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Anterior Skull Base

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https://www.readbyqxmd.com/read/28093693/a-simple-post-mortem-room-angiography-method-for-the-investigation-of-traumatic-basal-subarachnoid-hemorrhage
#1
Christopher P Johnson, Mike Murphy, George A Johnson, Stephen M Wills, Jonathan E Medcalf
Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room...
January 17, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28092970/surgery-of-anterior-skull-base-lesions-in-children
#2
Thomas Karl Hoffmann, Marc Oliver Scheithauer, Fabian Sommer, Jörg Lindemann, Ernst-Johannes Haberl, Ulrike Friebe-Hoffmann, Marie-Nicole Theodoraki
INTRODUCTION: Lesions affecting the anterior skull base represent a rare group of craniofacial pathologies. A tumor of the facial midline, meningitis, or rhinoliquorrhea may be indicative of malformations like dermoid cysts, gliomas, encephaloceles, or nasal fistulas. METHODS: We present a case series of 13 children (4 months to 12 years; 8 males, 5 females) with lesions involving the anterior skull base, which were treated surgically in an interdisciplinary setting...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28042017/-the-extended-lateral-supraorbital-approach-and-extradural-anterior-clinoidectomy-through-a-fronto-pterio-orbital-window-technical-note-and-pilot-surgical-series
#3
Hugo Andrade-Barazarte, Max Jägersberg, Sirajeddin Belkhair, Rachel Tymianski, Mazda K Turel, Karl Schaller, Juha A Hernesniemi, Michael Tymianski, Ivan Radovanovic
BACKGROUND: Lateral approaches to treat anterior cranial fossa lesions have evolved since the first frontotemporal approach described by Dandy in 1918 OBJECTIVE: To describe a less invasive approach to perform an extradural anterior clinoidectomy (EAC) through a lateral supraorbital approach (LSO) for anterior circulation aneurysms and antero-lateral skull base lesions METHODS: The extended LSO involves performing a standard lateral supraorbital craniotomy, followed by drilling of the sphenoid wing and the lateral wall of the orbit through the frontal bony opening of the LSO without any temporal extension of the craniotomy...
December 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28038480/intracranial-ameloblastoma-arising-from-the-maxilla-an-interdisciplinary-surgical-approach
#4
Johanna Quick-Weller, Felix Koch, Nazife Dinc, Stephanie Lescher, Peter Baumgarten, Patrick Harter, Friedrich Scheerer, Robert Sader, Volker Seifert, Gerhard Marquardt, Thomas Freiman
Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#5
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28011374/robust-cranial-cavity-segmentation-in-ct-and-ct-perfusion-images-of-trauma-and-suspected-stroke-patients
#6
Ajay Patel, Bram van Ginneken, Frederick J A Meijer, Ewoud J van Dijk, Mathias Prokop, Rashindra Manniesing
A robust and accurate method is presented for the segmentation of the cranial cavity in computed tomography (CT) and CT perfusion (CTP) images. The method consists of multi-atlas registration with label fusion followed by a geodesic active contour levelset refinement of the segmentation. Pre-registration atlas selection based on differences in anterior skull anatomy reduces computation time whilst optimising performance. The method was evaluated on a large clinical dataset of 573 acute stroke and trauma patients that received a CT or CTP in our hospital in the period February 2015-December 2015...
December 13, 2016: Medical Image Analysis
https://www.readbyqxmd.com/read/27977492/analysis-of-anatomical-characteristics-and-morphometric-aspects-of-infraorbital-and-accessory-infraorbital-foramina
#7
Paulo Antônio Martins-Júnior, Cristiano Pereira Rodrigues, Marilda Luz de Andrade De Maria, Larissa Matias Nogueira, Janice Henriques da Silva, Micena Roberta Miranda Alves E Silva
OBJECTIVE: This study aimed to perform a morphological and morphometric study of the characteristics of the infraorbital foramen (IOF) and accessory infraorbital foramen (AIOF) in Brazilian skulls. METHODS: A sample calculation determined a total of 94 human skulls to be evaluated by a trained examiner for number, shape, diameters, and location of IOF in relation to anatomical landmarks. Number, size, shape, diameters, location, orientation, position, and distances in relation to anatomical landmarks were evaluated for the AIOF...
