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https://www.readbyqxmd.com/read/28967316/combined-petrosal-approach-for-petroclival-meningioma
#1
Omar Arnaout, Ossama Al-Mefty
The authors present the case of a 56-year-old patient who presented with a large petroclival meningioma and clinical symptoms of brainstem compression and hydrocephalus. The authors describe a two-stage combined petrosal approach for complete resection of the tumor. The nuances of the approach and microsurgical technique are discussed, as well as the radiographic and clinical outcomes. The video can be found here: https://youtu.be/JxoTXS-uiHM .
October 2017: Neurosurgical Focus
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
#2
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
#3
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/28967307/introduction-surgical-management-of-skull-base-meningiomas
#4
Gabriel Zada, Mustafa K Başkaya, Mitesh V Shah
Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962038/site-specific-considerations-in-the-surgical-management-of-skull-base-chondrosarcomas
#5
Shaan M Raza, Paul W Gidley, Michael E Kupferman, Ehab Y Hanna, Shirley Y Su, Franco DeMonte
BACKGROUND: Numerous approaches have been reported in the management of skull base chondrosarcomas. Data are lacking for surgical outcomes by the tumor site of origin. OBJECTIVE: To provide insight into outcomes by site of origin and factors affecting resection in order to aid in surgical approach selection. METHODS: A retrospective review was conducted of 49 patients with chondrosarcoma treated at our institution. Charts were reviewed for tumor- and treatment-related factors...
September 9, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28875113/fully-endoscopic-minimally-invasive-transrectus-capitis-posterior-muscle-triangle-approach-to-the-posterolateral-condyle-and-jugular-tubercle
#6
Wang Mingdong, Juan C Fernandez-Miranda, Roger Neves Mathias, Eric Wang, Paul Gardner, Hong Wang
Background  We evaluated a transrectus capitis posterior muscle triangle approach to the posterolateral foramen magnum, occipital condyles, jugular tubercle, and the fourth ventricle. We also assessed factors that affect the amount of bone removal required. Objective  To evaluate if the proposed approach is as effective as standard open approaches to expose the lateral portion of the foramen magnum. Methods  The proposed minimally invasive fully endoscopic approach was performed in 15 cadaveric specimens using 4-mm (0- and 45-degree) endoscopes...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28862550/voxel-based-lesion-mapping-of-meningioma-a-comprehensive-lesion-location-mapping-of-260-lesions
#7
Ryuichi Hirayama, Manabu Kinoshita, Hideyuki Arita, Naoki Kagawa, Haruhiko Kishima, Naoya Hashimoto, Yasunori Fujimoto, Toshiki Yoshimine
OBJECTIVE In the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques. METHODS Magnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28735380/the-midline-suboccipital-subtonsillar-approach-to-the-cerebellomedullary-cistern-how-i-do-it
#8
Stephan Herlan, Florian Roser, Florian H Ebner, Marcos Tatagiba
BACKGROUND: Lesions lateral to the lower brainstem in an area extending from the foraminae of Luschka to the foramen magnum are rare and include different pathologies. There is no consensus on an ideal surgical approach. METHOD: To gain access to this area, we use the midline suboccipital subtonsillar approach (STA). This midline approach with unilateral retraction of the cerebellar tonsil enables entry into the cerebellomedullary cistern. CONCLUSIONS: The STA offers excellent access with a panoramic view of the cerebellomedullary cistern and its structures and therefore can be useful for a number of different pathologies in the lower petroclival area...
