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Middle Skull Base

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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
#1
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/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#2
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/28299444/the-ethmoidal-arteries-a-cadaveric-study-based-on-cone-beam-computed-tomography-and-endoscopic-dissection
#3
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/28286392/complications-of-midface-swing-for-management-of-juvenile-nasopharyngeal-angiofibroma
#4
Sanjay Roy Chowdhury, K Rajkumar, Tushar Deshmukh
INTRODUCTION: Access osteotomies provide direct exposure to inaccessible areas of the deep part of craniofacial skeleton for treating pathologies involving vital structures. The use of maxillary swing approach for gaining wide access to the nasopharynx, infratemporal fossa, parapharyngeal space, middle fossa of skull base. Though the maxillary swing requires transfacial incision for wide exposure but with careful handling the scar is minimum and this approach can be used in young people...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28236049/analysis-of-the-venous-channel-within-the-clivus-using-multidetector-computed-tomography-digital-subtraction-venography
#5
Katsuhiro Mizutani, Masahiro Toda, Jun Kurasawa, Takenori Akiyama, Hirokazu Fujiwara, Masahiro Jinzaki, Kazunari Yoshida
PURPOSE: Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. METHODS: Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. RESULTS: Eighteen emissary veins were identified in 14 (28...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28171738/analysis-of-audiometric-outcomes-following-combined-middle-cranial-fossa-transmastoid-approaches-for-spontaneous-cerebrospinal-fluid-otorrhea
#6
Shawn M Stevens, Ryan Crane, Myles L Pensak, Ravi N Samy
Outcome Objectives To (1) explore audiometric outcomes following use of a combined transmastoid/middle cranial fossa (TM-MCF) approach in the treatment of spontaneous cerebrospinal fluid (CSF) otorrhea and (2) determine the influence of dehiscence location and reconstructive methodology on audiometric outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults with spontaneous CSF otorrhea were reviewed from 2007 to 2016 if they underwent combined TM-MCF. Definitive audiometric evaluations were performed at least 3 months postoperatively...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28153164/growth-changes-in-the-anterior-and-middle-cranial-bases-assessed-with-cone-beam-computed-tomography-in-adolescents
#7
Mona Afrand, Heesoo Oh, Carlos Flores-Mir, Manuel O Lagravère-Vich
INTRODUCTION: Initially, cone-beam computed tomography images from dry skulls were used to 3 dimensionally evaluate intrarater and interrater reliabilities and accuracy of selected 3-dimensional landmarks located in the anterior and middle cranial bases. Thereafter, dimensional changes of the anterior and middle cranial bases with growth were evaluated by using the previously selected landmarks. METHODS: Cone-beam computed tomography images of 10 dry skulls were used to identify useful landmarks from different areas of the anterior and middle cranial bases based on their reliability and accuracy...
February 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28121968/outcomes-of-the-suture-pull-through-technique-for-repair-of-lateral-skull-base-csf-fistula-and-encephaloceles
#8
Brendan P O'Connell, Jacob B Hunter, Alex D Sweeney, Reid C Thompson, Lola B Chambless, George B Wanna, Alejandro Rivas
OBJECTIVE: Describe the safety profile and surgical outcomes of a combined transmastoid-middle cranial fossa suture "pull-through" technique for repair of lateral skull base defects. STUDY DESIGN: Retrospective. SETTING: Tertiary care hospital. PATIENTS: Patients undergoing surgery for cerebrospinal fluid (CSF) fistula and/or encephalocele. INTERVENTION: Combined transmastoid and middle fossa approach using suture pull-through technique...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28116489/the-association-of-superior-attachment-of-uncinate-process-with-pneumatization-of-middle-turbinate-a-computed-tomographic-analysis
#9
Sheng-Yao Cheng, Chih-Jen Yang, Chiao-Hua Lee, Shao-Cheng Liu, Chao-Yin Kuo, Jih-Chin Lee, Cheng-Ping Shih
The frontal sinus outflow pathway is complex and can be influenced by the configuration of the uncinate process (UP). The UP can attach superior to the lamina papyracea, skull base, and middle turbinate. The factors associated with superior attachment remain unclear. This study analyzed the relationships between different types of superior UP attachment and characteristics of the surrounding structures including the agger nasi cell, skull base, and middle turbinate. This retrospective study utilized computed tomography images of 836 sides with identifiable sinus structure from 434 Taiwanese patients...