December 13, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27975017/endoscopic-adipofascial-radial-forearm-flap-reconstruction-of-a-clival-defect
#8
Trevor G Hackman
Skull base surgical defects present unique challenges to anatomic and functional reconstruction. Fortunately, many endonasal skull base defects are successfully managed with a variety of local and regional reconstructive techniques. However, when prior surgery or radiotherapy eliminates the use of these local and regional reconstructive options, more elaborate free tissue transfer techniques are required. Managing endoscopic skull base defects of the anterior cranial fossa and clivus is further complicated by the limited access afforded for flap inset...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27956252/clinical-features-management-considerations-and-outcomes-in-a-case-series-of-patients-with-parasellar-intracranial-aneurysms-undergoing-anterior-skull-base-surgery
#9
Daniel M Raper, Dale Ding, Elizabeth Evans, Robert M Starke, R Webster Crowley, Kenneth C Liu, Edward H Oldfield, John A Jane
BACKGROUND: The co-incidence of parasellar aneurysms (IA) and anterior skull base (ASB) lesions, while rare, presents a management challenge. IAs embedded within, or adjacent to, ASB lesions are at risk in the perioperative period, and may have unique presentations, natural histories, and outcomes. The objective of this study was to outline management options and nuances in patients with coexisting IAs and ASB lesions. METHODS: We retrospectively evaluated all patients who presented for management of IAs and ASB lesions from January 2006 to January 2014...
December 9, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27930469/frontal-sinus-pneumatization-affects-height-of-the-lateral-lamella-and-position-of-anterior-ethmoidal-artery
#10
Şenol Çomoğlu, Bayram Şahin, Said Sönmez, Kemal Değer
Preoperative evaluation of the frontal sinus (FS) and associated anatomical structures may reduce the risk of intraoperative complications and facilitate the management of potential complications. In this study, the authors aimed to evaluate relationship between FS pneumatization and critical anatomical structures. Paranasal sinus computerized tomography scans of 350 sides of 175 patients were evaluated. The pneumatization pattern of the FS, FS dimensions (on the axial, coronal, and sagittal slices), anterior ethmoidal artery, and depth of the of olfactory fossa were evaluated for every patient on both sides...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27929605/nasopharyngeal-airway-to-prevent-tension-pneumocephalus-after-open-resection-of-anterior-skull-base-tumors
#11
Matthew E Spector, Jon-Paul Pepper, Stephen Sullivan, Lawrence Marentette, Erin McKean
We conducted a retrospective study to assess the efficacy of using a nasopharyngeal airway in lieu of a tracheotomy or prolonged intubation for the diversion of airflow to prevent tension pneumocephalus after an open resection of anterior skull base tumors. Our study population was made up of 120 patients-74 males and 46 females, aged 12 to 84 years (mean: 48.7)-who had undergone an anterior skull base resection with documented nasopharyngeal airway placement from 1996 through 2009. Our main outcome measure was the presence of tension pneumocephalus while controlling for the placement of a lumbar drain, the development of a cerebrospinal fluid (CSF) leak, and the type of reconstruction...
December 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27928413/a-rare-case-of-unilateral-progressive-vision-loss-and-pachymeningitis
#12
Reuben Mari Valenzuela, Bonnie Keung, John H Pula, Jorge C Kattah
We describe a 32-year-old man with presumed Vogt-Koyanagi Harada (VKH) syndrome, whose presenting symptoms were headache and progressive loss of vision in the right eye. Neuro-ophthalmic examination showed anterior and posterior uveitis, and retinal detachment in the right eye. Ocular coherence tomography (OCT) showed extensive submacular fluid in the right eye, while the fundus fluorescein angiogram (FFA) confirmed perifoveal retinal pigment epithelium (RPE) disruption and multifocal fluorescein leakage in the right eye...
October 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27923275/nasoethmoid-schwannoma-with-intracranial-extension-case-report-and-review-of-the-literature
#13
Christopher S Hong, I Jonathan Pomeraniec, Robert M Starke, Mark E Shaffrey
Nasoethmoid schwannomas with significant intracranial extension are rare tumours that typically present with visual and olfactory deficits. We describe a nasoethmoid schwannoma in a patient who was completely asymptomatic. Despite impressive intracranial involvement, nasoethmoid schwannomas may present asymptomatically and should be considered in the differential of contrast-enhancing anterior skull base lesions.
