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endoscopic endonasal

Gokmen Kahilogullari, Fatih Yakar, Eyup Bayatli, Esra Erden, Cem Meco, Agahan Unlu
INTRODUCTION: Dermoid cysts (DCs) are unusual benign congenital intracranial tumors that typicallyarise in the midline and form as a result of abnormal sequestration of ectodermal cells during neural tubeformation. In all age groups, endoscopic approaches are preferable for the removal of sellar lesions. A 6-year-old girl with recurrent meningitis underwent endoscopic endonasal surgery forsellar DC. CONCLUSION: To the best of our knowledge, we present the first case of a suprasellar DC in a pediatric patient that was removed endoscopically...
March 20, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mathew Geltzeiler, Ana Carolina Igami Nakassa, Meghan Turner, Pradeep Setty, George Zenonos, Andrea Hebert, Eric Wang, Juan Fernandez-Miranda, Carl Snyderman, Paul Gardner
BACKGROUND: Vascularized intranasal flaps are the primary reconstructive option for endoscopic skull base defects. Flap vascularity may be compromised by injury to the pedicle or prior endonasal surgery. There is currently no validated technique for intraoperative evaluation of intranasal flap viability. OBJECTIVE: To evaluate the efficacy of indocyanine green (ICG) near-infrared angiography in predicting the viability of pedicled intranasal flaps during endoscopic skull base surgery through a pilot study...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Francisco Vaz-Guimaraes, Maria Koutourousiou, John R de Almeida, Elizabeth C Tyler-Kabara, Juan C Fernandez-Miranda, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE Epidermoid and dermoid cysts may be found along the cranial base and are commonly resected via open transcranial approaches. The use of endoscopic endonasal approaches for resection of these tumors has been rarely reported. METHODS The authors retrospectively reviewed the medical records of 21 patients who underwent endoscopic endonasal surgery for epidermoid and dermoid cyst resection at the University of Pittsburgh Medical Center between January 2005 and June 2014. Surgical outcomes and variables that might affect the extent of resection and complications were analyzed...
March 16, 2018: Journal of Neurosurgery
Douglas A Hardesty, Daniel M Prevedello
No abstract text is available yet for this article.
March 15, 2018: Journal of Neurosurgical Sciences
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
Teishiki Shibata, Motoki Tanikawa, Tomohiro Sakata, Mitsuhito Mase
Craniopharyngiomas are benign tumors and account for approximately 5.6-13% of all intracranial tumors in children. Diagnosis of pediatric craniopharyngioma is often delayed until the tumor becomes relatively large and manifests severe visual and/or endocrine disturbance. Endoscopic endonasal approaches have recently been introduced to surgery for craniopharyngioma. These techniques, however, have rarely been utilized in patients affected with craniopharyngioma as young as 1 year old. This report documents a 12-month-old male infant with sellar craniopharyngioma who presented with acute total vision loss...
March 14, 2018: Pediatric Neurosurgery
David T Fernandes Cabral, Georgios A Zenonos, Maximiliano Nuñez, Pinar Celtikci, Carl Snyderman, Eric Wang, Paul A Gardner, Juan C Fernandez-Miranda
BACKGROUND: The endoscopic endonasal approach (EEA) has been proposed as a potential alternative for ventral brainstem lesions. The surgical anatomy, feasibility, and limitations of the EEA for intrinsic brainstem lesions are still poorly understood. OBJECTIVE: To describe the surgical planning, anatomy, and technique of an intrinsic pontine glioma operated via EEA. METHODS: Six-human brainstems were prepared for white matter microdissection...
March 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
Alexandre Bossi Todeschini, Alaa S Montaser, Douglas A Hardesty, Ricardo L Carrau, Daniel M Prevedello
Endoscopic endonasal approaches (EEA) have gained popularity and acceptance in skull base surgery over the last two decades. So-called expanded EEA allow access in the sagittal plane from the frontal sinus to the odontoid process. The endoscopic endonasal transclival approach allows a unique trajectory into the midline clivus and skull base that is unachievable from traditional craniotomy approaches to lesions such as chondrosarcomas, chordomas, and posterior fossa meningiomas. In this review, we will assess the benefits and drawbacks to using an endoscopic endonasal approach versus transcranial approach to these challenging lesions, assess the anatomical limits of endoscopic endonasal transclival surgery, and discuss the published literature on the topic...
March 8, 2018: Journal of Neurosurgical Sciences
Srikant Chakravarthi, Alejandro Monroy-Sosa, Lior Gonen, Melanie Fukui, Richard Rovin, Nathaniel Kojis, Mark Lindsay, Sammy Khalili, Juanita Celix, Martin Corsten, Amin Kassam
Endoscopic endonasal access to the jugular foramen and occipital condyle-the transcondylar- transtubercular approach-is anatomically complex and requires detailed knowledge of the relative position of critical neurovascular structures, in order to avoid inadvertent injury and resultant complications. However, access to this region can be confusing as the orientation and relationships of osseous, vascular, and neural structures are very much different from traditional dorsal approaches. This review aims at providing an organizational construct for a more understandable framework in accessing the transcondylar-transtubercular window...
