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Middle Skull Base

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https://www.readbyqxmd.com/read/27913068/occult-infratemporal-fossa-neurofibroma-presenting-with-persistent-unilateral-tinnitus-and-middle-ear-effusion-more-than-meets-the-eye
#1
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
https://www.readbyqxmd.com/read/27898607/effects-of-intratympanic-dexamethasone-on-high-dose-radiation-ototoxicity-in-vivo
#2
Christine T Dinh, Si Chen, John Dinh, Stefania Goncalves, Esperanza Bas, Kyle Padgett, Perry Johnson, Nagy Elsayyad, Fred Telischi, Thomas Van De Water
BACKGROUND: Stereotactic radiosurgery for lateral skull base tumors can cause hearing loss when the cochleae are exposed to high doses of single-fraction radiation. Currently, there are no known nondosimetric preventative treatments for radiation-induced ototoxicity. HYPOTHESIS: Intratympanic (IT) dexamethasone (DXM), a synthetic steroid, protects against radiation-induced auditory hair cell (HC) and hearing losses in rats in vivo. METHODS: Seven rats received radiation (12 Gy) to both cochleae...
November 24, 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27891396/endoscopic-excision-of-symptomatic-simple-bone-cyst-at-skull-base
#3
Prashant Gunawat, Salman Tehran Shaikh, Vikram Karmarkar, Chandrashekhar Deopujari, Nishit Shah
Seizure is a classical feature of intra axial brain parenchymal lesion. Simple bone cyst is an unusual bony pathology at skull base presenting with unexpected symptoms of complex partial seizures. Skull base neuro-endoscopy has managed such lesions more effectively with reduced post-operative morbidity as compared to transcranial approach. This case report discusses a 20-year-old male who presented with 3 episodes of seizure over a time period of 10 months. MRI brain revealed T1 hypo and T2 hyper intense cystic lesion in middle cranial fossa with no enhancement on contrast administration...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27888269/internal-carotid-artery-pseudoaneurysm-and-ischemic-stroke-secondary-to-retropharyngeal-and-parapharyngeal-abscess-a-case-report-and-review-of-the-literature
#4
Michael W Ruff, Deena M Nasr, James P Klaas, Deborah L Renaud
Internal carotid artery pseudoaneurysm is an uncommon complication of retropharyngeal and parapharyngeal abscess in children. Treatment of the pseudoaneurysm has evolved in recent years from surgical ligation to endovascular techniques. Neurologic sequelae most commonly consist of Horner's syndrome with cerebral ischemia being uncommon. The clinical course of a 2-year-old boy with retropharyngeal abscess complicated by internal carotid artery pseudoaneurysm, is described and the literature is reviewed. A conventional angiogram confirmed the presence of a large pseudoaneurysm with no anterograde flow distal to the pseudoaneurysm and substantial collateral flow across the circle of Willis, with filling of the left anterior and middle cerebral arteries via the anterior and posterior communicating arteries...
November 25, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27855982/the-skull-of-homo-naledi
#5
Myra F Laird, Lauren Schroeder, Heather M Garvin, Jill E Scott, Mana Dembo, Davorka Radovčić, Charles M Musiba, Rebecca R Ackermann, Peter Schmid, John Hawks, Lee R Berger, Darryl J de Ruiter
The species Homo naledi was recently named from specimens recovered from the Dinaledi Chamber of the Rising Star cave system in South Africa. This large skeletal sample lacks associated faunal material and currently does not have a known chronological context. In this paper, we present comprehensive descriptions and metric comparisons of the recovered cranial and mandibular material. We describe 41 elements attributed to Dinaledi Hominin (DH1-DH5) individuals and paratype U.W. 101-377, and 32 additional cranial fragments...
November 14, 2016: Journal of Human Evolution
https://www.readbyqxmd.com/read/27837265/unusual-foramen-in-the-middle-cranial-fossae-of-adult-black-south-african-skull-specimens
#6
Pedzisai Mazengenya, Okobi Ekpo
Variations of the skull base foramina are quite common and often cause surgical confusion during surgical intervention of the region. The unusual foramen was observed in five (0.98%) adult skulls of black South Africans obtained from the Raymond A Dart collection of human specimens housed in the School of Anatomical Sciences at the University of the Witwatersrand. Three of the five specimens were females while the remaining two were males. In four of the five skulls, the unusual foramen was located anterolateral to the foramen rotundum both on the left and right sides...
