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Anterior Skull Base

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https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#1
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29676691/defining-the-lateral-limits-of-the-endoscopic-endonasal-transtuberculum-transplanum-approach-anatomical-study-with-pertinent-quantitative-analysis
#2
Alberto Di Somma, Jorge Torales, Luigi Maria Cavallo, Jose Pineda, Domenico Solari, Rosa Maria Gerardi, Federico Frio, Joaquim Enseñat, Alberto Prats-Galino, Paolo Cappabianca
OBJECTIVE The extended endoscopic endonasal transtuberculum transplanum approach is currently used for the surgical treatment of selected midline anterior skull base lesions. Nevertheless, the possibility of accessing the lateral aspects of the planum sphenoidale could represent a limitation for such an approach. To the authors' knowledge, a clear definition of the eventual anatomical boundaries has not been delineated. Hence, the present study aimed to detail and quantify the maximum amount of bone removal over the planum sphenoidale required via the endonasal pathway to achieve the most lateral extension of such a corridor and to evaluate the relative surgical freedom...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29671958/synoptic-reporting-of-pituitary-magnetic-resonance-imaging
#3
Rana S Dhillon, James A King, Tony Goldschlager, Yi Yuen Wang
BACKGROUND: Pituitary adenomas are common, often asymptomatic tumours that are diagnosed incidentally by magnetic resonance imaging (MRI) of the brain. There is considerable variation in the reporting of pituitary MRI, in part because there is no consensus as to what information should be included in such reports. Synoptic reporting consists of using structured checklists to standardize communication. It has been adopted in the surgical pathology literature and more recently in the breast imaging field...
April 19, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29671688/a-guide-to-identification-and-selection-of-axial-planes-in-magnetic-resonance-imaging-of-the-brain
#4
Shoichiro Otake, Toshiaki Taoka, Masayuki Maeda, William Tc Yuh
For brain magnetic resonance (MR) examination, three-dimensional imaging is commonly performed. Radiologists need to know the appropriate imaging angle for viewing. We present six imaging angles for the axial images. Each angle is determined by the reference line. The landmarks on the midsagittal MR image to determine the angle of the reference lines are as follows: the supraorbito-meatal line (the center of the mammillary body and the fastigium of the fourth ventricle), the orbito-meatal (OM) line (the center of the mammillary body and the most posterior point of the cerebellar tentorium), the Talairach anterior commissure (AC)-posterior commissure (PC) line (the superior edge of the AC and the inferior edge of the PC), the Schaltenbrand AC-PC line (the center of the AC and the center of the PC), the subcallosal line (the inferior border of the genu and the inferior border of the splenium of the corpus callosum), Reid's baseline (the center of the pituitary gland and the most posterior point of the cerebellar tentorium) and the brainstem vertical line (the line perpendicular to the posterior border of the brainstem)...
January 1, 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29661661/three-dimensional-study-of-31-cases-of-synostotic-anterior-plagiocephaly-before-and-after-surgical-management-the-lille-protocol
#5
Ambre Simon, Emmanuelle Bocquet, Philippe Pellerin, Matthieu Vinchon, Patrick Dhellemmes, Véronique Martinot, Alexis Wolber, Clotilde Calibre, Philippe Charlier, Pierre Guerreschi
Synostotic anterior plagiocephaly is a rare pathological cranial malformation. Therapeutic options are rarely studied due to the rarity of the malformation and difficulties in diagnosis and care management. The objective of this study was to analyze the results obtained with the Lille protocol based on 62 CT-scans done before and after surgery in 31 patients. A specific analysis was designed for this work. Nine cephalometric measures enabled to evidence on each CT-Scan the corrections made on the fronto-orbital bandeau and the potential impact of surgery on the craniofacial structures...
