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https://www.readbyqxmd.com/read/29775983/classification-and-microvascular-flap-selection-for-anterior-cranial-fossa-reconstruction
#1
James D Vargo, Wojciech Przylecki, Paul J Camarata, Brian T Andrews
BACKGROUND:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. METHODS:  A retrospective review was performed. Reconstructions were anatomically classified as low (anterior skull base), middle (frontal bar/sinus), and high (frontal bone/soft tissue)...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29764791/giant-cell-tumor-of-the-temporal-bone-and-skull-base-a-case-report
#2
İsa Kaya, Murat Benzer, Göksel Turhal, Gode Sercan, Cem Bilgen, Tayfun Kirazlı
Giant cell tumor (GCT) is a benign tumor that originates from undifferentiated mesenchymal cells of the bone marrow. The cranium as well as temporal bone is a rare location for GCTs. Despite its benign nature, GCT may be locally aggressive and has the potential to recur locally. Furthermore, GCT may give rise to pulmonary metastases (~1%) in addition to causing local bone destruction. Surgical excision is the treatment of choice for patients with GCT. We describe the case of a 56-year-old female who presented with headache and hearing loss with extensive GCT, which originated in the squamous part of the temporal bone and extended into the left mandibular fossa and middle ear...
April 2018: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/29762326/temporal-progression-of-craniofacial-dysmorphology-in-unilateral-coronal-synostosis-a-mechanistic-hypothesis
#3
Kirun Baweja, Alexander H Sun, Rajendra Sawh-Martinez, John A Persing
AIM: This study chronicles skull base and face development in nonsyndromic unilateral coronal synostosis (UCS) during infancy, to characterize the mechanistic progression of facial dysmorphology. METHODS: Computed tomography scans from 51 subjects were reviewed (26 UCS, 25 controls) and data were reconstructed. Patients were stratified into 5 age groups. A series of measurements were taken from the reconstructions. RESULTS: All patients had a unilaterally fused coronal suture at the time of analysis...
May 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29761256/quantitative-analysis-of-cranial-orbital-changes-in-infants-with-anterior-synostotic-plagiocephaly
#4
Rosalinda Calandrelli, Fabio Pilato, Luca Massimi, Marco Panfili, Concezio Di Rocco, Cesare Colosimo
PURPOSE: The effects of premature fusion of one coronal suture cause skull and orbital alterations in term of side-to-side asymmetry. This study aimed to quantify the cranio-orbital complex changes related to the severity of skull base dysmorphology in patients with unicoronal synostosis. METHODS: Twenty-four infants affected by unicoronal synostosis were subdivided in three subgroups according to the severity of skull base deformity and their high-resolution CT images were quantitatively analyzed (groups IIa, IIb, III)...
May 14, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29760919/anatomy-of-the-posterior-and-middle-ethmoidal-arteries-via-computed-tomography
#5
Hiroki Yamamoto, Kazuhiro Nomura, Hiroshi Hidaka, Yukio Katori, Naohiro Yoshida
Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon. Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29751190/preoperative-embolization-of-skull-base-meningiomas-outcomes-in-the-onyx-era
#6
Colin J Przybylowski, Jacob F Baranoski, Alfred P See, Bruno C Flores, Rami O Almefty, Dale Ding, Kristina M Chapple, Nader Sanai, Andrew F Ducruet, Felipe C Albuquerque
OBJECTIVE: Preoperative embolization may facilitate skull base meningioma resection, but its safety and efficacy in the Onyx era have not been investigated. In this retrospective cohort study, we evaluated the outcomes of preoperative embolization of skull base meningiomas using Onyx as the primary embolysate. METHODS: We queried an endovascular database for patients with skull base meningiomas who underwent preoperative embolization at our institution in 2007-2017...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#7
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29749910/a-novel-low-cost-reusable-high-fidelity-neurosurgical-training-simulator-for-cerebrovascular-bypass-surgery
#8
Ulas Cikla, Balkan Sahin, Sahin Hanalioglu, Azam S Ahmed, David Niemann, Mustafa K Baskaya
OBJECTIVE Cerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techniques. Most available training tools, however, either lack the realism of the actual bypass surgery (e.g., artificial vessel, chicken wing models) or require special facilities and regulations (e...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29747315/-value-of-pet-ct-in-the-prognosis-of-extranodal-nk-t-cell-lymphoma
#9
G H Dong, Y Li, H F Wan, C Y He, L Yang, J W Wang, L P Gong, Y H Zhao, Z F Gao, H G Liu
Objective: To explore the value of Positron-Emission Tomography/Computed Tomography (PET/CT) in the prognosis of extranodal NK/T cell lymphoma. Methods: The patients of NK/T cell lymphoma diagnosed from January 2007 to July 2016 in Department of Pathology of Beijing Tongren Hospital were enrolled in this study. Seventy-two in-hospital patients were examined on the invasion of adjecent tissue or organ by PET/CT. The PET/CT results were analyzed retrospectively. Kaplan-Meier method was used to analyze the prognostic value of the positive results by PET/CT on overall survival (OS)...
