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Middle Skull Base

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https://www.readbyqxmd.com/read/28602922/the-spheno-pterional-point-a-strategic-point-for-burr-role-placement-in-frontotemporal-craniotomies
#1
Baltazar Leão Reis, Roberto Leal da Silveira, Sebastião Nataniel Silva Gusmão
BACKGROUND: Frontotemporal craniotomies are the most commonly performed neurosurgical approaches. We studied the external bony landmarks on the lateral surface of the skull to identify a "strategic" point where both the anterior and middle cranial fossae are exposed simultaneously during frontotemporal craniotomies through a single burr hole placed over the greater wing of sphenoid bone (spheno-pterional point). OBJECTIVE: This study aimed to anatomically define the spheno-pterional point via craniometric measurements taken on the lateral surface of the human skull...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28574308/clinical-outcomes-of-an-endoscopic-transclival-and-transpetrosal-approach-for-primary-skull-base-malignancies-involving-the-clivus
#2
Yong Hwy Kim, Chiman Jeon, Young-Bem Se, Sang Duk Hong, Ho Jun Seol, Jung-Ii Lee, Chul-Kee Park, Dong Gyu Kim, Hee-Won Jung, Doo Hee Han, Do-Hyun Nam, Doo-Sik Kong
OBJECTIVE The endoscopic endonasal approach for treating primary skull base malignancies involving the clivus is a formidable task. The authors hypothesized that tumor involvement of nearby critical anatomical structures creates hurdles to endoscopic gross-total resection (GTR). The aim of this study was to retrospectively review the clinical outcomes of patients who underwent an endoscopic endonasal approach to treat primary malignancies involving the clivus and to analyze prognostic factors for GTR. METHODS Between January 2009 and November 2015, 42 patients underwent the endoscopic endonasal approach for resection of primary skull base malignancies involving the clivus at 2 independent institutions...
June 2, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28540121/comprehensive-preoperative-staging-system-for-endoscopic-single-and-multicorridor-approaches-to-juvenile-nasal-angiofibromas
#3
Trichy N Janakiram, Shilpee B Sharma, Ekkehard Kasper, Onkar Deshmukh, Iype Cherian
BACKGROUND: Juvenile nasal angiofibromas (JNA) is a benign lesion with high vascularity and propensity of bone erosion leading to skull base invasion and intracranial extension. It is known to involve multiple compartments, which are often surgically difficult to access. With evolution in surgical expertise and technical innovations, endoscopic and endoscopic-assisted management has become the preferred choice of surgical management. Over the last four decades, various staging systems have been proposed, which are largely based on the extent of nasal angiofibroma...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28502655/earliest-mysticete-from-the-late-eocene-of-peru-sheds-new-light-on-the-origin-of-baleen-whales
#4
Olivier Lambert, Manuel Martínez-Cáceres, Giovanni Bianucci, Claudio Di Celma, Rodolfo Salas-Gismondi, Etienne Steurbaut, Mario Urbina, Christian de Muizon
Although combined molecular and morphological analyses point to a late middle Eocene (38-39 million years ago) origin for the clade Neoceti (Odontoceti, echolocating toothed whales plus Mysticeti, baleen whales, and relatives), the oldest known mysticete fossil dates from the latest Eocene (about 34 million years ago) of Antarctica [1, 2]. Considering that the latter is not the most stemward mysticete in recent phylogenies and that Oligocene toothed mysticetes display a broad morphological disparity most likely corresponding to contrasted ecological niches, the origin of mysticetes from a basilosaurid ancestor and its drivers are currently poorly understood [1, 3-8]...