July 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28731399/expanding-the-endoscopic-transpterygoid-corridor-to-the-petroclival-region-anatomical-study-and-volumetric-comparative-analysis
#9
Jacob L Freeman, Raghuram Sampath, Steven Craig Quattlebaum, Michael A Casey, Zach A Folzenlogen, Vijay R Ramakrishnan, A Samy Youssef
OBJECTIVE The endoscopic endonasal transmaxillary transpterygoid (TMTP) approach has been the gateway for lateral skull base exposure. Removal of the cartilaginous eustachian tube (ET) and lateral mobilization of the internal carotid artery (ICA) are technically demanding adjunctive steps that are used to access the petroclival region. The gained expansion of the deep working corridor provided by these maneuvers has yet to be quantified. METHODS The TMTP approach with cartilaginous ET removal and ICA mobilization was performed in 5 adult cadaveric heads (10 sides)...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28725517/preoperative-embolization-for-skull-base-meningiomas
#10
Kensuke Suzuki, Masaya Nagaishi, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Ryotaro Suzuki, Yosuke Kawamura, Ryuta Nakae, Yoshihiro Tanaka, Akio Hyodo
The results of preoperative embolization for skull base meningiomas were retrospectively evaluated to confirm the efficacy of this procedure. Skull base meningiomas that were treated with preoperative embolization were evaluated in 20 patients. The occluded arteries, embolic materials, treatment time, excision rate, neurologic manifestations, and complications were analyzed. The embolic material was 80% liquid, 30% coils, and 15% particles. The surgery was normally completed within 3 to 5 hours. Blood loss was normally approximately 250 mL, excluding four patients having the following conditions: malignant meningioma, a large tumor located on the medial side of the sphenoidal ridge, the petroclival tumor, and infiltrated tumor into the sigmoid sinus...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28713632/radiographic-assessment-of-the-presigmoid-retrolabyrinthine-approach
#11
Andrew K Wong, Melissa M Stamates, Anita P Bhansali, Michael Shinners, Ricky H Wong
BACKGROUND: Lesions of the petroclival fissure are difficult to access surgically. Both retrosigmoid and presigmoid retrolabyrinthine approaches have been described to successfully treat these complex tumors. The retrosigmoid approach offers quick and familiar access, whereas the presigmoid retrolabyrinthine approach reduces the operative distance and the need for cerebellar retraction. The presigmoid retrolabyrinthine approach, however, is constrained by anatomical limits that can be subject to patient variation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28683438/gamma-knife-radiosurgery-for-petroclival-meningioma-long-term-outcome-and-failure-pattern
#12
Jin Wook Kim, Dong Gyu Kim, Young-Bem Se, Sung Kwon Kim, Hyun-Tai Chung, Sun Ha Paek, Hee-Won Jung
Total removal of petroclival meningioma is difficult, and aggressive extirpation is often associated with significant surgical morbidity and mortality. The aim of this study was to evaluate the long-term outcome and failure pattern of treatment with Gamma Knife radiosurgery (GKRS) in patients with petroclival meningiomas. Eighty-nine consecutive patients with petroclival meningiomas underwent GKRS between 1998 and 2013. Fifty-eight patients received GKRS as a primary treatment and 31 patients underwent GKRS as a secondary treatment after microsurgery...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28541487/tumor-progression-following-petroclival-meningioma-subtotal-resection-a-volumetric-study
#13
Jacob B Hunter, Brendan P O'Connell, Matthew L Carlson, Lola C Chambless, Robert J Yawn, Ray Wang, Akshitkumar Mistry, Reid C Thompson, Kyle D Weaver, George B Wanna
BACKGROUND: One study has investigated postoperative growth rates following subtotal resection of petroclival meningiomas utilizing linear measurements, which are insensitive to the multidimensional complex growth of meningiomas, to estimate tumor volume. OBJECTIVE: To describe petroclival meningioma growth patterns following less-than-complete resection utilizing volumetric analysis and to identify variables associated with tumor progression. METHODS: Patients with surgically resected WHO grade I petroclival meningiomas were retrospectively reviewed (1999-2015)...
