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Middle Skull Base

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https://www.readbyqxmd.com/read/29135804/surgical-management-of-tumors-involving-meckel-s-cave-and-cavernous-sinus-role-of-an-extended-middle-fossa-and-lateral-sphenoidectomy-approach
#1
Daniel Q Sun, Arnold H Menezes, Matthew A Howard, Bruce J Gantz, David M Hasan, Marlan R Hansen
OBJECTIVE: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). STUDY DESIGN: Retrospective patient series. SETTING: Tertiary referral center. PATIENTS: Twenty-two consecutive patients (mean age: 45 yr, range: 16-76) who underwent transzygomatic, extended middle fossa approaches for tumors involving MC and CS...
November 13, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29134165/an-innovate-robotic-endoscope-guidance-system-for-transnasal-sinus-and-skull-base-surgery-proof-of-concept
#2
D T Friedrich, F Sommer, M O Scheithauer, J Greve, T K Hoffmann, P J Schuler
Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29134162/lesions-mimicking-small-vestibular-schwannomas
#3
Matthias Scheich, Rudolf Hagen, Desiree Ehrmann-Müller, Brigitte Bison, Thomas Günthner-Lengsfeld, Camelia-Maria Monoranu, Hans-Ullrich Völker
Objective  Most tumors of the internal auditory canal and cerebellopontine angle (CPA) are vestibular schwannomas (VSs). Preoperative diagnosis is based on typical clinical symptoms and radiological findings. In rare cases, histopathology can, however, show different results. Design  This is a retrospective chart and database review. Setting  The study was conducted at a tertiary skull base referral center at a university hospital. Participants  A total of 207 consecutive cases of VS surgery via the middle cranial fossa approach performed between December 2005 and January 2015 were reviewed...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29124088/considerations-and-code-for-partial-volume-correcting-18-f-av-1451-tau-pet-data
#4
Suzanne L Baker, Anne Maass, William J Jagust
[(18)F]-AV-1451 is a leading tracer used with positron emission tomography (PET) to quantify tau pathology. However, [(18)F]-AV-1451 shows "off target" or non-specific binding, which we define as binding of the tracer in unexpected areas unlikely to harbor aggregated tau based on autopsy literature [1]. Along with caudate, putamen, pallidum and thalamus non-specific binding [2], [3], we have found binding in the superior portion of the cerebellar gray matter, leading us to use inferior cerebellar gray as the reference region...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/29114160/clinical-characteristics-of-troublesome-pediatric-tinnitus
#5
Annett Szibor, Topi Jutila, Antti Mäkitie, Antti Aarnisalo
Objectives: The frequency of tinnitus in children and adults is practically the same. However, although adults reveal their symptoms and seek for medical aid, the suffering often remains unrecognized in the young. This is due to both the inability of children to properly describe their symptoms and the lack of recognition. Materials and methods: Among 5768 patients entering our department with complaints of tinnitus between 2010 and 2015, there were only 112 children...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/29098132/mycotic-pseudoaneurysm-associated-with-skull-base-osteomyelitis-treated-with-endovascular-embolization
#6
Ali S Haider, Brandon I Esianor, Mrigank S Shail, Margaret I Engelhardt, Aida Kafai Golahmadi, Ramiz Khan, Umair Khan, Steven Vayalumkal, Richa Thakur, Kennith F Layton
Pseudoaneurysms occur due to malformations in arterial wall uniformity, leading to blood collection between the outer arterial layers and resultant outpouching of the vessel. Unlike true aneurysms, pseudoaneurysms do not involve all layers of the blood vessel. Mycotic pseudoaneurysms can occur after associated vessel adventitia infection, leading to transmural dissection. Here we present a case of a 78-year-old man with a history of chronic otitis externa and osteomyelitis who presented with increasing right ear pain with bloody discharge and associated headache...
August 28, 2017: Curēus
https://www.readbyqxmd.com/read/29094066/surgical-repair-of-spontaneous-cerebrospinal-fluid-csf-leaks-a-systematic-review
#7
REVIEW
Brian C Lobo, Maraya M Baumanis, Rick F Nelson
Objectives: To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources: A systematic review of English articles using MEDLINE. Review Methods: Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles by 3 authors. Results: Patients with spontaneous CSF leaks are often obese (average BMI of 38 kg/m(2)) and female (72%)...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29076075/proximal-type-epithelioid-sarcoma-in-skull-base-a-pathological-diagnosis-challenge-with-other-intracranial-tumors
#8
Duan Zejun, Yao Kun, Lu Dehong, Qi Xueling
Proximal-type ES (PES) is a rare and aggressive sarcoma originated from soft tissues with uncertain differentiation. It mainly affects middle-aged patients and often locates in proximal extremity and deep-seated tissues. Only one case of PES located in the skull base has been reported to date. Herein, we report two cases of PES occurred in the middle cranial fossa in two middle-aged Chinese women. Microscopically, the tumors were consisted of epithelial-like cells with or without rhabdoid cells. And frequent mitotic activity and coagulation necrosis were present...
