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https://www.readbyqxmd.com/read/28623412/long-term-follow-up-after-endoscopic-trans-sphenoidal-surgery-or-initial-observation-in-clivus-chordomas
#1
Jon Ramm-Pettersen, Radek Frič, Jon Berg-Johnsen
BACKGROUND: Resection of clivus chordomas through extensive skull base approaches is associated with high mortality and morbidity even in experienced hands. We report our experience with endoscopic trans-sphenoidal surgery, or a "wait-and-scan" strategy in selected patients. METHOD: Ten patients were diagnosed with clivus chordomas during an 8-year period. Six patients underwent primary treatment with endoscopic trans-sphenoidal surgery, followed by adjuvant proton-beam therapy in three of these patients...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28615985/treatment-of-movement-disorders-with-focused-ultrasound
#2
REVIEW
Paul S Fishman, Victor Frenkel
Although the use of ultrasound as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists or neurologists are familiar with this technology. Stereotactic brain lesioning had been widely used as a treatment for medically refractory patients with essential tremor (ET), Parkinson disease (PD), and dystonia but has been largely replaced by deep brain stimulation (DBS) surgery, with advantages both in safety and efficacy. However, DBS is associated with complications including intracerebral hemorrhage, infection, and hardware malfunction...
2017: Journal of Central Nervous System Disease
https://www.readbyqxmd.com/read/28611936/large-transcalvarial-meningioma-surgical-resection-aided-by-preoperative-embolization
#3
Ali S Haider, Haris Rana, Lyndon K Lee, Mrigank S Shail, Dean Leonard, Umair Khan, Richa Thakur, Tijani Osumah, Sam Finn, Kennith F Layton
Meningiomas are the most common type of primary brain tumors, accounting for about 30% of all brain tumors. Meningiomas originate from the meninges and can be associated with any part of the skull. Classification of meningiomas is based upon the World Health Organization (WHO) classification system and prognosis of meningiomas can be determined via histologic grading. Surgery is the gold standard treatment option for all types of meningiomas. Due to the high vascularity of some meningiomas, surgical resection can lead to certain complications including intraoperative blood loss and hemorrhage...
May 8, 2017: Curēus
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#4
R Alex Harbison, Yangming Li, Angelique M Berens, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives  Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design  Case series. Setting  Tertiary academic center. Participants  A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures  Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#5
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28594934/effects-of-ppar%C3%AE-inhibition-in-head-and-neck-paraganglioma-cells
#6
Rosalba Florio, Laura De Lellis, Viviana di Giacomo, Maria Carmela Di Marcantonio, Loredana Cristiano, Mariangela Basile, Fabio Verginelli, Delfina Verzilli, Alessandra Ammazzalorso, Sampath Chandra Prasad, Amelia Cataldi, Mario Sanna, Annamaria Cimini, Renato Mariani-Costantini, Gabriella Mincione, Alessandro Cama
Head and neck paragangliomas (HNPGLs) are rare tumors that may cause important morbidity, because of their tendency to infiltrate the skull base. At present, surgery is the only therapeutic option, but radical removal may be difficult or impossible. Thus, effective targets and molecules for HNPGL treatment need to be identified. However, the lack of cellular models for this rare tumor hampers this task. PPARα receptor activation was reported in several tumors and this receptor appears to be a promising therapeutic target in different malignancies...