November 11, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27773560/surgical-resection-of-sinonasal-hemangiopericytoma-involving-anterior-skull-base-case-reports-and-literature-review
#7
Jonathan C Simmonds, Elie E Rebeiz
Hemangiopericytomas are soft tissue tumors composed of pericytic cells that are characterized by their "staghorn" vascular branching and their variable clinical presentation. Fifteen to 25% of all HPC occur in the head and neck, with only 5% found in the nose or paranasal sinuses. Sinonasal hemangiopericytoma (SNHPC) is considered distinct from its soft tissue counterpart - the former showing a more uniform cellular organization, has convincing pericytic differentiation and is associated with a far better prognosis...
September 28, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27767958/noncavernous-arteriovenous-shunts-mimicking-carotid-cavernous-fistulae
#8
Chai Kobkitsuksakul, Pakorn Jiarakongmun, Ekachat Chanthanaphak, Sirintara Pongpech
PURPOSE: The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages...
November 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27763982/review-of-life-quality-of-patients-with-benign-tumors-of-the-anterior-and-middle-part-of-the-skull-base-after-surgery-and-during-follow-up-in-russian-by-kadasheva-ab-cherekaev-va-shifrin-ma-kozlov-av-golbin-da-tsukanova-tv-galkin-mv-belov-ai-radchenkov-ns-in
#9
https://www.readbyqxmd.com/read/27755457/posterior-fossa-spontaneous-cerebrospinal-fluid-leaks
#10
Cameron C Wick, Daniel E Killeen, Michael Clark, Joe Walter Kutz, Brandon Isaacson
OBJECTIVE: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa. STUDY DESIGN: Retrospective case review. SETTING: Tertiary university hospital. PATIENTS: Adult patients from 2005 to 2015 who underwent surgical repair of a spontaneous lateral skull base CSF leak with intraoperative confirmation of a posterior fossa leak source...
October 14, 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27752754/visualization-of-anatomy-in-normal-and-pathologic-middle-ears-by-cone-beam-ct
#11
Christian Güldner, Isabell Diogo, Eva Bernd, Stephanie Dräger, Magis Mandapathil, Afshin Teymoortash, Hesham Negm, Thomas Wilhelm
Cone beam computed tomography (CBCT, syn. digital volume tomography = DVT) was introduced into ENT imaging more than 10 years ago. The main focus was on imaging of the paranasal sinuses and traumatology of the mid face. In recent years, it has also been used in imaging of chronic ear diseases (especially in visualizing middle and inner ear implants), but an exact description of the advantages and limitations of visualizing precise anatomy in a relevant number of patients is still missing. The data sets of CBCT imaging of the middle and inner ear of 204 patients were analyzed regarding the visualization of 18 different anatomic structures...
October 17, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27730788/skull-base-osteomyelitis-caused-by-an-elegant-fungus
#12
Sharafine Stephen, Beula Subashini, Regi Thomas, Ajay Philip, Rajan Sundaresan
Malignant otitIs externa (skull base osteomyelitis) is predominantly caused by bacteria while fungal etiology is rare. We report a middle aged diabetic gentleman who succumbed to invasive skull base infection due to Apophysomyces elegans a fungus belonging to Zygomycetes which causes only skin and soft tissue infections. Mortality and invasive infections due to this genus is rarely reported, especially in the ear.
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27717944/-intracranial-arachnoid-cysts-in-the-clinical-and-radiological-aspect
#13
Gustaw Wojcik
Arachnoid cysts are intracranial pathologies in the space between the pia mater and the dura mater of the brain and cerebellum. Arachnoid cysts are derived from the arachnoidea mater, which while yielding to germination or splitting creates a space filled with liquid with a composition similar to cerebrospinal fluid. The aim of the study is to present possible clinical symptoms and radiological presentation of intracranial arachnoid cysts. The symptoms of intracranial arachnoid cysts are dependent on its size and location...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27651410/rare-case-of-bilateral-traumatic-internal-carotid-artery-dissection
#14
Joanne May Jenkins, Joel Norton, Timothy Hampton, Robert Weeks
A 55-year-old man was working in a trench when the wall collapsed in on him, pinning him to the wall. On arrival in the emergency department the patient began reporting of right-sided headache. Neurological examination revealed left-sided reduced sensation with weakness. Whole-body CT scan showed right-sided flail chest and bilateral haemothorax as well as loss of flow and thinning of the distal right internal carotid artery (ICA) and loss of grey white matter differentiation in keeping with traumatic ICA dissection with a right middle cerebral artery (MCA) infarct...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27650322/the-turbinal-flap-an-additional-option-for-anterior-skull-base-reconstruction-cadaveric-feasibility-study-and-case-report
#15
Alberto Schreiber, Davide Mattavelli, Marco Ferrari, Vittorio Rampinelli, Davide Lancini, Francesco Belotti, Luigi Fabrizio Rodella, Piero Nicolai
BACKGROUND: Over the past decade, the treatment of complex intradural and extradural pathologies via expanded endonasal approaches has been made possible by progresses and refinements in skull base reconstruction techniques. The aim of this anatomic study is to describe a novel endonasal flap, the turbinal flap (TF), based on the middle and superior turbinate mucosa and pedicled on the ethmoidal arteries system. METHODS: Three fresh-frozen (6 sides) cadaver heads previously injected with colored silicone were dissected...