May 24, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28435113/microsurgical-and-endoscopic-anatomy-for-intradural-temporal-bone-drilling-and-applications-of-the-electromagnetic-navigation-system-various-extensions-of-the-retrosigmoid-approach
#14
Ken Matsushima, Noritaka Komune, Satoshi Matsuo, Michihiro Kohno
OBJECTIVE: The use of the retrosigmoid approach has recently been expanded by several modifications, including the suprameatal, transmeatal, suprajugular, and inframeatal extensions. Intradural temporal bone drilling without damaging vital structures inside or beside the bone, such as the internal carotid artery and jugular bulb, is a key step for these extensions. This study aimed to examine the microsurgical and endoscopic anatomy of the extensions of the retrosigmoid approach and to evaluate the clinical feasibility of an electromagnetic navigation system during intradural temporal bone drilling...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28377283/the-combined-transpetrosal-approach-anatomic-study-and-literature-review
#15
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/28338439/stereotactic-radiosurgery-in-the-treatment-of-parasellar-meningiomas-long-term-volumetric-evaluation
#16
Or Cohen-Inbar, Athreya Tata, Shayan Moosa, Cheng-Chia Lee, Jason P Sheehan
OBJECTIVE Parasellar meningiomas tend to invade the suprasellar, cavernous sinus, and petroclival regions, encroaching on adjacent neurovascular structures. As such, they prove difficult to safely and completely resect. Stereotactic radiosurgery (SRS) has played a central role in the treatment of parasellar meningiomas. Evaluation of tumor control rates at this location using simplified single-dimension measurements may prove misleading. The authors report the influence of SRS treatment parameters and the timing and volumetric changes of benign WHO Grade I parasellar meningiomas after SRS on long-term outcome...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28330424/tentorial-meningioma-supplied-by-a-marginal-tentorial-artery-arising-from-the-superior-cerebellar-artery-anatomic-and-technical-considerations
#17
Stéphanie Lenck, Kentaro Watanabe, Jean-Pierre Saint-Maurice, Moujahed Labidi, Marc-Antoine Labeyrie, Sébastien Froelich, Emmanuel Houdart
Background and importance The marginal tentorial artery runs over the free edge of the tentorium. Different origins have been described, always involving branches of the carotid artery. We report the superior cerebellar artery as an unknown origin of this artery. We developed our strategy in a case of a tentorial meningioma mainly supplied by this artery. Clinical presentation A 53-year-old man was admitted in our institution for the surgical treatment of a large tentorial and petroclival meningioma. A 2D conventional angiogram was insufficient to detect the tumoral blush...
August 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28223248/endoscopic-intradural-subtemporal-keyhole-approach-with-neuronavigational-assistance-to-the-suprasellar-petroclival-and-ventrolateral-brainstem-regions-an-anatomic-study
#18
Zhemin Ding, Qing Wang, Xiaojie Lu, Xinwei Qian
OBJECTIVE: The purposes of this study were to evaluate the feasibility of a purely endoscopic intradural approach to the suprasellar, petroclival, and ventrolateral brainstem regions through a subtemporal keyhole and to assess the value of neuronavigational assistance in the Kawase approach. METHODS: Twenty endoscopic intradural subtemporal keyhole approaches were performed on 10 cadaveric heads. An intradural Kawase approach and a navigation-assisted intradural Kawase approach were then carried out on a random side of each specimen...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203025/-trigemino-cardiac-reflex-in-skull-base-surgery
#19
H Z Duan, Y Zhang, L Li, J Y Zhang, Z Q Yi, S D Bao
OBJECTIVE: To explore the mechanism, clinical features, and prognosis of Trigemino-cardiac reflex (TCR) during skull base operations. METHODS: A retrospective analysis was performed on 291 patients with skull base disease from Jan. 2009 to Oct. 2015 in Peking University First Hospital. By reviewing the patients' operative data and anaesthetic electrical record, and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures, clinical features, influence factors, and prognosis...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202836/-pre-and-intra-operative-supporting-technology-for-brain-tumors-4-transpetrosal-approach-for-petroclival-tumors
#20
Takeo Goto
No abstract text is available yet for this article.
February 2017: No Shinkei Geka. Neurological Surgery
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