical risk structures of the lateral skull base preoperatively. Primary endpoints of the study represented the evaluation of the CI-Wizards usability, accuracy, subjectively perceived and objectively measured time in clinical practice. In a period from January 2014 to March 2015, n = 36 participants were included in this study. These members were divided into three groups of equal number (n = 12), but different level of experience...
September 2, 2016: European Archives of Oto-rhino-laryngology
Noritaka Komune, Satoshi Matsuo, Koichi Miki, Albert L Rhoton
OBJECTIVE The application of the endoscope in the lateral skull base increases the importance of the middle ear cavity as the corridor to the skull base. The aim of this study was to define the middle ear as a route to the fundus (lateral end) of the internal acoustic canal and to propose feasible landmarks to the fundus. METHODS This was a cadaveric study; 34 adult cadaveric temporal bones and 2 dry bones were dissected with the aid of the endoscope and microscope to show the anatomy of the transcanal approach to the middle ear and fundus of the internal acoustic canal...
September 2, 2016: Journal of Neurosurgery
Jia Xu, Haijin Yi, Xin Li, Wenjing Chen, Jinkun Xu
OBJECTIVE: To investigate the surgical treatment and related experience of lateral skull base lesions. METHODS: In a retrospective, clinical data analysis of 20 patients with lateral skull base diseases, 11 cases with temporal bone space-occupying lesions and intracranial invasion were treated by translabyrinthine surgery, mastoid cavity drainage, or transmastoid surgery to remove the lesion; two cases of cholesteatoma with destruction of tympanic cavity and tympanic sinus canopy with intracranial invasion were treated by extended radical mastoidectomy; seven cases with lateral skull base bone destruction with cerebrospinal fluid otorrhea caused by trauma and deformity were treated by translabyrinth and transmastoid repair...
August 31, 2016: Acta Oto-laryngologica
A Samy Youssef, Raghuram Sampath, Jacob L Freeman, Jameson K Mattingly, Vijay R Ramakrishnan
BACKGROUND: Loss of olfaction has been considered inevitable in endoscopic endonasal resection of olfactory groove meningiomas. Olfaction preservation may be feasible through an endonasal unilateral transcribriform approach, with the option for expansion using septal transposition and contralateral preservation of the olfactory apparatus. METHODS: An expanded unilateral endonasal transcribriform approach with septal transposition was performed in five cadaver heads...
October 2016: Acta Neurochirurgica
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