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Base of skull surgery

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https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#1
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28816690/complications-of-the-middle-cranial-fossa-approach-for-acoustic-neuroma-removal
#2
Matthias Scheich, Christian Ginzkey, Desiree Ehrmann Müller, Wafaa Shehata Dieler, Rudolf Hagen
OBJECTIVE: To analyze postoperative complications after microsurgery for acoustic neuroma (AN) via the middle fossa approach (MFA). MATERIALS AND METHODS: In total, 203 consecutive patients of a tertiary skull base referral center at a university hospital were included in this retrospective chart and database analysis. All patients had undergone primary microsurgery at the Otorhinolaryngology department via MFA between December 2005 and October 2014. Postoperative complications were documented during the inpatient stay and outpatient follow-up...
August 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28808799/transorbital-endoscopic-approach-for-exposure-of-the-sylvian-fissure-middle-cerebral-artery-and-crural-cistern-an-anatomical-study
#3
João Paulo Almeida, Armando S Ruiz-Treviño, Sathwik R Shetty, Sacit B Omay, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The availability of minimal access instrumentation and endoscopic visualization has revolutionized the field of minimally invasive skull base surgery. The transorbital endoscopic approach using an eyelid incision has been proposed as a new minimally invasive technique for the treatment of skull base pathology, mostly extradural tumors. Our study aims to evaluate the anatomical aspects and potential role of the transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern...
August 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28807253/interdisciplinary-reconstruction-of-oncological-resections-at-the-skull-base-scalp-and-facial-region
#4
REVIEW
P M Vogt, T R Mett, G F Broelsch, C Radtke, N-C Gellrich, J K Krauss, M Samii, R Ipaktchi
Extensive bone and soft tissue defects of the skull require unique plastic and reconstructive techniques to avoid and optimize aesthetic appearance following oncological resections. Procedures are ideally planned in an interdisciplinary board composed of neurosurgery, otorhinolaryngology, plastic and reconstructive surgery to facilitate reconstructive procedures of soft tissue and bone as early as possible in one approach. Large resections may require plastic surgery involvement from the beginning. Herein, we describe the function of a multidisciplinary approach to complex oncologic resections of the cranial base, scalp, and facial regions for neuro-oncologic patients...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806981/understanding-the-potentiality-of-accelerator-based-boron-neutron-capture-therapy-for-osteosarcoma-dosimetry-assessment-based-on-the-reported-clinical-experience
#5
Silva Bortolussi, Ian Postuma, Nicoletta Protti, Lucas Provenzano, Cinzia Ferrari, Laura Cansolino, Paolo Dionigi, Olimpio Galasso, Giorgio Gasparini, Saverio Altieri, Shin-Ichi Miyatake, Sara J González
BACKGROUND: Osteosarcoma is the most frequent primary malignant bone tumour, and its incidence is higher in children and adolescents, for whom it represents more than 10% of solid cancers. Despite the introduction of adjuvant and neo-adjuvant chemotherapy that markedly increased the success rate in the treatment, aggressive surgery is still needed and a considerable percentage of patients do not survive due to recurrences or early metastases. Boron Neutron Capture Therapy (BNCT), an experimental radiotherapy, was investigated as a treatment that could allow a less aggressive surgery by killing infiltrated tumour cells in the surrounding healthy tissues...
August 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28799867/endoscope-assisted-repair-of-csf-otorrhea-and-temporal-lobe-encephaloceles-via-keyhole-craniotomy
#6
Pamela C Roehm, Derrick Tint, Norman Chan, Ryan Brewster, Vishad Sukul, Kadir Erkmen
OBJECTIVE Temporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. Standard middle fossa craniotomy exposes patients to dural retraction, which can lead to postoperative neurological complications. Endoscopic and minimally invasive techniques have been used in other surgeries to minimize brain retraction, and so these methods were applied to repair the lateral skull base...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28791194/a-case-report-of-surgical-management-of-hemangiopericytoma-at-the-foramen-magnum
#7
Nobuhiko Arai, Satoshi Takahashi, Hatano Mami, Yukina Tokuda, Kazunari Yoshida
BACKGROUND: Hemangiopericytoma (HPC) is a highly vascularized mesenchymal tumor known for its high rates of recurrence and metastasis. The extent of tumor removal is known to be the most trustful prognostic factor. Skull base HPCs are challenging to treat because of the difficulty of the surgical approach and proximity to vital vascular and neuronal structures. We successfully treated a case of HPC at the ventral foramen magnum through surgical gross tumor removal via a far-lateral transcondylar approach...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28768937/definitive-surgical-treatment-of-osteomalacia-induced-by-skull-base-tumor-and-determination-of-the-half-life-of-serum-fibroblast-growth-factor-23
#8
Taijun Hana, Shota Tanaka, Hirofumi Nakatomi, Masaaki Shojima, Seiji Fukumoto, Masako Ikemura, Nobuhito Saito
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome often associated with fibroblast growth factor 23 (FGF23)-producing tumors such as phosphaturic mesenchymal tumor, mixed connective tissue variant (PMTMCT) affecting the bone and soft tissue. We experienced a patient with progressive bone and muscle pain due to FGF23-related TIO. Venous sampling had strongly suggested the anterior skull base as a source of FGF23, which led to the discovery of a small tumor in the ethmoid sinus extending intracranially...