April 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28097430/how-i-do-it-the-mononostril-endonasal-transethmoidal-paraseptal-approach
#10
Robert Reisch, Hans Rudolf Briner, Anne-Katrin Hickmann
BACKGROUND: The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach. METHODS: The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28094160/a-case-of-generalized-lymphatic-anomaly-causing-skull-base-leakage-and-bacterial-meningitis
#11
Kenichi Suga, Aya Goji, Miki Inoue, Masami Kawahito, Masako Taki, Kazuhiro Mori
Generalized lymphatic anomaly is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 3year-old Japanese boy presented with right facial palsy due to cystic tumors in the ipsilateral petrous bone. Pericardial effusion had been found incidentally and generalized lymphatic anomaly had been diagnosed by pericardial biopsy. Petrous bone tumor had been followed up without surgery. At the age of seven he presented with fever and disturbance of consciousness, and bacterial meningitis due to Streptococcus pneumoniae was diagnosed...
January 13, 2017: Brain & Development
https://www.readbyqxmd.com/read/28050639/cerebral-bone-subtraction-ct-angiography-using-80%C3%A2-kvp-and-sinogram-affirmed-iterative-reconstruction-contrast-medium-and-radiation-dose-reduction-with-improvement-of-image-quality
#12
Yasunori Nagayama, Takeshi Nakaura, Akinori Tsuji, Joji Urata, Mitsuhiro Furusawa, Hideaki Yuki, Kenichiro Hirarta, Seitaro Oda, Masafumi Kidoh, Daisuke Utsunomiya, Yasuyuki Yamashita
INTRODUCTION: The purpose of this study was to evaluate the feasibility of a contrast medium (CM), radiation dose reduction protocol for cerebral bone-subtraction CT angiography (BSCTA) using 80-kVp and sinogram-affirmed iterative reconstruction (SAFIRE). METHODS: Seventy-five patients who had undergone BSCTA under the 120- (n = 37) or the 80-kVp protocol (n = 38) were included. CM was 370 mgI/kg for the 120-kVp and 296 mgI/kg for the 80-kVp protocol; the 120- and the 80-kVp images were reconstructed with filtered back-projection (FBP) and SAFIRE, respectively...
January 3, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28042016/spontaneous-intraventricular-hemorrhage-a-rare-presentation-of-a-skull-base-mesenchymal-chondrosarcoma
#13
Altaf Ali Laghari, Gohar Javed, Muhammad Faheem Khan, Syed Ijlal Ahmed, Karim Rizwan Nathani, Riyasat Ahmed
BACKGROUND: Chondrosarcomas are very rare malignant, slow-growing tumors that develop in or near the petroclival region of the brain. We report a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage leading to an acute comatose presentation. CASE DESCRIPTION: A 28-year-old man initially presented to the outpatient department with a 1-month history of headache, vomiting, vertigo, and left facial numbness. A lesion at the cerebellopontine angle with extension into the middle cranial fossa was demonstrated on computed tomography and magnetic resonance imaging...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28032687/transnasal-endoscopic-partial-maxillectomy-operative-nuances-and-proposal-for-a-comprehensive-classification-system-based-on-1378-cases
#14
Mario Turri-Zanoni, Paolo Battaglia, Apostolos Karligkiotis, Davide Lepera, Jacopo Zocchi, Iacopo Dallan, Maurizio Bignami, Paolo Castelnuovo
BACKGROUND: Despite the development of functional endoscopic endonasal surgery, there are still areas of the maxillary sinus that remain technically difficult to access using a standard middle meatal antrostomy as well as deep-seated skull base lesions requiring expanded transmaxillary approaches. METHODS: All patients who underwent transnasal endoscopic partial maxillectomy (TEPM) in a single institution from 2000 to 2014 were retrospectively reviewed. The TEPM was classified into 5 types according to the anatomic structures progressively removed and to the access provided...
