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Anterior Skull Base

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https://www.readbyqxmd.com/read/29045680/report-of-a-novel-case-of-anaplastic-olfactory-groove-meningioma-and-its-methylation-subtype
#1
Aaron Song Chuan Foo, Dominic Ti Ming Tan, Char Loo Tan, Felix Sahm, Andreas von Deimling, Tseng Tsai Yeo
We report a novel case of a World Health Organization grade 3 anaplastic meningioma arising from the olfactory groove in an 83-year-old woman. Molecular and methylation profiling confirm this lesion to be an NF2 subtype, methylation class intermediate type B meningioma. As most meningiomas in this location are indolent SMO subtype lesions, our report suggests that even though rare, aggressive NF2 subtype meningiomas can also occur along the midline anterior skull base.
October 16, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/29038084/management-of-through-and-through-penetrating-skull-injury-a-railroad-stake-that-transgressed-the-anterior-skull-base
#2
Reid Hoshide, Jeffrey Steinberg, Arvin Wali, Audrey Ko, J Scott Pannell, Clark C Chen
Penetrating injuries involving foreign objects that transgress the entirety of the human skull presents challenges in the management of vascular injuries, infectious risk, cerebrospinal fluid leak, and cosmetic repair. Ultimately, effective management of these injuries requires a multi-disciplinary team and judicious surgical planning. Here we present the management of a patient who suffered a penetrating injury from a railroad stake, with entry and exit points involving left and right anterior aspect of the temporal fossa, respectively...
October 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29036029/-anterior-skull-base-and-pericranial-flap-ossification-after-frontofacial-monobloc-advancement
#3
Anne Morice, Giovanna Paternoster, Agnès Ostertag, Syril James, Martine Cohen-Solal, Roman H Khonsari, Eric Arnaud
BACKGROUND: Frontofacial monobloc advancement (FFMBA) creates a communication between the anterior cranial fossa and nasal cavities. To tackle this issue, trans-orbital pericranial pedicled flaps (PF) are routinely performed in our center. This study aimed to assess the post-operative ossification of the anterior skull base and PF following FFMBA, and to identify factors influencing this ossification. METHODS: Measurements of the skull base only (SB) and of the ossified PF together with the SB (SB-OPF) were performed on CT scans at the naso-frontal (NF) and the naso-ethmoïdo-frontal (NEF) junctions...
October 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29024761/pattern-of-closure-of-skull-base-synchondroses-in-crouzon-syndrome
#4
Guillaume Coll, Laurent Sakka, Céline Botella, Nathalie Pham-Dang, Corine Collet, Michel Zerah, Eric Arnaud, Federico Di Rocco
BACKGROUND: The age of closure of skull base synchondroses has never been analyzed in a homogenous population of children with Crouzon syndrome. METHOD: A retrospective case-control study was performed on 30 Crouzon children (17M, 13F) aged 1 month to 12.48 years with Fibroblast Growth Factor Receptor type 2 mutation. Eleven synchondroses were analyzed on millimetric computed tomodensitometry slices before surgery. Syndromic patients were compared to a series of 235 healthy children previously published...
October 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28990662/the-radioanatomy-of-endonasal-flap-coverage-of-skull-base-defects-a-tool-for-preoperative-planning
#5
Francisco J D MacArthur, Gerald W McGarry
OBJECTIVES/HYPOTHESIS: To develop a tool for the calculation of surgical skull base defects and endonasal flap dimensions on preoperative computed tomography (CT) to aid surgical planning. STUDY DESIGN: Case series. METHODS: A literature search was conducted to identify all endonasal flaps. There were five basic models identified. These are the nasoseptal flap, anterior lateral nasal wall flap, bipedicled anterior septal flap, posterior pedicled inferior turbinate flap, and middle turbinate flap...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28989048/supraorbital-keyhole-approach-to-the-sella-and-anterior-skull-base-via-a-forehead-wrinkle-incision
#6
Jin Xiao, Weihong Wang, Xianxiang Wang, Zhongxiang Mao, Hao Qi, Hongwei Cheng, Yongqiang Yu
OBJECTIVE: The aim of this study was to evaluate the safety and effectiveness of the supraorbital keyhole approach to the sella and anterior skull base via a forehead wrinkle incision. METHODS: We analyzed and reclassified the forehead wrinkle types in 100 recruited healthy individuals. Twenty selected patients with different intracranial lesions in the sella and anterior skull base areas were selected for surgery using the supraorbital keyhole approach via a forehead wrinkle incision by types...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28986226/internal-carotid-artery-and-its-relationship-with-structures-in-sellar-region-anatomy-study-and-its-clinical-applications
#7
Yishui Zhang, Wen Yang
BACKGROUND: Complications of the ICA in surgeries are rare but severe. This study aims to locate the ICA with 5 stationary bony structures in the sellar region: the anterior clinoid process (ACP), the tuberculum sellae, the bottom of the hypophyseal fossa, the posterior edge of the hypophyseal fossa and the post clinoid process and do measurements to determine their anatomic relationship with the ICA. METHODS: After multiple planar reconstructions on computer tomographic angiography images of 120 ICA in 60 individuals, we defined the 5 bony structures as 5 origins in horizontal, sagittal and vertical planes with the 3D coordinate system and got the cross-sections of bilateral ICA on the coronal plane passing through each origin...