August 2, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28766024/usefulness-of-intraoperative-electromyographic-monitoring-of-oculomotor-and-abducens-nerves-during-skull-base-surgery
#9
Zi-Yi Li, Ming-Chu Li, Jian-Tao Liang, Yu-Hai Bao, Ge Chen, Hong-Chuan Guo, Feng Ling
BACKGROUND: Intraoperative neurophysiologic monitoring of the extraocular cranial nerve (EOCN) is not commonly performed because of technical difficulty and risk, reliability of the result and predictability of the postoperative function of the EOCN. METHODS: We performed oculomotor nerve (CN III) and abducens nerve (CN VI) intraoperative monitoring in patients with skull base surgery by recording the spontaneous muscle activity (SMA) and compound muscle action potential (CMAP)...
August 2, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28765065/reconstructive-outcome-of-intraoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-surgery-for-tumors-involving-skull-base
#10
Chi-Man Jeon, Sang Duk Hong, Ho Jun Seol, Jung-Il Lee, Do-Hyun Nam, Yoon Jung Hwang, Doo-Sik Kong
Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28764208/assessing-the-viability-of-hadad-flap-by-postoperative-contrast-enhanced-magnetic-resonance-imaging
#11
Hegde Jyotirmay, Sunil Kumar Saxena, A S Ramesh, K Nagarajan, Shreshta Bhat
INTRODUCTION: The Expanded Endonasal Approaches (EEAs) have been widely used for various skull base lesions. The reconstruction of the skull base defects is of vital importance to prevent postoperative complications. The vascular pedicled-nasoseptal flap (Hadad-Bassagasteguy flap) is used as a workhorse in reconstruction of majority of the defects. AIM: The purpose of this study was: (a) To assess the postoperative MRI appearance of vascularised pedicled nasoseptal flap for its viability; (b) To determine the variations in MRI that may suggest potential flap failure...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761532/skull-base-bony-lesions-management-nuances-a-retrospective-analysis-from-a-tertiary-care-centre
#12
Amit Kumar Singh, Arun Kumar Srivastava, Jayesh Sardhara, Kamlesh Singh Bhaisora, Kuntal Kanti Das, Anant Mehrotra, Rabi Narayan Sahu, Awadhesh Kumar Jaiswal, Sanjay Behari
BACKGROUND: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability in the involvement of important local structure. Through this retrospective analysis from a Tertiary Care Centre, we are summarizing the details of skull base bony lesions and its management nuances...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761516/surgical-management-of-giant-skull-osteomas
#13
Farid Yudoyono, Roland Sidabutar, Rully Hanafi Dahlan, Arwinder Singh Gill, Sevline Estethia Ompusunggu, Muhammad Zafrullah Arifin
OBJECTIVE: Surgical management of giant skull osteomas Osteomas are benign, generally slow growing, bone forming tumors limited to the craniofacial and jaw bones. MATERIALS AND METHODS: A retrospective review of all cases of osteoma diagnosed from 2009 to 2013 treated in our hospital. The data collected included age at diagnosis, gender, lesion location, size, presenting and duration of symptoms, treatment, complication and outcome. RESULTS: During our study period there were 15 cases that were treated surgically...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761512/surgical-treatment-of-large-and-giant-cavernous-carotid-aneurysms
#14
REVIEW
Kitiporn Sriamornrattanakul, Ittichai Sakarunchai, Kei Yamashiro, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Yoko Kato
Cavernous carotid aneurysms (CCAs) are uncommon pathologic entities. Extradural place and the skull base location make this type of an aneurysm different in clinical features and treatment techniques. Direct aneurysm clipping is technically difficult and results in a significant postoperative neurological deficit. Therefore, several techniques of indirect surgical treatment were developed with different surgical outcomes, such as proximal occlusion of internal carotid artery (ICA) or trapping with or without bypass (superficial temporal artery-middle cerebral artery bypass or high-flow bypass)...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28758410/current-and-emerging-principles-in-surgery-for-meningioma
#15
Wenya Linda Bi, Ian F Dunn
Surgery continues to be the preferred method to treat meningioma. Recent advancements in the understanding of meningioma biology, including a new appreciation for remarkable molecular heterogeneity in these tumors, has sharpened the drive for disease control, especially on initial diagnosis. Microsurgical and skull base techniques and principles dominate the surgical approaches for meningiomas. At the same time, biologic tools may improve the extent of surgical resection as well as provide novel adjuvant therapy options for challenging meningiomas...
