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Skull base tumor

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https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#1
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089805/surgical-outcomes-of-endoscopic-endonasal-skull-base-surgery-of-craniopharyngiomas-evaluated-according-to-the-degree-of-hypothalamic-extension
#2
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Sparing the hypothalamus following craniopharyngiomas treatment is a prerequisite to ensure a good quality of life. In this study, the functional prognosis of craniopharyngioma following Endoscopic endonasal skull base surgery (EES) was examined in function of the degree of hypothalamic extension. MATERIALS AND METHODS: Twenty cases of craniopharyngioma treated by EES were categorized according to Puget's classification using preoperative and postoperative MRI...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089417/venous-sinus-compromise-after-pre-sigmoid-transpetrosal-approach-for-skull-base-tumors-a-study-on-the-asymptomatic-incidence-and-report-of-a-rare-dural-arteriovenous-fistula-as-symptomatic-manifestation
#3
Walter C Jean, Daniel R Felbaum, Andrew B Stemer, Michael Hoa, H Jeffrey Kim
The sigmoid sinus is routinely exposed and manipulated during pre-sigmoid, transpetrosal approaches to the skull base, but there is scant data available on the incidence of venous sinus compromise after surgery. We encountered a dural arteriovenous fistula as a result of sigmoid sinus occlusion and examined the incidence of venous sinus thrombosis or narrowing after transpetrosal surgeries. We performed a retrospective analysis of a series of patients treated by the senior surgeons (WCJ, MH, HJK), who underwent either a posterior petrosectomy or translabyrinthine approach for various skull base tumors...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28074281/one-step-cad-cam-titanium-cranioplasty-after-drilling-template-assisted-resection-of-intraosseous-skull-base-meningioma-technical-note
#4
A Carolus, S Weihe, K Schmieder, C Brenke
INTRODUCTION: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery. A preoperative virtual planning of resection margins and the simultaneously fabrication of the cranioplasty could be a possibility to subsume the steps tumor resection and cosmetic restoration to a single procedure. METHODS: We present two cases of patients with complex intra-osseous spheno-orbital meningioma...
January 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28059654/clinical-features-and-surgical-outcomes-of-patients-with-skull-base-chordoma-a-retrospective-analysis-of-238-patients
#5
Liang Wang, Zhen Wu, Kaibing Tian, Ke Wang, Da Li, Junpeng Ma, Guijun Jia, Liwei Zhang, Junting Zhang
OBJECTIVE Skull base chordoma is relatively rare, and a limited number of reports have been published regarding its clinical features. Moreover, the factors associated with extent of resection, as well as the value of marginal resection for long-term survival, are still in question for this disease. The objective of this study was to investigate these factors by evaluating their clinical features and surgical outcomes. METHODS A retrospective analysis of 238 patients with skull base chordomas, who met the inclusion criteria, was performed...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28049034/hypervascular-lesions-of-the-cerebellopontine-angle-the-relevance-of-angiography-as-a-diagnostic-and-therapeutic-tool-and-the-role-of-stereotactic-radiosurgery-in-management-a-comprehensive-review
#6
REVIEW
Yosef Laviv, Ajith Thomas, Ekkehard M Kasper
The cerebellopontine angle (CPA) is a narrowed skull base area, containing important cranial nerves and vessels and bordering with eloquent areas of the posterior fossa. Tumors of the CPA are a heterogeneous group and can arise extradural, intradural-extraaxial or intraaxial. Accordingly, their vascular supply changes, depending on their anatomical origin. Symptomatic, large CPA tumors require surgical resection in order to prevent irreversible, severe neurological damages. However, its tight and strategical location make surgery in the CPA very challenging and require appropriate pre-surgical planning...
December 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28047469/th-cd-209-06-let-based-adjustment-of-impt-plans-using-prioritized-optimization
#7
J Unkelbach, P Botas, N Qin, X Jia, D Giantsoudi, H Paganetti
PURPOSE: In-vitro experiments suggest an increase in proton relative biological effectiveness (RBE) towards the end of range. However, proton treatment planning and dose reporting for clinical outcome assessment has been based on physical dose and constant RBE. Therefore, treatment planning for intensity-modulated proton therapy (IMPT) is unlikely to transition radically to pure RBE-based planning. We suggest a hybrid approach where treatment plans are initially created based on physical dose constraints and prescriptions, and are subsequently altered to avoid high linear energy transfer (LET) in critical structures while limiting the degradation of the physical dose distribution...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046865/su-f-t-637-single-isocenter-versus-multiple-isocenter-vmat-srs-for-unusual-multiple-metastasis-case-with-two-widely-separated-lesions
#8
E M Thomas, R A Popple, J B Fiveash
PURPOSE: Single-isocenter (SI) volumetric modulated arc therapy has been shown to be an effective and efficient approach to multiple metastasis radiosurgery. However, certain extreme cases raise the question of whether multiple-isocenter (MI) approaches can still generate superior plans. In this study, we ask this question with respect to a clinical case with two very widely separated lesions. METHODS: A patient with two widely separated (d = 12cm) tumors was treated with SI-VMAT SRS using 10MV flattening filter free (FFF) beam with high-definition multi-leaf collimator (HD-MLC, 2...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046585/su-f-t-221-an-assessment-of-the-potential-for-improved-local-control-of-skull-base-chordomas-via-reduction-of-the-proton-beam-range-uncertainty