October 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28978266/parapharyngeal-space-tumor-surgery-using-a-modified-cervical-parotid-approach
#8
Isaku Okamoto, Kiyoaki Tsukahara, Hiroki Sato
OBJECTIVES: The cervical approach to parapharyngeal space tumors is blind in cases involving an approach to the vicinity of the skull base from below. We therefore devised a procedure to improve the safety of surgery in the vicinity of the skull base. METHODS: With this surgical technique, the temporal branch from the main trunk is first identified, as in the case of parotid gland tumor surgery. We then approach the skull base by entering the posterior aspect of the parotid gland tissue from above the temporal branch and anterior auricular space, allowing clear visual confirmation of the upper part of the tumor...
October 5, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28973679/the-minimal-clinically-important-difference-of-the-anterior-skull-base-nasal-inventory-12
#9
Nicholas Gravbrot, Daniel F Kelly, John Milligan, Chester F Griffiths, Garni Barkhoudarian, Heidi Jahnke, William L White, Andrew S Little
BACKGROUND: The minimal clinically important difference (MCID) is defined as the smallest change in health-related quality of life (QOL) that patients consider meaningful. The MCID is essential for determining clinically significant changes, rather than simply statistically significant changes, in QOL scores. The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12), a site-specific sinonasal QOL instrument, has emerged as a standard instrument for assessing QOL in patients who have undergone endonasal transsphenoidal surgery...
August 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28973649/dural-closure-in-confined-spaces-of-the-skull-base-with-nonpenetrating-titanium-clips
#10
Chad A Glenn, Cordell M Baker, Joshua D Burks, Andrew K Conner, Adam D Smitherman, Michael E Sughrue
BACKGROUND: Dural repair in areas with limited operative maneuverability has long been a challenge in skull base surgery. Without adequate dural closure, postoperative complications, including cerebrospinal fluid (CSF) leak and infection, can occur. METHODS: We reviewed 53 consecutive surgical patients in whom a dural repair technique utilizing titanium microclips was performed from 2013 to 2016 at our institution. The repairs primarily involved difficult-to-reach dural defects in which primary suturing was difficult or impractical...
July 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28967315/the-transcondylar-approach-to-craniocervical-meningiomas
#11
Marcio S Rassi, Jean G de Oliveira, Luis A B Borba
Surgical removal of foramen magnum meningiomas poses great challenges due their deep location within the central skull base and their proximity to vital neurovascular structures. This video depicts the operative nuances of surgical management for a 59-year-old female who presented with a right-sided spinocranial meningioma. Simpson Grade I resection was achieved through a right transcondylar approach. The patient's postoperative period was unremarkable, and she was discharged home on postoperative Day 5 for periodic follow-up...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967313/extended-middle-fossa-approach-with-anterior-petrosectomy-for-resection-of-upper-petroclival-meningioma-involving-meckel-s-cave-operative-video-and-technical-nuances
#12
James K Liu
The surgical management of petroclival meningiomas remains a formidable challenge. These tumors are deep in the base of the skull and arise medial to the fifth cranial nerve. In this operative video, the author demonstrates the extended middle fossa approach with anterior petrosectomy to resect an upper petroclival meningioma extending into Meckel's cave with brainstem compression. This approach is very useful for accessing deep tumors located above and below the tentorium, and between the fifth and seventh cranial nerves...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967312/resection-of-middle-petroclival-meningioma-via-combined-anterior-transpetrosal-and-retrosigmoid-approaches-at-two-separate-stages-3d-operative-video
#13
Ihsan Dogan, Pinar Eser Ocak, G Mark Pyle, Mustafa K Başkaya
Surgical access to the petroclival region poses a challenge to neurosurgeons. A wide range of approaches has been demonstrated in the past. In this video, the authors present a 69-year-old male patient who presented with 3-month history of worsening left-sided numbness. The tumor was totally removed in 2 sessions via anterior transpetrosal and retrosigmoid approaches, respectively. The authors demonstrate 2 separate skull base approaches to resect a petroclival meningioma and discuss pitfalls and problems of management for challenging meningiomas...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962950/transoral-decompression-and-stabilization-of-the-upper-cervical-segments-of-the-spine-using-custom-made-implants-in-various-pathological-conditions-of-the-craniovertebral-junction
#14
A N Shkarubo, A A Kuleshov, I V Chernov, M S Vetrile, I N Lisyansky, S N Makarov, G P Ponomarenko, Michael Spyrou
BACKGROUND: Surgical treatment of patients with atlantoaxial instability caused by pathological changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate.Currently, anterior stabilization of the atlantoaxial junction is a promising approach that allows for the resection of the pathological lesion of the skull base and craniovertebral junction with subsequent stabilization of C1-C2 or C1-C3 in one stage...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28950429/the-role-of-ellis-van-creveld-2-evc2-in-mice-during-cranial-bone-development
#15
Edwin K Kwon, Ke'ale Louie, Anshul Kulkarni, Marilia Yatabe, Antonio Carlos de Oliveira Ruellas, Taylor N Snider, Yoshiyuki Mochida, Lucia H S Cevidanes, Yuji Mishina, Honghao Zhang
EvC syndrome is a type of autosomal-recessive chondrodysplasia. Previous case studies in patients suggest abnormal craniofacial development, in addition to dwarfism and tooth abnormalities. To investigate how craniofacial development is affected in EvC patients, surface models were generated from micro-CT scans of control mice, Evc2 global mutant mice and Evc2 neural crest-specific mutant mice. The anatomic landmarks were placed on the surface model to assess the morphological abnormalities in the Evc2 mutants...
