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Ryota Tamura, Ryosuke Tomio, Farrag Mohammad, Masahiro Toda, Kazunari Yoshida
OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed...
March 16, 2018: Journal of Neurosurgery
Thomas Coquet, Michel Lefranc, Louis Chenin, Pascal Foulon, Éric Havet, Johann Peltier
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Tamer Altay, Cem Akkurt
Epidermoid tumors are rare benign neoplasms. They commonly occur in the parasellar region and the cerebellopontine angle but may sometimes present in the so-called petroclival region, or beyond the boundaries of this location. For those that are localized in multiple compartments, staged surgeries, extensive transtemporal approaches, or somewhat limited extended middle fossa approach are generally performed. Although a good resection can be achieved by these approaches, they carry relatively high morbidity and mortality...
January 2018: Asian Journal of Neurosurgery
Wei Liu, Matyas Molnar, Carolyn Garnham, Heval Benav, Helge Rask-Andersen
The human inner ear, which is segregated by a blood/labyrinth barrier, contains resident macrophages [CD163, ionized calcium-binding adaptor molecule 1 (IBA1)-, and CD68-positive cells] within the connective tissue, neurons, and supporting cells. In the lateral wall of the cochlea, these cells frequently lie close to blood vessels as perivascular macrophages. Macrophages are also shown to be recruited from blood-borne monocytes to damaged and dying hair cells induced by noise, ototoxic drugs, aging, and diphtheria toxin-induced hair cell degeneration...
2018: Frontiers in Immunology
Wei Liu, Hubert Löwenheim, Peter A Santi, Rudolf Glueckert, Annelies Schrott-Fischer, Helge Rask-Andersen
TMPRSS3 (Trans-membrane Serine Protease 3) is a type II trans-membrane serine protease that has proteolytic activity essential for hearing. Mutations in the gene cause non-syndromic autosomal recessive deafness (DFNB8/10) in humans. Knowledge about its cellular distribution in the human inner ear may increase our understanding of its physiological role and involvement in deafness, ultimately leading to therapeutic interventions. In this study, we used super-resolution structured illumination microscopy for the first time together with transmission electron microscopy to localize the TMPRSS3 protein in the human organ of Corti...
February 19, 2018: Cell and Tissue Research
Anil Nanda, Devi Prasad Patra, Amey Rajan Savardekar, Tanmoy K Maiti, Nasser Mohammed
No abstract text is available yet for this article.
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
B Pintea, J A Kandenwein, H Lorenzen, J P Boström, F Daher, V Velazquez, R A Kristof
OBJECTIVE: To describe the patient's self assessed health related quality of life (saHRQoL) based upon the medical outcome study 36-item short form health survey (SF-36) as well as the factors of influence upon the saHRQoL following surgery for petroclival (PCM) and lateral posterior surface of the pyramid (LPPM) meningiomas. PATIENTS AND METHODS: In a series of 78 patients operated consecutively for PCM (n = 46) or LPPM (n = 32) the preoperative, intraoperative and postoperative data were collected retrospectively...
January 26, 2018: Clinical Neurology and Neurosurgery
H G Kortman, I Boukrab, G Bloemsma, J P Peluso, M Sluzewski, B van der Pol, G N Beute, C B Majoie, W J van Rooij
Objective: Tentorial dural arteriovenous fistulas usually drain into cortical veins and often present with hemorrhage. Treatment goal is occlusion of the draining vein, either by surgery or endovascular techniques. We present the multimodality treatment results of 12 patients with tentorial dural arteriovenous fistulas. Materials and Methods: Between January 2007 and January 2017, 12 consecutive patients with tentorial dural arteriovenous fistulas were treated. There were 11 men and 1 woman with a mean age of 62 years (range 44-85)...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Xiang Yang, Jiagang Liu, Yanming Ren, Seidu A Richard, Yuekang Zhang
RATIONALE: Rosai -Dorfman disease (RDD) is a rare, idiopathic, and non-neoplastic histioproliferative disease with distinctive entity of unknown etiology. Central nervous system (CNS) RDD is uncommon, hence, isolated intracranial RDD is extremely rare. So far only 6 cases of CNS RDD with the lesions originating from petroclival region have been reported. We present a case of isolated intracranial RDD mimicking petroclival meningioma. PATIENT CONCERNS: A 14-year-old girl was admitted at our hospital with a 3-month history of dizziness, slowly progressing headache, and 2-month history of instability in walking...
November 2017: Medicine (Baltimore)
Can Tang, Lujun Pang, Hengzhu Zhang, Zhengcun Yan, Xiaodong Wang, Lun Dong, Lei She, Xingdong Wang, Min Wei
OBJECTIVE: This study aimed to observe the range of exposure, indications, and feasibility of the retromastoid keyhole approach via grinding partial petrous ridge to the middle fossa. METHODS: Simulated endoscopic surgeries via grinding suprameatal tubercle and petrous ridge to expose the middle fossa in retromastoid keyhole approach were performed on 8 adult cadaver heads (16 sides) fixed by formalin. The maximum exposure range in endoscope was observed. The boundaries of Parkinson triangle and the anatomic structures contained by Meckel cave and cavernous sinus (CS) lateral wall were revealed...
January 29, 2018: Journal of Craniofacial Surgery
Nishanth Sadashiva, Rajalakshmi Poyuran, Anita Mahadevan, Dhananjaya I Bhat, Sampath Somanna, Bhagavatula Indira Devi
Chordoid meningioma is a rare variant of meningioma, with a higher incidence in the young and a supposed association with Castleman's syndrome. They have an aggressive clinical course, and are assigned as WHO grade II meningiomas. To the best of our knowledge, 284 chordoid meningiomas have been reported in the literature. This series reporting 33 cases is the third largest series in published literature from a single Institution. We reviewed Clinico-pathological characteristics of 33 patients diagnosed with chordoid meningioma between 2001 and 2015 in our institution...
January 27, 2018: Journal of Neuro-oncology
Zjiwar H A Sadik, Suan Te Lie, Sieger Leenstra, Patrick E J Hanssens
OBJECTIVE Petroclival meningiomas (PCMs) can cause devastating clinical symptoms due to mass effect on cranial nerves (CNs); thus, patients harboring these tumors need treatment. Many neurosurgeons advocate for microsurgery because removal of the tumor can provide relief or result in symptom disappearance. Gamma Knife radiosurgery (GKRS) is often an alternative for surgery because it can cause tumor shrinkage with improvement of symptoms. This study evaluates qualitative volumetric changes of PCM after primary GKRS and its impact on clinical symptoms...
January 26, 2018: Journal of Neurosurgery
Juergen Grauvogel, Waseem Masalha, Dieter Henrik Heiland, Nadja Jarc, Tanja Daniela Grauvogel, Christian Scheiwe
BACKGROUND: Piezosurgery (PS) is a relatively new technique based on microvibrations generated by the piezoelectric effect. It selectively cuts bone tissue and preserves the surrounding soft tissue. OBJECTIVE: To evaluate the use of PS for performing lateral suboccipital craniotomy. METHODS: PS was used to perform a lateral suboccipital craniotomy in 22 patients who underwent surgery for different cerebellopontine angle (CPA) pathologies in the neurosurgical department...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
Osama Al-Mefty
No abstract text is available yet for this article.
January 2018: Neurosurgical Focus
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: .
October 2017: Neurosurgical Focus
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
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
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
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.)
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
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