March 28, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29660990/novel-radiographic-assessment-of-the-cribriform-plate
#6
Kimia G Ganjaei, Zachary M Soler, Elliott D Mappus, Robert J Taylor, Mitchell L Worley, Jennifer K Mulligan, Jose L Mattos, Nicholas R Rowan, Guilherme J M Garcia, Judy R Dubno, Mark A Eckert, Lois J Matthews, Rodney J Schlosser
Background The cribriform plate (CP) is a common site of spontaneous cerebrospinal fluid (SCSF) leaks. Radiographic assessment of the anterior and lateral skull base has shown thinner bone in patients with SCSFs; however, prior assessment of the CP has required postmortem cadaver dissection. Objective To develop novel radiographic techniques to assess the anatomy of the CP. Methods Computed tomography (CT) scans were performed on cadaveric specimens. Bone density and anatomy of a predefined volume of interest of the posterior CP were assessed by two independent reviewers...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29660043/delayed-occipitocervical-instability-with-cranial-settling-after-far-lateral-transcondylar-surgery-for-invasive-skull-base-tumor
#7
Marcus D Mazur, Andrew T Dailey, Lubdha Shah, Jonathan P Scoville, William T Couldwell
BACKGROUND: Occipitocervical instability is a rare but potentially severe complication of a far-lateral transcondylar surgical approach to the skull base. OBJECTIVE: To investigate the incidence of clinically significant occipitocervical instability after transcondylar surgery via a far-lateral approach and to determine whether the extent of occipital condyle resection relative to the hypoglossal canal was associated with the development of occipitocervical instability...
April 11, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29657910/anterolateral-triangle-a-cadaveric-study-with-neurosurgical-significance
#8
Andre Granger, Ornella Bricoune, Tina Rajnauth, David Kimball, Heather Kimball, R Shane Tubbs, Marios Loukas
The anterolateral triangle is one of 10 surgical triangles of the cavernous sinus and serves as an important anatomic landmark for the skull base surgeon. There are few studies in the English literature that have precisely defined and measured the borders of the anterolateral triangle and little agreement has been made regarding the nomenclature within the English literature. A total of 12 midsagittally hemisected adult human cadaveric head halves were dissected to expose the anterolateral triangle. The triangle was defined and measurements of the anterior, posterior, and lateral borders were taken...
February 12, 2018: Curēus
https://www.readbyqxmd.com/read/29649644/endoscopic-transseptal-approach-with-a-bilateral-nasoseptal-flap-in-challenging-skull-base-tumors
#9
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, Sung Won Kim
OBJECTIVE: To examine the utility of an endoscopic transseptal approach and the creation of a bilateral nasoseptal flap using a two-nostrils/four-hands technique in patients with challenging skull-base tumors. METHODS: The medical records of patients operated on via an endoscopic transseptal approach between 2009 and 2017 were retrospectively reviewed. Two patients with ossifying fibroma, two with orbital hemangioma, two with trigeminal nerve schwannoma, and one patient each with juvenile angiofibroma, meningioma, and myxofibrosarcoma were included in the study...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29606050/pretemporal-trans-meckel-s-cave-transtentorial-approach-for-large-petroclival-meningiomas
#10
Chih-Hsiang Liao, Jui-To Wang, Chun-Fu Lin, Shao-Ching Chen, Chung-Jung Lin, Sanford P C Hsu, Min-Hsiung Chen
OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to 2017, patients harboring large PCMs (> 3 cm) and undergoing their first resection via this procedure at the authors' institute were included. In combination with pretemporal transcavernous and anterior transpetrosal approaches, the trans-Meckel's cave transtentorial route was created...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29606040/decision-making-algorithm-for-minimally-invasive-approaches-to-anterior-skull-base-meningiomas
#11
Malte Ottenhausen, Kavelin Rumalla, Andrew F Alalade, Prakash Nair, Emanuele La Corte, Iyan Younus, Jonathan A Forbes, Atef Ben Nsir, Matei A Banu, Apostolos John Tsiouris, Theodore H Schwartz
OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the possibility of reducing brain and nerve retraction, minimizing incision size, and speeding patient recovery; however, appropriate case selection and results in large series are lacking. METHODS The authors developed an algorithm for selecting a supraorbital keyhole minicraniotomy (SKM) for olfactory groove meningiomas or an expanded endoscopic endonasal approach (EEA) for tuberculum sella (TS) or planum sphenoidale (PS) meningiomas based on the presence or absence of olfaction and the anatomical extent of the tumor...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29588899/combined-frontotemporal-transbasal-approach-for-the-resection-of-a-giant-rathke-s-cleft-cyst-operative-video-and-technical-nuances
#12
James K Liu