September 26, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28944942/paramedian-forehead-flap-for-repair-of-refractory-high-flow-anterior-skull-base-csf-leak
#16
Jeremy Ciporen, Brandon Lucke-Wold, Haley Gillham, David Cua, Jason Kim, Paul Akins
AIM: The paramedian forehead flap (PMFF) has been well described for nasal reconstruction. However, it has never been reported for use in the repair of high flow anterior skull base cerebral spinal fluid (CSF) leaks. MATERIAL AND METHODS: The patient is a 55 yo African American male cocaine abuser who initially presented with a high flow anterior skull base CSF leak, extensive pneumocephalus, and intra-cerebral and intra-ventricular abscesses with an oro-nasal-cerebral fistula...
July 11, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28943419/severe-cerebral-complications-secondary-to-perforation-injury-of-the-anterior-skull-base-during-sinonasal-surgery-an-underappreciated-problem
#17
Shadi Al-Afif, Elvis J Hermann, Gökce Hatipoglu Majernik, Makoto Nakamura, Peter Raab, Thomas Lenarz, Joachim K Krauss
OBJECTIVE: Functional endonasal sinus surgery (FESS) is widely practiced and is considered a generally safe procedure. Skull base injuries occur in less than 1% of procedures and are typically associated with cerebrospinal fluid leaks. Rarely, skull base injuries might result in cerebral lesions. Here we present a series of four patients with iatrogenic perforating injuries of the anterior skull base and cerebral lesions after routine FESS. METHODS: Four patients with iatrogenic perforating cerebral lesions after routine FESS performed at other institutions were referred to a tertiary neurosurgery department within a 10-year period...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28940007/-infantile-hemangiopericytoma-of-the-nasal-cavity
#18
A Heyduck, S Wemmert, I Leuschner, B Schick
An infantile sinunasal hemangiopericytoma as a variant of infantile myofibroma is a rare finding. The observation of a sinunasal, infantile hemangiopericytoma affecting the anterior skull base and ethmoid bone in a female infant is presented. Chromosomal gains (6q14q16.2 und 18q22qter) as well as chromosomal losses (5q33.3q35.2, 10p11.2p12.2, 10q24.3q26.1, 15q23q25, 17p12pter and 22q11.2q13.2) were present. Endonasal tumor resection was achieved.
September 22, 2017: HNO
https://www.readbyqxmd.com/read/28937919/neurosurgical-management-of-a-rare-congenital-supratentorial-neurenteric-cyst-with-associated-nasal-dermal-sinus-case-report
#19
Paul MacMahon, Stanca Iacob, Sarah E Bach, Eric T Elwood, Julian J Lin, Anthony M Avellino
The authors describe the case of a patient with the classic clinical presentation and radiographic features of a nasal dermal sinus with an associated intracranial cyst; however, histopathology revealed that the intracranial cyst was neurenteric instead of the typical epidermoid or dermoid cyst. Preoperative assessment included CT and MRI, which revealed a direct communication between the patient's nasal polypoid lesion and the anterior skull base via the foramen cecum. At the hands of a multidisciplinary plastic surgery and neurosurgery team, the patient underwent concurrent gross-total resection of the nasal polypoid lesion, the intracranial intradural cystic lesion, and their interconnecting tract...
September 15, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28935488/utility-of-tc-99m-mdp-bone-spect-in-evaluation-of-osseous-involvement-in-craniofacial-malignancies
#20
Shabana Saeed, Saif Ul Haq, Muhammad Sohaib, Ali Nawaz Khan
PURPOSE: To assess the role of technetium-99m methoxy diphosphonate (Tc-99m MDP) single photon emission tomography (SPECT) imaging for the detection of osseous invasion in craniofacial malignancies. MATERIAL AND METHODS: The study was performed in 45 subjects using Tc-99m MDP (740 MBq). Out of 45 subjects, 30 were patients had different craniofacial malignancies, and 15 subjects who did not have any malignancy served as controls. Planar imaging was performed. Anterior, lateral and oblique lateral views of the skull were obtained...
August 24, 2017: Journal of Cranio-maxillo-facial Surgery
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