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Middle Skull Base

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https://www.readbyqxmd.com/read/28171738/analysis-of-audiometric-outcomes-following-combined-middle-cranial-fossa-transmastoid-approaches-for-spontaneous-cerebrospinal-fluid-otorrhea
#1
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
#2
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
#3
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
#4
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...
January 23, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28097430/how-i-do-it-the-mononostril-endonasal-transethmoidal-paraseptal-approach
#5
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
#6
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
#7
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
#8
Altaf Ali Laghari, Gohar Javed, Muhammad Faheem Khan, Syed Ijlal Ahmed, Karim Rizwan Nathani, Riyasat Ahmed
INTRODUCTION: Chondrosarcomas (CSA) are very rare malignant slow growing tumors which develop in or near the petroclival region of the brain. We report our experience of a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage (IVH) leading to an acute comatose presentation. CASE DESCRIPTION: A 28 year old male initially presented in outpatient department (OPD) with a 1 month history of headache, vomiting, vertigo and left facial numbness...
December 29, 2016: 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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