We present a case of a giant Rathke's cleft cyst with significant superior extension into the third and right lateral ventricles and lateral extension into the left Sylvian fissure and over the anterior clinoid process. An extended modification of the frontotemporal approach was performed using a combined frontotemporal transbasal approach. This allowed wide exposure to both transsylvian and subfrontal corridors to the retrochiasmatic space. This video atlas demonstrates the operative technique and surgical nuances of the skull base approach, microdissection of the tumor, and safe handling of the neurovascular structures...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29582975/feasibility-of-endoscopic-endonasal-approach-for-clip-application-of-cerebral-aneurysms-a-systematic-review
#13
Jonathan A Forbes, Sophie D' Herbemont, Kurt R Lehner, Diego Pineda Martinez, Ignacio P Navarro-Chávez, Diego Mendez Rosito, Theodore H Schwartz
INTRODUCTION: While open, microsurgical clipping and endovascular coiling remain the gold standards for treatment of cerebral aneurysms, a growing number of aneurysms treated via endoscopic endonasal methods have been reported in the literature. The aim of this study was to conduct a systematic review of the literature to gain a more thorough appreciation of the potential benefits and drawbacks of the endoscopic endonasal strategy in this setting. EVIDENCE ACQUISITION: We performed a detailed systematic review of the medical literature on endoscopic endonasal skull base surgery for treatment of cerebral aneurysms utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29577103/traumatic-chiasmal-syndrome-a-meta-analysis
#14
Loganathan Vellayan Mookan, Philip A Thomas, Ankit Anil Harwani
Purpose: To report a case presenting with bitemporal hemianopia due to traumatic chiasmal syndrome after head injury, and to compare the findings with individual case reports published in the literature. Methods: A detailed search was made in PubMed, MedIND, Taylor and Francis online and Wiley online library databases for individual case reports of traumatic chiasmal syndrome. All the case reports were read in full and the findings summarized in a table, which included details of the case who presented with bitemporal hemianopia as an index case...
March 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29574221/endoscopic-endonasal-clipping-of-anterior-circulation-aneurysm-surgical-techniques-and-results
#15
Li-Min Xiao, Bin Tang, Shen-Hao Xie, Guan-Lin Huang, Zhi-Gang Wang, Er-Ming Zeng, Tao Hong
OBJECTIVE: Endoscopic endonasal clipping of intracranial aneurysms may utilize the microsurgical techniques as an alternative to the transcranial approach. The aim of this manuscript is to report a series of patients who underwent endoscopic endonasal approach(EEA) for microsurgical clipping of anterior circulation aneurysms. METHOD: A retrospective chart review was conducted. All the patients who underwent standard binostril EEA for aneurysm clipping were included...
March 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29558996/management-of-irreducible-unilateral-facet-joint-dislocations-in-subaxial-cervical-spine-two-case-reports-and-a-review-of-the-literature
#16
Yu Zhou, Zhenyu Zhou, Lifeng Liu, Xuecheng Cao
BACKGROUND: Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. CASE PRESENTATION: The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed...
March 21, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29549022/landmark-independent-method-to-determine-midsagittal-plane-and-its-clinical-application-in-craniomaxillofacial-trauma
#17
Xiaotian Lian, Jun Guo, Wei Zeng, Hai Qing, Rui Ju, Wei Tang
PURPOSE: The purpose of this study was to explore new landmark-independent methods suitable for determining the midsagittal plane (MSP) in patients with craniomaxillofacial trauma and its clinical application. MATERIALS AND METHODS: Preoperative computed tomography data of 25 patients with craniomaxillofacial trauma were imported into Mimics software (Materialise, Leuven, Belgium) to reconstruct 3-dimensional skull models. In the experimental group, the MSP was determined by different landmarks that were clear, were scattered, and did not have displacement according to the types of fractures...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29543222/-variability-and-age-related-features-of-the-anatomy-of-the-midline-structures-of-the-anterior-skull-base
#18
D A Gol'bin, V A Cherekaev
The article presents the literature data on the structural variability and age-related features of the midline anatomical structures of the anterior skull base (frontal sinus, ethmoid bone, anterior parasellar region, and medial orbital wall). This is the area of surgical interests of neurosurgeons and rhinosurgeons. The study objective is to analyze the literature data on the individual variability and age-related anatomy of these structures. The work is illustrated with original images from the authors' personal archive...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29543220/-the-use-of-platelet-gel-for-repair-of-a-cerebrospinal-fluid-fistula-of-the-skull-base-a-case-report-and-literature-review
#19
O I Sharipov, M A Kutin, A V Bayuklin, A A Imaev, A A Abdilatipov, A B Kurnosov, D V Fomichev, N I Mikhaylov, P L Kalinin
Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29541802/unilateral-duplicated-abducens-nerve-coursing-through-both-the-sphenopetroclival-venous-gulf-and-cavernous-sinus-a-case-report
#20
Thomas Coquet, Michel Lefranc, Louis Chenin, Pascal Foulon, Éric Havet, Johann Peltier
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
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