April 24, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29744230/skull-base-osteomyelitis-from-otitis-media-presenting-as-the-collet-sicard-syndrome
#10
Wong-Kein Low, Hui-Ling Lhu
Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae , this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media...
2018: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29741741/microsurgical-resection-of-glomus-jugulare-tumors-with-facial-nerve-reconstruction-3-dimensional-operative-video
#11
Duarte N C Cândido, Jean Gonçalves de Oliveira, Luis A B Borba
Paragangliomas are tumors originating from the paraganglionic system (autonomic nervous system), mostly found at the region around the jugular bulb, for which reason they are also termed glomus jugulare tumors (GJT). Although these lesions appear to be histologically benign, clinically they present with great morbidity, especially due to invasion of nearby structures such as the lower cranial nerves. These are challenging tumors, as they need complex approaches and great knowledge of the skull base. We present the case of a 31-year-old woman, operated by the senior author, with a 1-year history of tinnitus, vertigo, and progressive hearing loss, that evolved with facial nerve palsy (House-Brackmann IV) 2 months before surgery...
May 8, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29737744/-clinical-analysis-of-adult-spontaneous-cerebrospinal-fluid-rhinorrhea
#12
Zheng Jie Zhu, Lan Cheng, Jun Yang, Qi Huang, Guo Zhen Meng, Rong Ping Cao
OBJECTIVES: To discuss the clinical characteristics, diagnosis and treatment of adult spontaneous cerebrospinal fluid rhinorrhea (CSFR). METHODS: A retrospective study was conducted on 18 patients of CSFR. Nasal secretion was collected for biochemical analysis. Imaging examination was done for identification of the bony defect in skull base. RESULTS: In all cases, the glucose concentration of nasal secretion were more than 1.7 mmol/L, and the β-2 transferrin detected by immunoelectrophoresis technique were positive...
March 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29726777/surgical-outcomes-after-reoperation-for-recurrent-skull-base-meningiomas
#13
Stephen T Magill, David S Lee, Adam J Yen, Calixto-Hope G Lucas, David R Raleigh, Manish K Aghi, Philip V Theodosopoulos, Michael W McDermott
OBJECTIVE Skull base meningiomas are surgically challenging tumors due to the intricate skull base anatomy and the proximity of cranial nerves and critical cerebral vasculature. Many studies have reported outcomes after primary resection of skull base meningiomas; however, little is known about outcomes after reoperation for recurrent skull base meningiomas. Since reoperation is one treatment option for patients with recurrent meningioma, the authors sought to define the risk profile for reoperation of skull base meningiomas...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682061/transcranial-and-epidural-approach-for-spontaneous-cerebrospinal-fluid-leakage-due-to-meningoencephalocele-of-the-lateral-sphenoid-sinus
#14
Ryosuke Shintoku, Masahiko Tosaka, Tatsuya Shimizu, Yuhei Yoshimoto
We experienced a case of sphenoid sinus type meningoencephalocele manifesting as severe cerebrospinal fluid (CSF) rhinorrhea. A 35-year-old man became aware of serous nasal discharge 1 year previously, which had gradually worsened. The nasal discharge was diagnosed as CSF rhinorrhea. Head computed tomography (CT) showed several small depressions in the bone of the left middle cranial fossa, and the largest depression extended through the bone to the lateral sphenoid sinus. Head magnetic resonance imaging revealed that the meningoencephalocele projected to the lateral sphenoid sinus, through this small bone defect of the middle cranial fossa...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29676691/defining-the-lateral-limits-of-the-endoscopic-endonasal-transtuberculum-transplanum-approach-anatomical-study-with-pertinent-quantitative-analysis
#15
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/29671218/neuroimaging-of-meckel-s-cave-in-normal-and-disease-conditions
#16
REVIEW
Ajay Malhotra, Long Tu, Vivek B Kalra, Xiao Wu, Ali Mian, Rajiv Mangla, Elias Michaelides, Pina Sanelli, Dheeraj Gandhi
Meckel's cave is a dural recess in the posteromedial portion of the middle cranial fossa that acts as a conduit for the trigeminal nerve between the prepontine cistern and the cavernous sinus, and houses the Gasserian ganglion and proximal rootlets of the trigeminal nerve. It serves as a major pathway in perineural spread of pathologies such as head and neck neoplasms, automatically upstaging tumours, and is a key structure to assess in cases of trigeminal neuralgia. The purpose of this pictorial review is threefold: (1) to review the normal anatomy of Meckel's cave; (2) to describe imaging findings that identify disease involving Meckel's cave; (3) to present case examples of trigeminal and non-trigeminal processes affecting Meckel's cave...
