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cranial base surgery

Ahmed Hegazy, Hieder Al-Shami, Mohammed Fathy Adel Ali, Mohamad Fathallah, Ahmed Salah, Hashim Mohamed, Emad Ibrahim Ahmed, Haytham Hussien Mohammed Osman, Arundhati Biswas
Objective: The aim of this study was to determine whether adding mobilization of the outer cavernous sinus membrane as a part of the approach, in large spheno-clinoidal meningiomas without cavernous sinus extension, would reduce bleeding and increase the extent of resection. Methods: This prospective randomized controlled trial was held between February 2016 and April 2017 at Cairo University Hospitals. The study recruited 94 patients with spheno-clinoidal meningiomas without cavernous sinus involvement...
March 2018: Neurology India
Francisco Vaz-Guimaraes, Maria Koutourousiou, John R de Almeida, Elizabeth C Tyler-Kabara, Juan C Fernandez-Miranda, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE Epidermoid and dermoid cysts may be found along the cranial base and are commonly resected via open transcranial approaches. The use of endoscopic endonasal approaches for resection of these tumors has been rarely reported. METHODS The authors retrospectively reviewed the medical records of 21 patients who underwent endoscopic endonasal surgery for epidermoid and dermoid cyst resection at the University of Pittsburgh Medical Center between January 2005 and June 2014. Surgical outcomes and variables that might affect the extent of resection and complications were analyzed...
March 16, 2018: Journal of Neurosurgery
Olabisi R Sanusi, Omar Arnaout, Rudy J Rahme, Craig Horbinski, James P Chandler
OBJECTIVE: Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiotherapy. The accepted standard of treatment for chordomas of the mobile spine which includes en-bloc resection with wide margins cannot be easily applied to the chordomas of the skull base given their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant radiation in the treatment of chordomas over 16 years...
March 12, 2018: World Neurosurgery
O I Sharipov, M A Kutin, A V Bayuklin, A A Imaev, A A Abdilatipov, A B Kurnosov, D V Fomichev, N I Mikhaylov, P L Kalinin
Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Konstantinos Natsis, Maria Piagkou, Nikolaos Lazaridis, Trifon Totlis, Nikolaos Anastasopoulos, Jannis Constantinidis
PURPOSE: The current study investigated the incidence, morphology and morphometry of the ossified ligaments expanding between petrous bone and posterior clinoid processes and in between the anterior, middle and posterior clinoid processes. Side symmetry, gender dimorphism and age influence were also studied. MATERIALS AND METHODS: A total of 123 adult Greek dry skulls were observed. RESULTS: A caroticoclinoid bar (CCB) was found in 60.2%. Partial CCBs appeared more commonly (36...
February 10, 2018: Journal of Cranio-maxillo-facial Surgery
Antonio R Porras, Beatriz Paniagua, Andinet Enquobahrie, Scott Ensel, Hina Shah, Robert Keating, Gary F Rogers, Marius George Linguraru
The outcome of cranial vault reconstruction for the surgical treatment of craniosynostosis heavily depends on the surgeon's expertise because of the lack of an objective target shape. We introduce a surface-based diffeomorphic registration framework to create the optimal post-surgical cranial shape during craniosynostosis treatment. Our framework estimates and labels where each bone piece needs to be cut using a reference template. Then, it calculates how much each bone piece needs to be translated and in which direction, using the closest normal shape from a multi-atlas as a reference...
September 2017: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
Qing Wang, Xinjie Wu, Mingsheng Tan, Gaoju Wang, Shuang Xu, Yingna Qi
OBJECTIVE: To describe lower cranial nerve palsy (LCNP) following vertical over-distraction when performing occipitocervical fusion (OCF) to treat vertical atlantoaxial dislocation (AAD) and basilar invagination (BI) and to investigate its possible causes. METHODS: We report 4 cases with vertical AAD and BI who postoperatively presented with neurogenic dysphagia, dysarthria, and bucking after undergoing anatomical reduction. RESULTS: Patients underwent revision surgery to achieve partial reduction and demonstrated remarkable recovery of 9th , 10th and 11th nerve deficits...
