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Anterior Skull Base

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https://www.readbyqxmd.com/read/28328602/intracranial-anatomic-landmarks-for-endoscopic-endonasal-transcribriform-approach-to-anterior-skull-base
#1
Pinghua Wu, Huikun Zeng, Ying Guan, Ligen Mo, Danke Su
OBJECTIVES: To help surgeons locating anatomic landmarks when performing endoscopic endonasal transcribriform approach to anterior skull base. METHODS: High-resolution axial computed tomography (CT) images at thickness of 0.6 mm, and reconstructed 0.41-mm thick gapless sagittal and coronal CT images were taken from 123 subjects. Using mimics software, first located elementary points and line: nasal spine, midpoint of posterior hard palate and the line between them; then located measured points right/left posterior and anterior points; measured distances between measured points and from measured points to nasal spine and angles between lines connecting measured points to nasal spine and the basic line...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28321987/cephalometric-findings-among-children-with-velopharyngeal-dysfunction-following-adenoidectomy-a-retrospective-study
#2
Firas Kassem, Yaniv Ebner, Ben Nageris, Nezar Watted, Ari DeRowe, Ariela Nachmani
OBJECTIVES: To characterize the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). DESIGN: Retrospective study. SETTING: Speech and swallowing clinic of a single academic hospital. PARTICIPANTS: 39 children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children...
March 21, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#3
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321385/the-laparoscopically-harvested-omental-free-flap-a-compelling-option-for-craniofacial-and-cranial-base-reconstruction
#4
Peter D Costantino, David Shamouelian, Tristan Tham, Robert Andrews, Wojciech Dec
Background Management of craniofacial and cranial base tumors is a challenge due to the anatomic intricacies associated with the calvarium, the pathological diversity of lesions that present, and the potential complications. Clinical outcomes in laparoscopically harvested omentum free flaps for cranial base and craniofacial reconstruction are presented in this paper, in the largest case series to date. Methods A retrospective single-center experience for over 10 years with laparoscopically harvested omentum flaps used to reconstruct craniofacial and cranial base defects...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321377/single-layer-repair-of-large-anterior-skull-base-defects-without-vascularized-mucosal-flap
#5
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321373/a-review-of-skull-base-tumor-clinical-trials-past-trends-and-future-opportunities
#6
Anand Devaiah, Charles Murchison
Objective Tumors of the anterior and lateral skull base (TALSB) are relatively rare but can be devastating to patients. By examining trials focused on TALSB, we can characterize the studies that predominate and better understand current directions of study. This gives us a better understanding of future studies to pursue. Study Design This is a retrospective analysis. Settings We set skull base tumor clinical trials in the United States which are listed in ClinicalTrials.gov. Subjects and Methods We used the information available on ClinicalTrials...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#7
Edward C Kuan, Frederick Yoo, Won Kim, Karam W Badran, Thomas E Heineman, Ali R Sepahdari, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls. Design Radiographic review of preoperative magnetic resonance images (MRI) of the pituitary gland. Setting Tertiary academic medical center...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28317322/cerebrospinal-fluid-leaks-during-endoscopic-sinus-surgery-in-thirty-two-patients
#8
Georg J Ledderose, Klaus Stelter, Christian S Betz, Anna S Englhard, Carola Ledderose, Andreas Leunig
The inadvertent cerebrospinal fluid (CSF) leak is a very rare but potentially hazardous complication in endoscopic sinus surgery. We performed a systematic review of a series of 32 cases of CSF leaks occurring during sinus surgery. We identified surgical inexperience and impaired orientation in the surgical field as the main risk factors for iatrogenic CSF leaks. The lateral lamella of the cribriform plate and the anterior ethmoid roof are predilection sites for CSF leaks in the anterior skull base. We determined suitable methods of repair based on the location of the leak and found high success rates after endoscopic leak closure...