July 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28758183/neuronavigation-guided-endoscopic-endonasal-excision-of-schwannoma-like-chordoma-of-the-meckel-s-cave-a-case-report
#16
Ali Akay, Sercan Göde, M Sedat Çağli
Chordomas are locally aggressive malignant tumors due to their recurrence potential, originating from the embryonic notochord remnants. Chordomas can originate anywhere on the axial skeleton. They are extradural and are spread by bone destruction. Chordomas are locally aggressive tumors which invade the dura mater, and may also present with secondary intradural growth. The Meckel's cave location of chordomas has been very rarely reported in the literature. Chordomas located in the Meckel's cave can be radiologically confused with trigeminal schwannomas...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28757702/clinical-characteristics-of-crouzon-syndrome
#17
L Balyen, L S Deniz Balyen, S Pasa
Crouzon syndrome (CS) is an genetic disorder with autosomal dominant inheritance caused by mutation of the gene for fibroblast growth factor receptor 2 (FGFR2) was described as one of the varieties of craniosynostosis. In this presented case, premature closure of the sutures had caused restricted skull growth and lack of space for the growing brain resulted to shallowed eyes and cranial and ophthalmic deformities and impairment in tooth development. Management of a patient of CS has two components. First is the release of prematurely fused sutures based on evidence of raised intracranial pressure...
May 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28754434/improved-method-for-cannula-fixation-for-long-term-intracerebral-brain-infusion
#18
Ádám Sike, Jonas Wengenroth, Jolanta Upīte, Thomas Brüning, Iván Eiriz, Petra Sántha, Henrik Biverstål, Baiba Jansone, Håvard Jostein Haugen, Markus Krohn, Jens Pahnke
BACKGROUND: Implanted osmotic minipumps are commonly used for long-term, brain-targeted delivery of a wide range of experimental agents by being connected to a catheter and a cannula. During the stereotactical surgery procedure, the cannula has to be placed correctly in the x-y directions and also with respect to the injection point in the z-direction (deepness). However, the flat fixation base of available cannula holders doesn't allow an easy, secure fixation onto the curve-shaped skull...
July 25, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28751167/volume-staged-gamma-knife-surgery-for-the-treatment-of-large-skull-base-meningioma-surrounding-the-optical-apparatus-a-snowman-shape-design
#19
Chain-Fa Su, Dai-Wei Liu, Cheng-Chia Lee, Tsung-Lang Chiu
BACKGROUND: In cases of meningioma surrounding the optical apparatus, this study sought to reduce the incidence of radiation-induced optical neuropathy resulting from gamma knife surgery (GKS) by dividing the treatment volume into 2 or 3 fractions. METHODS: Four patients with a large skull base meningioma (1 male and 3 females; median age: 42 years; range: 33-43 yrs) were treated using volume-staged GKS. In stage I, the large basal part of the tumor (13.2 mL; range: 3...
July 24, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28748855/clinical-characteristics-and-endoscopic-endonasal-removal-of-foreign-bodies-within-sinuses-orbit-and-skull-base
#20
Yi-Hui Wen, Wei-Jian Hou, Wen-Bin Lei, Feng-Hong Chen, Xiao-Lin Zhu, Zhang-Feng Wang, Ren-Qiang Ma, Wei-Ping Wen
BACKGROUND: Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS. METHODS: We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center...
August 5, 2017: Chinese Medical Journal
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