December 6, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27911234/ventriculostomy-associated-hemorrhage-a-risk-assessment-by-radiographic-simulation
#14
Faith C Robertson, Muhammad M Abd-El-Barr, Srinivasan Mukundan, William B Gormley
OBJECTIVE Ventriculostomy entry sites are commonly selected by freehand estimation of Kocher's point or approximations from skull landmarks and a trajectory toward the ipsilateral frontal horn of the lateral ventricles. A recognized ventriculostomy complication is intracranial hemorrhage from cortical vessel damage; reported rates range from 1% to 41%. In this report, the authors assess hemorrhagic risk by simulating traditional ventriculostomy trajectories and using CT angiography (CTA) with venography (CTV) data to identify potential complications, specifically from cortical draining veins...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27906848/calculation-of-an-optic-nerve-injury-risk-profile-before-sphenoid-sinus-surgery
#15
Erdem Atalay Cetinkaya, Koray Koc, Mehmet Fatih Kucuk, Pinar Koc, Nuray Bayar Muluk, Cemal Cingi
OBJECTIVES: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. METHODS: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27890190/imaging-of-the-sella-and-parasellar-region
#16
REVIEW
John L Go, Anandh G Rajamohan
The sella and parasellar region, found between the anterior and central skull base, represents the central aspect of the skull base. Given the location of the pituitary gland in this location, small lesions in this location may have major physiologic effects on the human body. This article reviews the anatomy, development, and pathologic processes that may involve this region.
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27890187/imaging-of-paranasal-sinuses-and-anterior-skull-base-and-relevant-anatomic-variations
#17
REVIEW
Estushi Iida, Yoshimi Anzai
This article reviews the normal anatomy and variants of the anterior skull base and sinonasal cavities that are relevant to endoscopic sinus and skull base surgery. Radiologists should be aware of sinonasal anatomy that can be impediments to surgical access and increase risk of vascular or cranial nerve injury during surgery. Imaging features of the paranasal sinuses and anterior skull base pathologies are also discussed.
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27888269/internal-carotid-artery-pseudoaneurysm-and-ischemic-stroke-secondary-to-retropharyngeal-and-parapharyngeal-abscess-a-case-report-and-review-of-the-literature
#18
Michael W Ruff, Deena M Nasr, James P Klaas, Deborah L Renaud
Internal carotid artery pseudoaneurysm is an uncommon complication of retropharyngeal and parapharyngeal abscess in children. Treatment of the pseudoaneurysm has evolved in recent years from surgical ligation to endovascular techniques. Neurologic sequelae most commonly consist of Horner's syndrome with cerebral ischemia being uncommon. The clinical course of a 2-year-old boy with retropharyngeal abscess complicated by internal carotid artery pseudoaneurysm, is described and the literature is reviewed. A conventional angiogram confirmed the presence of a large pseudoaneurysm with no anterograde flow distal to the pseudoaneurysm and substantial collateral flow across the circle of Willis, with filling of the left anterior and middle cerebral arteries via the anterior and posterior communicating arteries...
November 25, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27885953/targeted-sequencing-of-smo-and-akt1-in-anterior-skull-base-meningiomas
#19
Matthew R Strickland, Corey M Gill, Naema Nayyar, Megan R D'Andrea, Christian Thiede, Tareq A Juratli, Gabriele Schackert, Darrell R Borger, Sandro Santagata, Matthew P Frosch, Daniel P Cahill, Priscilla K Brastianos, Fred G Barker
OBJECTIVE Meningiomas located in the skull base are surgically challenging. Recent genomic research has identified oncogenic SMO and AKT1 mutations in a small subset of meningiomas. METHODS The authors performed targeted sequencing in a large cohort of patients with anterior skull base meningiomas (n = 62) to better define the frequency of SMO and AKT1 mutations in these tumors. RESULTS The authors found SMO mutations in 7 of 62 (11%) and AKT1 mutations in 12 of 62 (19%) of their cohort. Of the 7 meningiomas with SMO mutations, 6 (86%) occurred in the olfactory groove...
November 25, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27879303/smooth-muscle-tumour-of-uncertain-malignant-potential-smtump-in-the-nasal-cavity-an-incidental-finding
#20
Dipak Ranjan Nayak, Asheesh Dora Ghanpur, Apoorva N Reddy, Swati Sharma
Sino-nasal smooth muscle tumours of uncertain malignant potential (SMTUMP) are very rare neoplasms of mesenchymal origin with features in between a benign leiomyoma and a leiomyosarcoma. We report a rare case of SMTUMP in a 44-year-old woman, who presented with vague symptoms of pharyngitis. Nasal endoscopy revealed a smooth mass in left nasal cavity. Contrast-enhanced CT and MRI scans showed features likely to be inverted papilloma or olfactory neuroblastoma or meningioma. Excision was planned and intraoperatively, frozen section revealed a probable spindle cell lesion...
November 22, 2016: BMJ Case Reports
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