May 22, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28498268/transcanal-endoscopic-ear-surgery-for-excision-of-a-facial-nerve-venous-malformation-with-interposition-nerve-grafting-a-case-report
#5
Cameron C Wick, Mark Sakai, Timothy E Richardson, Brandon Isaacson
OBJECTIVE: To illustrate a novel approach for the surgical management of a venous malformation of the facial nerve, including interposition nerve grafting, via an exclusively transcanal endoscopic ear surgery (TEES) approach. PATIENT: Thirty nine-year-old woman with a preoperative House-Brackmann (HB) grade IV facial paresis secondary to a facial nerve tumor. INTERVENTION(S): Surgical excision and interposition nerve graft via a transcanal endoscopic approach...
July 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28487802/clinical-challenges-in-the-diagnosis-and-treatment-of-temporal-bone-osteomyelitis
#6
Liubov Kornilenko, Saulius Rocka, Svajunas Balseris, Irina Arechvo
Temporal bone osteomyelitis is a serious life-threatening condition-a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Changing trends of the disease make a differential diagnosis difficult. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. Neoplasm and granulomatous inflammation were excluded by multiple biopsies...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28481397/endoscopic-endonasal-cerebrospinal-fluid-leak-repair-on-the-ventral-midline-skull-base-a-single-neurosurgical-center-experience
#7
Cihan Isler, Merdin Lyutviev Ahmedov, Mehmet Yigit Akgun, Baris Kucukyuruk, Nurperi Gazioglu, Galip Sanus, Necmettin Tanriover
AIM: The aim of this study was to present the results of endoscopic endonasal repair of ventral midline skull base cerebrospinal fluid (CSF) leak (VMSBL) at our institution and to discuss the technique and results from a neurosurgical perspective. MATERIAL AND METHODS: A retrospective analysis of all VMSBL cases that underwent endoscopic endonasal skull base approach (EESBA) for CSF leak repair at a single tertiary neurosurgical center was performed. Twenty six patients with an average age of 44...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28465271/endoscopic-superior-ethmoidal-approach-for-anterior-cranial-base-resection-tailoring-the-approach-for-maximum-exposure-with-preservation-of-nasal-structures
#8
Maria Peris Celda, Tyler Kenning, Carlos D Pinheiro-Neto
OBJECTIVE: The traditional endoscopic anterior cranial base resection involves total removal of the ethmoidal cells including middle and superior turbinates. This is associated with increased volume of the nasal cavity postoperatively with more crusting and permanent change of the nasal airflow. The objective is to describe the step-by-step technique and feasibility of the superior ethmoidal approach for anterior cranial base resection with maximum exposure of the anterior cranial base maintaining the middle turbinates, uncinate processes and ostiomeatal complexes intact...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28460204/agenesis-of-the-internal-carotid-artery-a-family-pathology
#9
F M Perla, G Carbotta, D Di Nardo, M D'Avanzo, M C Colaiacomo, C Di Biasi, L Falvo, S Carbotta, A Maturo, F Tartaglia, L Tromba
The internal carotid artery agenesis is a rare malformation disorder. We report the case of a 12-year-old boy suffering migraine, who had presented an episode featuring amaurosis fugax, spontaneously regressed. CT angiography images show hypoplasia of the left common carotid artery with loss of opacification of the left internal carotid artery consistent to agenesis. Moreover CT scans through the skull base demonstrate absence of left petrous carotid canal and an hypertrophic left middle cerebral artery originating from an aberrant artery arising from the right cavernous carotid...