October 26, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#9
REVIEW
Srikant Chakravarthi, Lior Gonen, Alejandro Monroy-Sosa, Sammy Khalili, Amin Kassam
The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF)...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29064038/hypofractionated-high-energy-proton-beam-irradiation-is-an-alternative-treatment-for-who-grade-i-meningiomas
#10
Pavlos Vlachogiannis, Olafur Gudjonsson, Anders Montelius, Erik Grusell, Ulf Isacsson, Kristina Nilsson, Erik Blomquist
BACKGROUND: Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. METHOD: A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155)...
October 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29022108/middle-cranial-fossa-approach-for-the-repair-of-superior-semicircular-canal-dehiscence-is-associated-with-greater-symptom-resolution-compared-to-transmastoid-approach
#11
REVIEW
Thien Nguyen, Carlito Lagman, John P Sheppard, Prasanth Romiyo, Courtney Duong, Giyarpuram N Prashant, Quinton Gopen, Isaac Yang
BACKGROUND: Superior semicircular canal dehiscence (SSCD) is a disorder of the skull base that is gaining increasing recognition among neurosurgeons. Traditionally, the middle cranial fossa (MCF) approach has been used for the surgical repair of SSCD. However, the transmastoid (TM) approach is an alternative strategy that has demonstrated promising results. METHODS: We performed independent searches of a popular database to identify studies that described outcomes following the surgical repair of SSCD through MCF and TM approaches...
October 11, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28990662/the-radioanatomy-of-endonasal-flap-coverage-of-skull-base-defects-a-tool-for-preoperative-planning
#12
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/28986644/traumatic-occipito-cervical-dissociation-in-adults-a-middle-eastern-cohort-study
#13
K Venugopal Menon, Ismail Al Habsi, Khalifa Al Ghafri
The objective of this study is to describe a series of cranio-cervical dissociation victims and evaluate their outcomes as well as discuss the clinical dilemmas we faced in the context of current literature evidence. This is a retrospective cohort study of traumatic occipito-cervical dissociation in five patients (three males and two females) encountered between 2010 and 2016 at a tertiary care facility in the Middle East region. All patients underwent occipito-cervical fusion using screws and rods system with mean postoperative follow-up period of 2...
October 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28973649/dural-closure-in-confined-spaces-of-the-skull-base-with-nonpenetrating-titanium-clips
#14
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/28967313/extended-middle-fossa-approach-with-anterior-petrosectomy-for-resection-of-upper-petroclival-meningioma-involving-meckel-s-cave-operative-video-and-technical-nuances
#15
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
#16
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/28958924/moyamoya-disease-associated-with-tuberculum-sellae-meningioma-and-cavernous-sinus-hemangioma-case-report
#17
Feng Xu, Hailiang Tang, Ji Xiong, Xiaoxia Liu
BACKGROUND: Primary moyamoya disease associated with skull base tumors has been rarely reported in the literature. Surgical treatment can be complicated due to the compensatory collateral circulation through meningeal and leptomeningeal anastomosis. The standard frontotemporal craniotomy may interrupt critical transdural anastomoses. CASE DESCRIPTION: We reported a case of primary moyamoya disease coexisting with tuberculum sellae meningioma and left cavernous sinus hemangioma...
September 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28940480/thirty-day-morbidity-and-mortality-following-otologic-neurotologic-surgery-analysis-of-the-national-surgical-quality-improvement-program
#18
Zachary G Schwam, Elias Michaelides, Phoebe Kuo, Michael A Hajek, Benjamin L Judson, Christopher Schutt
OBJECTIVES/HYPOTHESIS: To determine the rate and timing of, as well as risk factors for, postoperative morbidity and mortality following otologic and neurotologic surgery. STUDY DESIGN: Retrospective cohort study. METHODS: A total of 1,381 patients were identified in the American College of Surgeons National Surgical Quality Improvement Program for the years 2005 to 2010. Simple summary statistics, χ(2) , and multivariable logistic regression were performed...
September 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28938328/bulla-down-endoscopic-sphenoidotomy
#19
Mohannad Al-Qudah
Surgical approach to the sphenoid sinus is still one of the most challenging steps in sinus surgery. The author describes a novel, simple, and safe technique to access sphenoid sinus to manage isolated sphenoid pathologies or approach skull base by removing the bulla ethmoidalis and temporarily lateralizing the middle turbinate during endoscopic sinus surgery. The current approach provides an effective method to access the sphenoid sinus without increasing morbidity and avoids unnecessary possible complications associated with turbinates' resection...
November 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28931257/morphometric-analysis-of-the-middle-clinoid-process-using-maxillofacial-computed-tomography-scans
#20
Christopher Miller, Roukoz Chamoun, David Beahm
BACKGROUND: The interest in detailed anatomy of the sella and parasellar regions has resurged recently due to the wide clinical applications of the expanded endoscopic approaches to the skull base. The middle clinoid process (MCP) is a bony structure that can affect wide endoscopic exposure of the sella and parasellar region. OBJECTIVE: To study and analyze the anatomic variations of the MCP in the general population using computed tomography scans. METHODS: A total of 150 maxillofacial computed tomography scans were reviewed to characterize the MCP...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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