March 20, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28314408/anterior-skull-base-malignancies-the-otolaryngologist-s-contribution
#9
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28314401/combined-endoscopic-and-open-approaches-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#10
REVIEW
James K Liu, Anni Wong, Jean Anderson Eloy
Combined transcranial and endoscopic endonasal approaches remain useful in the treatment of ventral skull base malignancies. The extended bifrontal transbasal approach provides wide access to the anterior ventral skull base and paranasal sinuses without transfacial incisions. In more extensive lesions, the bifrontal transbasal approach can then be combined with an endoscopic endonasal approach (EEA) from below. This article reviews the indications, surgical technique, and operative nuances of combined transbasal and EEA (cranionasal) approaches for the surgical management of ventral skull base malignancies...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28300710/frameless-and-maskless-stereotactic-navigation-with-a-skull-mounted-tracker-a-technical-report
#11
Andrew A Fanous, Timothy G White, Matthew B Hirsch, Shamik Chakraborty, Peter D Costantino, David J Langer, John A Boockvar
Intraoperative image-guided navigation has revolutionized neurosurgery. It undoubtedly increases the surgeon's confidence and the perception of safety. While fiducials and facial masks are currently the most widely used tools for intraoperative navigation, their use is associated with certain complications. For instance, such tools require rigid fixation of the head, which increases the risk of skull fractures and epidural hematomas, and decreases both surgical flexibility and surgeon's comfort. In addition, the use of a facial mask is at times undesirable, as it may represent an obstacle during surgeries involving the face and forehead...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28300709/delayed-carotid-pseudoaneurysms-from-iatrogenic-clival-meningeal-branches-avulsion-recognition-and-proposed-management
#12
Rami Almefty, Ian F Dunn, Muhammad Ali Aziz-Sultan, Ossama Al-Mefty
Carotid injury during anterior skull base approaches is promptly recognizable and mandates immediate treatment; likewise, development of pseudoaneurysms after such injuries is anticipated and managed. We report here on the delayed development of a pseudoaneurysm as the result of avulsion of clival meningeal arteries that manifests as unalarming intraoperative bleeding that appears as brisk and arterial but very easily controlled. Immediate postoperative angiography is negative, necessitating repeated angiography to depict the delayed formation...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28299444/the-ethmoidal-arteries-a-cadaveric-study-based-on-cone-beam-computed-tomography-and-endoscopic-dissection
#13
Marco Ferrari, Luca Pianta, Andrea Borghesi, Alberto Schreiber, Marco Ravanelli, Davide Mattavelli, Vittorio Rampinelli, Francesco Belotti, Luigi Fabrizio Rodella, Roberto Maroldi, Piero Nicolai
PURPOSE: To describe the anatomical variability of the ethmoidal arteries (EAs). To evaluate the reliability of cone beam computed tomography (CBCT) in preoperative assessment of EAs. METHODS: Fourteen cadaver heads underwent CBCT and endoscopic dissection. The following anatomical features were evaluated for anterior (AEA), middle (MEA), and posterior (PEA) EAs: presence, cranio-caudal position, antero-posterior position, and dehiscence of the bony canal. Accuracy of radiological assessment was calculated...
March 15, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28279778/readmission-and-other-adverse-events-after-transsphenoidal-surgery-prevalence-timing-and-predictive-factors
#14
David J Cote, Hormuz H Dasenbrock, Ivo S Muskens, Marike Ld Broekman, Hasan A Zaidi, Ian F Dunn, Timothy R Smith, Edward R Laws
BACKGROUND: Transsphenoidal surgery is a common neurosurgical procedure for accessing the pituitary and anterior skull base, yet few multicenter analyses have evaluated outcomes after this procedure. STUDY DESIGN: Patients undergoing transsphenoidal surgery from 2006 to 2015 were extracted from the ACS NSQIP database. Logistic regression was used to identify predictors of thirty-day complications. RESULTS: Of 1240 patients included in this analysis; 6...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28277484/delayed-breakdown-of-an-onlay-pericranial-flap-following-endoscopic-craniofacial-resection
#15
Xu Xinni, Sein Lwin, Yew Kwang Ong