January 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28435118/transoral-intracranial-injury-via-middle-skull-base-by-a-blunt-chopstick-in-a-child
#10
Thiti Samuthrat, Ke Ye, Ying Tong
BACKGROUND: Transoral penetrating injury from a blunt-tipped chopstick is unusual and should be promptly dealt with since it is associated with high morbidity and mortality. CASE DESCRIPTION: We report a peculiar case of a 2-year-old girl who suffered from a transoral penetrating brain injury after falling onto a bamboo chopstick, which penetrated through the hard palate and eventually led to middle skull base fracture as well as temporal lobe laceration and contusion...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433849/clinical-significance-of-long-term-follow-up-of-children-with-posttraumatic-skull-base-fracture
#11
Sharon Leibu, Guy Rosenthal, Yigal Shoshan, Mony Benifla
BACKGROUND: To assess in children with skull base fractures, incidences of cerebrospinal fluid (CSF) leak, meningitis, and the need for prophylactic antibiotics, anti-pneumococcal vaccination, and surgical interventions. METHODS: We reviewed the records of children with skull base fractures who were admitted to our tertiary care center during 2009-2014. RESULTS: 196 children (153 male) were hospitalized with skull base fractures, aged 1 month to 18 years (mean 6 ± 4 years)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28418817/virtual-mapping-of-the-frontal-recess-guiding-safe-and-efficient-frontal-sinus-surgery
#12
Neil S Patel, Amy C Dearking, Erin K O'Brien, John F Pallanch
Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center. Methods Adult patients with computed tomography (CT) without sinonasal pathology were included. Virtual endoscopy (using OsiriX) and corresponding CT reconstructions were used to identify all visible ostia in the frontal recess and characterize their positions in spaces between the uncinate/agger nasi (U), bulla ethmoidalis (EB), and middle turbinate (MT)...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28409727/clival-chordomas-considerations-after-16-years-of-endoscopic-endonasal-surgery
#13
Matteo Zoli, Laura Milanese, Rocco Bonfatti, Marco Faustini-Fustini, Gianluca Marucci, Giovanni Tallini, Corrado Zenesini, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28403097/predictive-factors-for-surgical-outcome-in-anterior-clinoidal-meningiomas-analysis-of-59-consecutive-surgically-treated-cases
#14
Ju-Hwi Kim, Woo-Youl Jang, Tae-Young Jung, In-Young Kim, Kyung-Hwa Lee, Woo Dae Kang, Seul-Kee Kim, Kyung-Sub Moon, Shin Jung
Despite the advances in the microsurgical technique and anatomical understanding of the anterior and middle skull base, anterior clinoidal meningiomas are still challenging lesions to resect completely and safely due to their intimate relationship with vital neurovascular structures. We report predictive factors for tumor recurrence and postoperative complications based on surgical outcome of patients with anterior clinoidal meningiomas treated at our institution.Fifty-nine consecutive patients with anterior clinoidal meningioma who were surgically treated between March, 1993, and July, 2015, were reviewed retrospectively...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28384240/supplementary-cranial-description-of-the-types-of-edmontosaurus-regalis-ornithischia-hadrosauridae-with-comments-on-the-phylogenetics-and-biogeography-of-hadrosaurinae
#15
Hai Xing, Jordan C Mallon, Margaret L Currie
The cranial anatomy of the flat-skulled hadrosaurine Edmontosaurus regalis (Ornithischia: Hadrosauridae) is extensively described here, based on the holotype and paratype collected from the middle part of the Horseshoe Canyon Formation in southern Alberta. Focus is given to previously undocumented features of ontogenetic and phylogenetic importance. This description facilitates overall osteological comparisons between E. regalis and other hadrosaurids (especially E. annectens), and revises the diagnosis of E...
2017: PloS One
https://www.readbyqxmd.com/read/28377283/the-combined-transpetrosal-approach-anatomic-study-and-literature-review
#16
REVIEW
M Burhan Janjua, James P Caruso, Jeffrey P Greenfield, Mark M Souweidane, Theodore H Schwartz
The combined petrosal approach is an essential technique for the skull base neurosurgeon. In this manuscript, the authors provide a brief history of the development of this approach, technical instruction with consideration of important landmarks, and a literature review of the broad range of clinical applications for this approach. The combined petrosal approach was performed bilaterally in 6 cadaveric injected specimens. The relationship of middle and posterior fossa dura, venous sinuses, cranial nerves (CNs), and the vascular anatomy were studied...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
#17
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
#18
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
#19
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
#20
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
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