2017: PloS One
https://www.readbyqxmd.com/read/28593110/endoscopic-endonasal-transclival-approach-versus-dual-transorbital-port-technique-for-clip-application-to-the-posterior-circulation-a-cadaveric-anatomical-and-cerebral-circulation-simulation-study
#7
Jeremy N Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin Cetas, William Cameron
Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593108/nano-hemostats-and-a-pilot-study-of-their-use-in-a-large-animal-model-of-major-vessel-hemorrhage-in-endoscopic-skull-base-surgery
#8
Alistair Jukes, Jae Murphy, Sarah Vreugde, Alkis Psaltis, P J Wormald
Nano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28583236/complete-response-of-skull-base-inverted-papilloma-to-chemotherapy-case-report
#9
Edward C Kuan, John W Frederick, Miguel F Palma Diaz, Dean W Lim, Jeffrey D Suh
BACKGROUND: Inverted papilloma (IP) is the most common benign sinonasal neoplasm. Endoscopic techniques, improved understanding of pathophysiology, and novel surgical approaches have allowed rhinologists to treat IPs more effectively, with surgery being the mainstay of therapy. Frontal sinus IP poses a challenge for surgical therapy due to complex anatomy and potentially difficult surgical access. OBJECTIVES: We reported a unique case of a massive frontal sinus IP that presented with intracranial and orbital extension, with near resolution after chemotherapy...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28582956/endoscopic-endonasal-transsphenoidal-approach-from-the-surgeon-point-of-view
#10
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Dong-Jun Lim, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, YulGyun Kim, Sung Won Kim
OBJECTIVE: In February 2009, the authors' center formed a team of neurosurgeons, otolaryngologists, endocrinologists, and radiologists to perform pituitary surgery using the endoscopic endonasal transsphenoidal approach (EETSA). This paper reviews the authors' experience with the technique, pathological outcomes, hormone profiles, and postoperative complications. METHODS: Between February 2009 and December 2015, 535 patients underwent the EETSA with 2-nostrils/4-hands surgery...
June 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28580203/single-fraction-stereotactic-radiosurgery-for-retreatment-of-skull-base-recurrent-head-and-neck-malignancies
#11
Rajal A Patel, Derrick Lock, Thomas Kim, Sandeep Samant, James P Chandler, Bharat B Mittal, Tim J Kruser
INTRODUCTION: Recurrent head and neck carcinomas are notoriously difficult to treat. Salvage surgery, brachytherapy, and repeat external beam radiotherapy have all been utilized, achieving modest local control at the expense of elevated toxicity. We performed a retrospective review to evaluate the efficacy of single fraction stereotactic radiosurgery (SRS) for the treatment of recurrent head and neck carcinomas. METHODS: Eighteen previously irradiated patients diagnosed with a locoregionally recurrent head and neck malignancy and treated with single fraction SRS from 2000 to 2016 were analyzed...
May 1, 2017: Curēus
https://www.readbyqxmd.com/read/28579577/evaluation-of-venous-drainage-patterns-for-skull-base-meningioma-surgery
#12
Kazuhide Adachi, Mitsuhiro Hasegawa, Yuichi Hirose
The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications...
June 5, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28579489/a-novel-protocol-for-planning-and-navigation-in-craniofacial-surgery-a-preclinical-surgical-study
#13
Leonardo Franz, Miriam Isola, Daniele Bagatto, Ferdinando Calzolari, Luciana Travan, Massimo Robiony
PURPOSE: In modern craniofacial surgery, the accuracy of osteotomies plays a central role in surgical technique. To reach a higher level of accuracy, many centers use virtual presurgical planning. In the past decade, some surgeons also have applied navigational approaches to craniofacial procedures. In this work, a novel protocol for surgical planning and intraoperative navigation is described and validated in a preclinical setting to determine its accuracy in guiding osteotomies. MATERIALS AND METHODS: This study was based on planning a set of osteotomies using 3-dimensional models of computed tomographic images of human skulls...