September 21, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27648394/basic-imaging-of-skull-base-trauma
#16
REVIEW
Matthew Bobinski, Peter Y Shen, Arthur B Dublin
Skull base fractures extend through the floor of the anterior, middle, or posterior cranial fossa. They are frequently associated with complex facial fractures and serious complications such as cranial nerve or vascular injury, cerebrospinal fluid leak, or meningitis. Several distinct patterns of skull base fractures have been recognized, each of them associated with different complications. Recognition of, often subtle, skull base fracture is essential to prevent or allow early treatment of these serious complications...
October 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27647276/the-superior-petrosal-sinus-a-review-of-anatomy-embryology-pathology-and-neurosurgical-relevance
#17
Martin M Mortazavi, Marcus A Cox, Erfanul Saker, Sanjay Krishnamurthy, Ketan Verma, Christoph J Griessenauer, Marios Loukas, Rod J Oskouian, R Shane Tubbs
The superior petrosal sinus is located between the middle and posterior cranial fossae and is important during many neurosurgical approaches to the skull base. Using standard search engines, the anatomical and clinical importance of the superior petrosal sinus was investigated. The superior petrosal sinus is important in many neurosurgical approaches and pathological entities. Therefore, it is important for those who operate at the skull base or interpret imaging here to have a good working knowledge of its anatomy, development, and pathological involvement...
September 19, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27637645/embryological-consideration-of-dural-avf
#18
Michihiro Tanaka
BACKGROUND: The distribution of intracranial dural AVFs (DAVFs) may be affected by the embryological bony structures that consist of membranous bone and endochondral bone. METHODS: We retrospectively analyzed the distribution of the shunt points in 58 consecutive cases of DAVFs. Shunt points were identified with selective digital subtraction angiography, high-resolution cone beam computed tomography (CT), or three-dimensional rotation angiography. All the shunt points were plotted on the map of the skull base in relation to the topography of the endochondral bone and the membranous bone...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27636184/is-less-always-better-keyhole-and-standard-subtemporal-approaches-evaluation-of-temporal-lobe-retraction-and-surgical-volume-with-and-without-zygomatic-osteotomy-in-a-cadaveric-model
#19
Serdar Ercan, Alba Scerrati, Phengfei Wu, Jun Zhang, Mario Ammirati
OBJECTIVE The subtemporal approach is one of the surgical routes used to reach the interpeduncular fossa. Keyhole subtemporal approaches and zygomatic arch osteotomy have been proposed in an effort to decrease the amount of temporal lobe retraction. However, the effects of these modified subtemporal approaches on temporal lobe retraction have never been objectively validated. METHODS A keyhole and a classic subtemporal craniotomy were executed in 4 fresh-frozen silicone-injected cadaver heads. The target was defined as the area bordered by the superior cerebellar artery, the anterior clinoid process, supraclinoid internal carotid artery, and the posterior cerebral artery...
September 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27631830/middle-cranial-fossa-mcf-approach-without-the-use-of-lumbar-drain-for-the-management-of-spontaneous-cerebral-spinal-fluid-csf-leaks
#20
Rick F Nelson, Joseph P Roche, Bruce J Gantz, Marlan R Hansen
OBJECTIVE: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial. STUDY DESIGN: Retrospective review from 2003 to 2015. SETTING: University of Iowa Hospitals and Clinics and Indiana University Health Center. PATIENTS: Those with a confirmed lateral skull base spontaneous CSF leaks and/or encephaloceles...
December 2016: Otology & Neurotology
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