April 18, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29666323/schinzel-giedion-syndrome-a-novel-case-review-and-revised-diagnostic-criteria
#17
Wei-Liang Liu, Zhi-Xu He, Fang Li, Rong Ai, Hong-Wei Ma
Schinzel-Giedion syndrome (SGS) is a rare autosomal dominant inheritance disorder. Heterozygous de novo mutations in the SETBP1 gene have been identified as the genetic cause of SGS. Here, we report a novel case with the syndrome with a novel insertion mutation in SETBP1. We also present a review of SGS cases, and first revise diagnostic criteria of SGS based on clinicalfindings and/or SETBP1 mutation worldwide. A revised diagnostic criteria and typing of SGS can be determined. Type I (complex and classic type) SGS patients present a development delay and typical facial features (prominent forehead, midface retraction, and short and upturned nose) associated with hydronephrosis or two of the characteristic skeletal anomalies (a sclerotic skull base, wideoccipital synchondrosis, increased cortical density or thickness, and broad ribs)...
March 2018: Journal of Genetics
https://www.readbyqxmd.com/read/29657910/anterolateral-triangle-a-cadaveric-study-with-neurosurgical-significance
#18
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/29617919/combined-nasoseptal-and-inferior-turbinate-flap-for-reconstruction-of-large-skull-base-defect-after-expanded-endonasal-approach-operative-technique
#19
Julien Boetto, Moujahed Labidi, Kentaro Watanabe, Shunya Hanakita, Schahrazed Bouazza, Thibault Passeri, Anne-Laure Bernat, Sebastien Froelich
BACKROUND: Increasing indications for endoscopic endonasal approaches have led neurosurgeons to develop new reconstruction techniques for larger skull base defects. Vascularized grafts have been a great adjunction to reduce the rate of cerebrospinal fluid leak and can also be used to cover exposed critical structures such as the internal carotid artery. The nasoseptal flap and the inferior or middle turbinate flap are thus widely used in endoscopic skull base surgery, but may be insufficient for very large defects...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29598947/locoregional-extension-and-patterns-of-failure-for-nasopharyngeal-carcinoma-with-intracranial-extension
#20
Caineng Cao, Feng Jiang, Qifeng Jin, Ting Jin, Shuang Huang, Qiaoying Hu, Yuanyuan Chen, Yongfeng Piao, Yonghong Hua, Xinglai Feng, Xiaozhong Chen
OBJECTIVE: To evaluate the locoregional extension and patterns of failure for nasopharyngeal carcinoma (NPC) with intracranial extension to improve clinical target volume (CTV) delineation. PATIENTS AND METHODS: A total of 205 NPC patients with intracranial extension by magnetic resonance imaging (MRI) were retrospectively reviewed. RESULTS: According to the cumulative incidence rates of tumor invasion, we initially classified anatomic sites surrounding the nasopharynx into three risk grades: high risk (≥35%), medium risk (≥10-35%), and low risk (<10%)...
April 2018: Oral Oncology
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