May 10, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28578115/2d-hd-versus-3d-endoscopy-in-endonasal-skull-base-surgery-a-comparative-pre-clinical-study
#14
Vittorio Rampinelli, Francesco Doglietto, Davide Mattavelli, Jimmy Qiu, Elena Raffetti, Alberto Schreiber, Andrea Bolzoni Villaret, Walter Kucharczyk, Francesco Donato, Marco Maria Fontanella, Piero Nicolai
BACKGROUND: Three-dimensional (3D) endoscopy has been recently introduced in endonasal skull base surgery. Only a relatively limited number of studies have compared it to two-dimensional, high definition (2D-HD) technology. OBJECTIVE: To analyze, in a preclinical setting for endonasal endoscopic surgery, surgical maneuverability comparing 2D-HD and 3D endoscopy. METHODS: A group of 68 volunteers, both novice and experienced surgeons, were asked to perform two tasks, namely simulating grasping and dissection surgical maneuvers, in a model of the nasal cavities...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28578114/inside-vietnam-s-largest-neurosurgery-department
#15
Constantine L Karras, Huy Minh Tran, David Dornbos, Phong Nguyen, Shahid M Nimjee, Daniel M Prevedello, Ciarán J Powers
Cho Ray Hospital is the premier tertiary care center in Ho Chi Minh City, Vietnam's most populous city. The neurosurgical department was founded in 1958 and is currently one of the busiest in the world. Last year the department was responsible for over 10,000 neurosurgical operations, excluding neuroendovascular cases. Most of the elective cases are craniotomies for complex lesions such as aneurysms, AMV's, skull base tumors, gliomas and meningiomas. While the neurosurgeons within the department are technically gifted, doing more with less predominates as the mantra at Cho Ray Hospital...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28576543/pycnodysostosis-at-otorhinolaryngology
#16
Tekin Baglam, Adem Binnetoglu, Muhammet Fatih Topuz, Nilay Baş Ikizoglu, Refika Ersu, Serap Turan, Murat Sarı
AIM: Pycnodysostosis is a rare autosomal, recessive, skeletal dysplasia caused by a mutation in the cathepsin k gene. Pycnodysostosis is characterized by short stature, characteristic facial appearance (delayed closure of fontanelles and cranial sutures, mandibular hypoplasia and angle disorder, blue sclera), and acroosteolysis of the distal phalanges. Our aim was to describe the otorhinolaryngologic findings, differential diagnoses, various treatment options, and followup in eight cases of pycnodysostosis...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28574314/a-microcontroller-based-simulation-of-dural-venous-sinus-injury-for-neurosurgical-training
#17
Daniel R Cleary, Dominic A Siler, Nathaniel Whitney, Nathan R Selden
OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures...
June 2, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28566514/modelling-human-skull-growth-a-validated-computational-model
#18
Joseph Libby, Arsalan Marghoub, David Johnson, Roman H Khonsari, Michael J Fagan, Mehran Moazen
During the first year of life, the brain grows rapidly and the neurocranium increases to about 65% of its adult size. Our understanding of the relationship between the biomechanical forces, especially from the growing brain, the craniofacial soft tissue structures and the individual bone plates of the skull vault is still limited. This basic knowledge could help in the future planning of craniofacial surgical operations. The aim of this study was to develop a validated computational model of skull growth, based on the finite-element (FE) method, to help understand the biomechanics of skull growth...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28566140/computer-assisted-orthognathic-surgery-evaluation-of-mandible-registration-accuracy-and-report-of-the-first-clinical-cases-of-navigated-sagittal-split-ramus-osteotomy
#19
H Naujokat, M Rohnen, J Lichtenstein, F Birkenfeld, M Gerle, C Flörke, J Wiltfang
Intraoperative navigation is a helpful tool in complex anatomical regions or procedures. The mobility of the mandible in relation to the skull base limits the use of navigation tools on the lower jaw if the reference device is installed on the forehead. A new workflow that allows navigation-assisted sagittal split osteotomy in orthognathic surgery using a separate non-invasive mandibular registration technique has been developed. An evaluation of accuracy in different anatomical regions and with different registration techniques was performed on skull models and skulls with movable mandibles...
May 28, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28556486/endoscopic-video-assisted-transoral-resection-of-lateral-oropharyngeal-tumors
#20
Nilantha De Zoysa, Neeraj Sethi, Jemy Jose
Endoscopic, video-assisted transoral resection of oropharyngeal tumors is a novel technique carried out using common instruments present in most otolaryngology departments. The technique facilitates oropharyngeal resection akin to transoral robotic surgery (TORS) without the need for a robot. A dual surgeon approach, analogous to that of endoscopic skull base surgery is used. Each surgeon can actively participate in the resection with several key advantages over current techniques. The technique is applicable to departments internationally especially where the use of a robot is prohibited by cost or availability...
May 26, 2017: Head & Neck
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