December 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27987512/-diagnosis-and-treatment-of-diffuse-tenosynovial-giant-cell-tumor-arising-from-temporomandibular-joints
#15
J H Meng, Y X Guo, H Y Luo, C B Guo, X C Ma
OBJECTIVE: To retrospectively analyze the clinical features, treatment and prognosis to the diffuse tenosynovial giant cell tumor (D-TSGCT) arising from the temporomandibular joint (TMJ), and to give a reference for the early diagnosis and treatment of this disease. METHODS: In this study, 15 patients finally diagnosed as D-TSGCT of TMJ histopathologically at the Peking University Hospital of Stomatology from October 2003 to August 2015 were selected and reviewed...
December 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27933634/middle-cranial-fossa-approach-to-repair-tegmen-defects-assisted-by-three-dimensionally-printed-temporal-bone-models
#16
Sameer Ahmed, Kyle K VanKoevering, Stephanie Kline, Glenn E Green, H Alexander Arts
OBJECTIVES/HYPOTHESIS: To explore the perioperative utility of three-dimensionally (3D)-printed temporal bone models of patients undergoing repair of lateral skull base defects and spontaneous cerebrospinal fluid leaks with the middle cranial fossa approach. STUDY DESIGN: Case series. METHODS: 3D-printed temporal bone models-based on patient-specific, high-resolution computed tomographic imaging-were constructed using inexpensive polymer materials...
December 9, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27932750/-a-case-report-of-spontaneous-cerebrospinal-fluid-otorrhea
#17
Hidenori Anami, Shigeru Ikeda, Kotaro Nakaya, Makoto Sugiura, Takakazu Kawamata
Spontaneous cerebrospinal fluid(CSF)otorrhea is less common than CSF leakage caused by trauma, and rarely occurs in adults. We report an adult case of CSF otorrhea. A 71-year-old woman with no traumatic or otologic history was hospitalized due to bacterial meningitis. After hospitalization, CSF leakage started suddenly from the left external ear canal. A high resolution CT scan with intrathecal administration of contrast material revealed CSF leakage in the left ear canal and multiple bone erosions in both the tegmen mastoideum and the posterior fossa aspect of the petrous bone...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27931523/a-blue-middle-ear-mass-cholesterol-granuloma-mimicking-a-glomus-tumor-and-endolymphatic-sac-tumor
#18
Clara Olcott, Barry Strasnick
Cholesterol granuloma (CG) is the most common benign lesion of the petrous apex, however, it can grow significantly large and become destructive causing a diagnostic dilemma. This case presents a 25-year-old female with 2-year history of left-sided progressive and profound hearing loss, a transient left-sided facial paralysis and cranial nerve 10 palsy who presented with a blue middle ear mass. Her diagnosis did not become apparent until direct visualization intraoperatively. The objective of this case study is to highlight the destructive capabilities of CG and the importance to keep it in the differential diagnosis of a large, erosive, expansile skull base lesion in order to avoid overly aggressive resection or other unnecessary treatment...
January 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27923935/radiographic-mastoid-and-middle-ear-effusions-in-intensive-care-unit-subjects
#19
Phillip Huyett, Yael Raz, Barry E Hirsch, Andrew A McCall
BACKGROUND: This study was conducted to determine the incidence of and risk factors associated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of Pittsburgh Medical Center neurologic ICU from April 2013 through April 2014 were retrospectively reviewed. Images were reviewed for absent, partial, or complete opacification of the mastoid air cells and middle ear space...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27913068/occult-infratemporal-fossa-neurofibroma-presenting-with-persistent-unilateral-tinnitus-and-middle-ear-effusion-more-than-meets-the-eye
#20
Lucas P Carlstrom, Kathryn M Van Abel, Matthew L Carlson, Eric J Moore, Janalee K Stokken
Herein, we present the case of a previously healthy 54year-old female who developed several weeks of unilateral tinnitus and aural fullness. She subsequently underwent unilateral pressure equalization tube placement at an outside institution after exam demonstrated a middle ear effusion, conductive hearing loss and normal nasopharyngoscopy. Ultimately, an MRI revealed an occult mass in the infratemporal fossa (ITF), which was successfully removed via an endoscopic transnasal ITF approach. Following resection of a histopathologically confirmed benign neurofibroma, she reported complete resolution of her symptoms...
November 23, 2016: American Journal of Otolaryngology
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