March 7, 2018: World Neurosurgery
Jéssica Araújo Figueira, Fábio Roberto de Souza Batista, Karina Rosso, Vanessa Cristina Veltrini, Angelo José Pavan
Gorlin-Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder with high penetrance and variable expressivity. The classic triad originally described by Gorlin and Goltz in 1960 is composed of multiple nevoid basal cell carcinomas (NBCCs), odontogenic keratocysts (OKCs) in the jaws and bifid ribs. in 1977, this triad was modified by Rayner et al, and to GGS diagnosis, the OKCs had to appear in combination with calcification of the cerebellar falx or palmar and plantar pits...
March 8, 2018: Journal of Craniofacial Surgery
Satoshi Fukai, Naoyuki Okabe, Hayato Mine, Hironori Takagi, Hiroyuki Suzuki
BACKGROUND: Garcin syndrome, which consists of unilateral palsies of almost all cranial nerves without either sensory or motor long-tract disturbances or intracranial hypertension, can be caused by malignant tumors at the skull base. The case of a patient with lung cancer that metastasized to the sphenoid bone and resulted in Garcin syndrome is presented. CASE PRESENTATION: A 76-year-old woman was diagnosed as having non-small cell lung cancer with pericardial and diaphragmatic infiltration, cT4N1M0, stage 3A...
March 6, 2018: World Journal of Surgical Oncology
Tyler Safran, Alex Viezel-Mathieu, Benjamin Beland, Alain J Azzi, Rafael Galli, Mirko Gilardino
INTRODUCTION: Craniosynostosis, the premature fusion of ≥1 cranial sutures, is the leading cause of pediatric skull deformities, affecting 1 of every 2000 to 2500 live births worldwide. Technologies used for the management of craniofacial conditions, specifically in craniosynostosis, have been advancing dramatically. This article highlights the most recent technological advances in craniosynostosis surgery through a systematic review of the literature. METHODS: A systematic electronic search was performed using the PubMed database...
March 1, 2018: Journal of Craniofacial Surgery
Akın Akakın, Kamran Urgun, Murat Şakir Ekşi, Baran Yılmaz, Özlem Yapıcıer, Mert Mestanoğlu, Zafer Orkun Toktaş, Mustafa Kemal Demir, Türker Kılıç
Chondrosarcoma is the second most common primary malignancy of bone after osteosarcoma. Cranial primary chondrosarcomas mostly originate from the skull base cartilage formation zones. Parasagittal falcine origin is very rare for primary extra-skeletal intracranial chondrosarcomas. We report a rare case of primary myxoid chondrosarcoma at falx cerebri. The patient was a 35-year-old lady with right arm and leg weakness. Her brain magnetic resonance imaging depicted a left parasagittal mass lesion attached to the falx cerebri...
January 2018: Asian Journal of Neurosurgery
Scott L Zuckerman, Mark H Bilsky, Ilya Laufer
BACKGROUND: Chordomas are rare, primary bone tumors that arise from the axial skeleton. Our objective was to analyze trends in radiation and surgery over time and determine location-based survival predictors for chordomas of the skull base, mobile spine, and sacrum. METHODS: A retrospective cohort study of the Surveillance Epidemiology and End Results (SEER) database from 1973-2013 was conducted. All patients had histologically confirmed chordomas. The principal outcome measure was overall survival (OS)...
February 24, 2018: World Neurosurgery
Daniel L Faden, Marion A Hughes, Philippe Lavigne, Brian T Jankowitz, Eric W Wang, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman
BACKGROUND: Nontraumatic pseudoaneurysms of the cranial base are rare and present unique diagnostic and treatment dilemmas compared with both true aneurysms and pseudoaneurysms outside of the cranial base. There is a dearth of knowledge regarding the management of these complicated lesions. METHODS: Nontraumatic pseudoaneurysms of the cranial base internal carotid artery (ICA) were retrospectively identified at the University of Pittsburgh Medical Center through a key word search of cranial base cases from 2010 to 2017...
February 27, 2018: International Forum of Allergy & Rhinology
Alexandra Macmillan, Joseph Lopez, Gerhard S Mundinger, Melanie Major, Miguel A Medina, Amir H Dorafshar
BACKGROUND: Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting. METHODS: A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included...