The pericranial flap is a well-vascularized, robust flap that is used to reconstruct anterior skull base defects following resection of skull base tumors. Failure of this flap is uncommon. However when it occurs, the consequences are potentially disastrous and it poses a challenge to further reconstruction. The authors report the first patient of onlay pericranial flap breakdown following endoscopic craniofacial resection. Possible contributing factors are identified and further management is discussed. With the endoscopic approach being increasingly utilized for craniofacial resection, it is imperative to be mindful of these factors to minimize the risks of onlay pericranial flap failure...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28274049/use-of-frontal-sinus-and-nasal-septum-pattern-as-an-aid-in-personal-identification-and-determination-of-gender-a-radiographic-study
#16
Kavita Verma, Prashant Nahar, Mohit Pal Singh, Hemant Mathur, S Bhuvaneshwari
INTRODUCTION: Personal identification and gender determination of unknown person has a vital importance in forensic investigation. Human skull radiography is a useful tool in human identification in natural disaster, in any accidents such as fire accident and road traffic accident where body remains become degraded or severely destroyed. AIM: Present study was performed to evaluate the measurement of frontal sinus, uniqueness of various pattern of nasal septum when combined with frontal sinus observed on posterio anterior cephalogram for sex determination as well as personal identification...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28274016/epignathus-leading-to-fatal-airway-obstruction-in-a-neonate
#17
Shruti Sudhir Jadhav, Charusheela Sujit Korday, Sushma Malik, Vivek Kishor Shah, Shilpa Kapil Lad
Teratomas are benign tumours containing cells from ectodermal, mesodermal and endodermal layers with an incidence of about 1 in every 4,000 births. Their commonest site is sacro-coccygeal region, followed by anterior mediastinum. The incidence of teratomas localised to the head and neck region is around 2-9% of all cases. Epignathus is a rare congenital oropharyngeal teratoma originating from the base of the skull. Here we present a rare case of oropharyngeal teratoma in a neonate who was referred to our institute with an ill-defined oral mass protruding through a cleft in the hard palate...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28258077/stereographic-measurement-of-orbital-volume-a-digital-reproducible-evaluation-method
#18
Matthias Mottini, Christian A Wolf, S Morteza Seyed Jafari, Konstantinos Katsoulis, Benoît Schaller
BACKGROUND/AIMS: Up to date, no standardised reproducible orbital volume measurement method is available. Therefore, this study aimed to investigate the accuracy of a new measurement method, which delineates the boundaries of orbital cavity three-dimensionally (3D). METHODS: In order to calculate the orbital volume from axial CT slice images of the patients, using our first described measurement method, the segmentation of the orbital cavity and the bony skull was performed using Amira 3D Analysis Software...
March 3, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28255303/reduction-of-radiation-dosage-in-visualization-of-paranasal-sinuses-in-daily-routine
#19
Christian Güldner, Isabell Diogo, Julia Leicht, Magis Mandapathil, Thomas Wilhelm, Afshin Teymoortash, Evelyn Jahns
Background. Preoperative imaging of the nose and paranasal sinus is standard in otorhinolaryngology. Previous studies on phantoms demonstrated the potential for dose reduction of cone beam computed tomography (CBCT) by varying the application parameters. Methodology. Based on previous studies, the standard protocol of paranasal sinus imaging by CBCT was altered. One hundred and fifty examinations using the old protocol (01/2010-01/2011, high dosage) and 150 examinations using the new protocol (09/2012-09/2013, low dosage) were evaluated and compared for the visibility of 17 anatomical structures, the Lund-Mackay Score, and technical parameters...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/28254539/video-is-part-of-the-ms-three-layer-reconstruction-with-iliotibial-tract-after-endoscopic-resection-of-sinonasal-tumors-technical-note
#20
Davide Mattavelli, Alberto Schreiber, Marco Ferrari, Remo Accorona, Andrea Bolzoni Villaret, Paolo Battaglia, Paolo Castelnuovo, Piero Nicolai
INTRODUCTION: Watertight reconstruction to separate the intradural compartment from the sinonasal cavities is crucial after endoscopic resection with transnasal craniectomy (ERTC) for naso-ethmoidal tumors. Three-layer reconstruction with the iliotibial tract (TRITT) is a safe and reliable alternative when vascularized flaps are not available. SURGICAL TECHNIQUE: The iliotibial tract graft is harvested on the lateral aspect of the thigh and divided in three portions, which are positioned in a multi-layered fashion to close the skull base defect...
February 22, 2017: World Neurosurgery
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