#9
L Muller, A Soldner, M Kirk, M Fager, T Solberg, L Robert, D Dolney
PURPOSE: The beam range uncertainty presents a special challenge for proton therapy. Novel technologies currently under development offer strategies to reduce the range uncertainty [1,2]. This work quantifies the potential advantages that could be realized by such a reduction for dosimetrically challenging chordomas at the base of skull. Therapeutic improvement was assessed by evaluating tumor control probabilities (TCP) and normal tissue complication probabilities (NTCP). METHODS: Treatment plans were made for a modulated-scanned proton delivery technique using the Eclipse treatment planning system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045745/avoiding-complications-in-endoscopic-skull-base-surgery
#10
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
December 23, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28042016/spontaneous-intraventricular-hemorrhage-a-rare-presentation-of-a-skull-base-mesenchymal-chondrosarcoma
#11
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/28038480/intracranial-ameloblastoma-arising-from-the-maxilla-an-interdisciplinary-surgical-approach
#12
Johanna Quick-Weller, Felix Koch, Nazife Dinc, Stephanie Lescher, Peter Baumgarten, Patrick Harter, Friedrich Scheerer, Robert Sader, Volker Seifert, Gerhard Marquardt, Thomas Freiman
Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28036318/unanticipated-compression-of-the-trachea-in-a-5-month-old-undergoing-an-mri-for-evaluation-of-neurofibromatosis
#13
Uduak Ursula Williams, Acsa M Zavala, Antoinette Van Meter, Elizabeth Rebello, Jens Tan, Pascal Owusu-Agyemang
Neurofibromatosis type 1 is an autosomal-dominant disorder with the tendency toward the formation of tumors. Plexiform neurofibromas are the most common type of tumors seen in neurofibromatosis type 1. Approximately 50% occur in the head and neck region with a 5% incidence of airway involvement. We describe the case of a 5 month old with a plexiform neurofibroma of the neck who developed complete airway obstruction on induction of anesthesia. Magnetic resonance imaging revealed a skull base neurofibroma extending to the hypopharynx and resulting in deviation of the airway...
January 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28034818/clivus-metastasis-of-a-duodenal-adenocarcinoma-a-case-report-and-literature-review
#14
REVIEW
Simone E Dekker, Jay Wasman, Kevin K Yoo, Fernando Alonso, Robert W Tarr, Nicholas C Bambakidis, Kenneth Rodriguez
BACKGROUND: Clival metastases of adenocarcinomas are exceptionally rare tumors, especially when they arise from the small intestine. To our knowledge, here we present first report of a metastasis of a duodenal adenocarcinoma to the clivus. We also present a systematic review detailing metastasis to the clivus. METHODS: Studies were identified using the search terms clivus metastasis, skull base metastasis, and clivus in PubMed. We collected the following information: histopathology of the primary tumor, symptoms, history, treatment, and follow up...
December 26, 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
#15
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/28027059/avoiding-complications-in-endoscopic-skull-base-surgery
#16
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#17
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28024719/prognostic-impact-of-adjuvant-chemotherapy-in-high-risk-nasopharyngeal-carcinoma-patients
#18
Yi-Chun Liu, Wen-Yi Wang, Chih-Wen Twu, Rong-San Jiang, Kai-Li Liang, Ching-Te Wu, Po-Ju Lin, Jing-Wen Huang, He-Yuan Hsieh, Jin-Ching Lin
OBJECTIVES: To investigate the prognostic impact of adjuvant chemotherapy (AdjCT) in patients with high-risk nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: A total 403 NPC patients with at least one of the following criteria (1) neck node>6cm; (2) supraclavicular node metastasis; (3) skull base destruction/intracranial invasion plus multiple nodes metastasis; or (4) multiple neck nodes metastasis with one of nodal size>4cm were retrospectively reviewed...
January 2017: Oral Oncology
https://www.readbyqxmd.com/read/28017748/spheno-orbital-meningiomas-a-16-year-surgical-experience
#19
Jacob L Freeman, Monica S Davern, Soliman Oushy, Stefan Sillau, D Ryan Ormond, A Samy Youssef, Kevin O Lillehei
OBJECTIVE: To examine the efficacy of spheno-orbital meningioma (SOM) resection aimed at symptomatic improvement, rather than gross total resection, followed by radiation therapy for recurrence. METHODS: A retrospective review of all patients having undergone resection by the senior author (KOL) between 2000 and 2016 was performed. Demographics, operative details, post-operative outcomes, recurrence rates and radiation treatment plans were analyzed. Statistical analysis was performed to assess for factors affecting recurrence (Fisher's exact and student's t-test), changes in exophthalmos index (student's t-test) and progression free survival (Kaplan-Meier and log rank)...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989983/optical-neuronavigation-without-rigid-head-fixation-during-awake-surgery
#20
C F Freyschlag, J Kerschbaumer, W Eisner, D Pinggera, K R Brawanski, O Petr, M Bauer, A E Grams, T Bodner, M Seiz, C Thomé
INTRODUCTION: Optical neuronavigation without rigid pin fixation of the head may lead to inaccurate results due to patient's movements in case of awake surgery. The aim of this study was to report our results, using a skull-mounted reference array for optical tracking in patients undergoing awake craniotomy for eloquent gliomas. METHODS: Between March 2013 and December 2014, eighteen consecutive patients (10 male, 8 female) with (fronto-)temporal (n=16) or frontoparietal (perirolandic, n=2) lesions underwent awake craniotomy without rigid pin fixation...
October 27, 2016: World Neurosurgery
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