February 23, 2018: Journal of Craniofacial Surgery
P Brandicourt, L Bonnet, Y Béjot, C Drouet, T Moulin, L Thines
INTRODUCTION: Moya-Moya angiopathy is a neurovascular disease that predisposes to ischemic or hemorrhagic strokes. It is generated by a steno-occlusion of the terminal portion of the internal carotid arteries, which induces the development of abnormal neovessels in the deep regions of the brain. Some pathologies such as sickle cell disease, Down syndrome or Graves' disease may be associated with Moya-Moya angiopathy. These syndromic forms harbor several differences compared with idiopathic Moya-Moya disease...
February 20, 2018: Neuro-Chirurgie
Tara L Braun, Bradley S Eisemann, Olushola Olorunnipa, Edward P Buchanan, Laura A Monson
BACKGROUND: Premature fusion of the metopic suture leads to a range of clinical presentations, with more severe patients presenting characteristically with trigonocephaly. Endoscopic-assisted correction of craniosynostosis is emerging as an alternative to the gold-standard open cranial vault remodeling. While there are several documented benefits of endoscopic correction, the management of craniosynostosis varies widely in the literature with little consensus as to the preferred timing and surgical technique for repair...
February 14, 2018: Journal of Craniofacial Surgery
Ryutaro Shiboi, Shogo Hayashi, Shinichi Kawata, Zhong-Lian Li, Philipp Pieroh, Hisashi Koga, Yuichi Takano, Hirohiko Inanami, Masahiro Itoh
The pedicle screw is one of the most common medical devices used in spinal surgery. Although there are well-established insertion points based on anatomical landmarks, such as the mammillary process and the transverse process, morphological data on the relationship between the accessory process and the pedicle are still scarce. To clarify this relationship, we recruited 50 cases of hernia of lumbar intervertebral disc, diagnosed using three-dimensional computed tomography of the lumbar vertebrae. We identified the pedicle isthmus in a transverse plane parallel to the upper endplate and measured the angles and distances from the tip of the accessory process to the intersection points at the medial or lateral surface, or at the midpoint between the two intersection points...
February 9, 2018: Anatomical Science International
Golda Grinblat, Manjunath Dandinarasaiah, Sampath Chandra Prasad, Gianluca Piras, Enrico Piccirillo, Andrea Fulcheri, Mario Sanna
OBJECTIVE: To study the clinical presentation, intraoperative findings and surgical management in meningo-encephalic-herniation (MEH) based on the etiology. STUDY DESIGN: A retrospective clinical study and is a follow-up on the previously published report in 2009. SETTING: A quaternary referral otology and skull base center PATIENTS AND METHODS:: The inclusion criteria were intraoperatively verified MEH in patients with a minimum follow-up of 12 months, which yielded 262 operated ears...
March 2018: Otology & Neurotology
Makoto Katsuno, Akira Matsuno
Background: Although vertebral artery (VA) dissecting aneurysms are treated by direct or endovascular surgery, some disadvantages are associated with each surgery. Therefore, the type of surgery should be selected based on the condition of the aneurysm. We performed aneurysm trapping by endovascular surgery via the contralateral VA after proximal direct ligation with bypass to prevent complications as well as achieve complete treatment. Case Description: We attempted to insert a distal clip to achieve complete trapping of the ruptured VA dissecting aneurysm after proximal ligation with occipital artery-posterior inferior cerebellar artery (PICA) anastomosis; however, the operative field was limited by the existence of lower cranial nerves, brain swelling, and tortuosity of VA...
2018: Surgical Neurology International
Daniele Marchioni, Marco Carner, Davide Soloperto, Luca Bianconi, Andrea Sacchetto, Luca Sacchetto, Barbara Masotto, Livio Presutti
Objective Vestibular schwannoma (VS) is a benign tumor of the lateral skull base. Different microscopic surgical techniques are described in literature: the retrosigmoid and translabyrinthine approaches are used to treat big tumors located in the cerebellopontine angle, and the middle cranial fossa approach is utilized for small tumors with good hearing preservation. The expanded transcanal transpromontorial (ExpTT) approach is a combined microscopic-endoscopic technique previously indicated for Koos stage I and II VS and now proposed for larger VS, up to 3 cm in diameter, with linear progression into the cerebellopontine angle and touching the brainstem...
February 1, 2018: Otolaryngology—Head and Neck Surgery
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