March 8, 2018: Journal of Neurosurgical Sciences
Fumihiko Nishimura, Young-Su Park, Yasushi Motoyama, Ichiro Nakagawa, Shuichi Yamada, Hiroyuki Nakase
BACKGROUND: Xanthomatous pituitary diseases rarely occur in childhood. We report a rare pediatric case of a xanthogranuloma that developed in the sellar region resulting in visual disturbance that was successfully treated by endoscopic endonasal surgery. CASE DESCRIPTIONS: A 13-year-old boy came to us with a headache and visual disturbance that had occurred 1 month prior. Clinical examination findings showed that he was alert with signs of bitemporal hemianopsia, an endocrinological examination showed partial hypopituitarism, and brain magnetic resonance imaging (MRI) revealed a cystic mass in the sellar turcica compressing the optic apparatus...
March 7, 2018: World Neurosurgery
Kyung Hwan Kim, Yong Hwy Kim, Yun-Sik Dho, Jung Hee Kim, Sang Duk Hong, Jung Won Choi, Ho Jun Seol, Do-Hyun Nam, Jung-Il Lee, Chul-Kee Park, Doo-Sik Kong
OBJECTIVE: Despite advances in endoscopic techniques, retrochiasmatic craniopharyngiomas are difficult to remove completely, because the low-lying optic chiasm often provides an obstacle to endoscopic endonasal approach. This study aimed to identify the endoscopic surgical outcomes of the retrochiasmatic CP and resolve the issues related to the low-lying optic chiasm. METHODS: The authors reviewed 154 consecutive patients with craniopharyngioma who underwent endonasal endoscopic resection from February 2009 to April 2017 at two independent institutions...
March 7, 2018: World Neurosurgery
Yang Ji-Hu, Huang Guo-Dong, Ji Tao, Wang Hai-Dong, Liu Yu-Fei, Guo Jian, Li Zhen, Li Wei-Ping
OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas(IPA). METHODS: A retrospective analysis of the clinical data of 74 patients(75 procedures) with invasive pituitary adenomas treated by different endoscopic endonasal approaches at the Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis and complications in different Knosp classifications and Hardy stages...
March 7, 2018: World Neurosurgery
Bin Tang, Limin Xiao, Shenhao Xie, Guanlin Huang, Zhigang Wang, Dongwei Zhou, Erming Zeng, Tao Hong
OBJECTIVES: Removal of recurrent or residual symptomatic craniopharyngiomas is more challenging than the primary surgery. The extended endoscopic endonasal (EEE) approach has been proposed an alternative surgical route for removal of various suprasellar tumors including craniopharyngiomas currently. In this study, we summarized the operative experience and described the feasibility and advantages of this technique in recurrent or residual symptomatic craniopharyngiomas. PATIENTS AND METHODS: A retrospective review of 15 patients (9 males and 6 females) whom underwent EEE approach between April 2012 and February 2017, were included in this study...
February 6, 2018: Clinical Neurology and Neurosurgery
Kevin J Choi, David W Jang, Ralph Abi Hachem
No abstract text is available yet for this article.
2018: International Ophthalmology Clinics
Rodrigo Fernandez-Gajardo, Joao Paulo Almeida, Suganth Suppiah, Ian Witterick, Gelareh Zadeh
BACKGROUND: Skull base meningoencephaloceles are a rare condition, frequently secondary to traumatic or iatrogenic causes. Cerebrofacial arteriovenous metameric syndrome (CAMS) is characterized by the presence of retinal, facial and cerebral arteriovenous malformations (AVMs) with metameric distribution. To the best of our knowledge, this is the first reported case associating these two conditions. CASE DESCRIPTION: A 45 years old female previously diagnosed with CAMS type 2 presented with a long history of cerebrospinal fluid (CSF) rhinorrhea...
March 3, 2018: World Neurosurgery
Stefan Linsler, David Breuskin, Thomas Tschernig, Joachim Oertel
INTRODUCTION: The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sellar and parasellar region. METHODS: A mononostril and binostril approach to the sellar region was performed on 4 formalin-fixed cadaveric heads. Predefined anatomical structures were identified. Additionally, a millimeter gauge was introduced into the surgical site and the extent of dorsal septectomy was analyzed for both approaches...
February 28, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Walid I Essayed, Prashin Unadkat, Ahmed Hosny, Sarah Frisken, Marcio S Rassi, Srinivasan Mukundan, James C Weaver, Ossama Al-Mefty, Alexandra J Golby, Ian F Dunn
OBJECTIVE Endoscopic endonasal approaches are increasingly performed for the surgical treatment of multiple skull base pathologies. Preventing postoperative CSF leaks remains a major challenge, particularly in extended approaches. In this study, the authors assessed the potential use of modern multimaterial 3D printing and neuronavigation to help model these extended defects and develop specifically tailored prostheses for reconstructive purposes. METHODS Extended endoscopic endonasal skull base approaches were performed on 3 human cadaveric heads...
March 2, 2018: Journal of Neurosurgery
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
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