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Yang Ji-Hu, Huang Guo-Dong, Ji Tao, Wang Hai-Dong, Liu Yu-Fei, Guo Jian, Li Zhen, Li Wei-Ping
OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas(IPA). METHODS: A retrospective analysis of the clinical data of 74 patients(75 procedures) with invasive pituitary adenomas treated by different endoscopic endonasal approaches at the Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis and complications in different Knosp classifications and Hardy stages...
March 7, 2018: World Neurosurgery
X L Zheng, Z Q Jiang, Y Han, T Sun, T Zhang, S J Zhang, F Y Lou
Objective: To explore the surgical technique and curative effect of microsurgical resection of large anterior skull base meningioma via unilateral subfrontal and interhemispheric approach. Method: The clinical data of 14 patients with large anterior skull base meningioma who received surgical treatment in the Department of neurosurgery in First Affiliated Hospital of Bengbu Medical College from April 2015 to September 2017 were analysed retrospectively.Of 9 cases were olfactory groove meningioma and 5 cases were tuberculum sellae meningioma...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
De-Zhi Kang, Ping Chen, Qing-Song Lin, Yuan-Xiang Lin, Xi-Yue Wu, Pei-Sen Yao
OBJECTIVE: To investigate the value of 3D printed models with pathological entities in enhancing the learning curve of surgery of tuberculum sellae meningioma. METHODS: We printed four 3D printed models of tuberculum sellae meningiomas based on radiological data using a 3D printer. Participants were allocated to 3D group and atlas group. In the 3D group, participants learned surgery with the assistance of 3D models. In the atlas group, participants used only two-dimensional materials to assist their learning...
February 9, 2018: World Neurosurgery
Oriela Rustemi, Renato Scienza, Alessandro Della Puppa
Tuberculum sellae meningioma remains a surgical challenge. Deep location of tumor, vascular and nerve encasement, and pituitary stalk involvement are the main technical issues. The frontopterional approach represents a natural, simple, and elegant approach to this area enabling surgeon to have a direct control on all anatomical structures. A 42-year-old woman was referred with a delayed diagnosis of tuberculum sellae meningioma due to the presence of HLA-B27-associated uveitis. She presented with 1/10 visual acuity in the left eye and no right visual function...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Mirza Pojskić, Kenan I Arnautović
In this video clip, the authors present the resection of a tuberculum sellae meningioma with compression of the left optic nerve and a chiasm ( Fig. 1 ) through a standard cranial orbital (CO) skull base approach. 1 2 3 The key step in the tumor resection was microsurgical dissection of left and right A1 segments of the anterior cerebral artery and the anterior communicating artery and the separation of the tumor from these vascular structures. This was followed by careful separation of the meningioma from both optic nerves, the chiasm and the pituitary stalk...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Duarte N C Cândido, Paulo E H Nakashima, Jean Gonçalves de Oliveira, Luis A B Borba
Tuberculum Sellae Meningiomas (TSMs) are lesions dramatically related to the optic apparatus once the principal clinical complain remains on visual alterations. This is the main picture on decision making to evaluate the best time, risk-benefit, and surgical approaches to the patient treatment. In this video, we present a 65 years old female with 30 days complaint of unilateral (right) complete blindness and complete impaired right eye field test. On physical examination, there were normal pupillary function to light tests...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Alexander Yang, Mohammed Aref, A Samy Youssef
This is a case of an extensive tuberculum sella meningioma involving the circle of Willis down to the basilar artery that presented with bilateral visual loss worse on the right than left side. A one-piece right orbitopterional approach along the worse eye was used to gain access to the three cranial fossae. The orbitotomy facilitates access to the midline structures and contralateral base of the tumor with minimal brain retraction. Tumor resection is initiated by first identifying the tumor capsule, followed by piecemeal debulking via ultrasonic aspiration...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Ihsan Dogan, Melih Ucer, Mustafa Kemal Başkaya
Microsurgical treatment of suprasellar tumors, in particular tuberculum sellae meningiomas, poses significant challenge. These tumors are surrounded by vital neurovascular structures, such as optic apparatus, pituitary stalk, internal carotid artery and its branches, and anterior cerebral arteries. In large and complex cases, early identification and decompression of these structures may facilitate safer dissection and resection. Therefore, extradural anterior clinoidectomy with optic unroofing facilitates the internal carotid artery exposure and optic nerve decompression...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
James K Liu, Kentaro Watanabe
The optimal approach for surgical resection of tuberculum sellae meningiomas remains controversial. Approach selection is largely based on a variety of factors, such as tumor size, extent and location relative to the optic canal and internal carotid artery, the presence of vascular encasement, and surgeon's preference. In this operative video manuscript, the authors demonstrate the importance of an open transcranial approach when the tumor extends lateral to the optic nerve over the internal carotid artery into the opticocarotid triangle, which is a difficult region to safely access with a purely endoscopic endonasal approach...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Justin R Davanzo, Neerav Goyal, Brad E Zacharia
This video abstract demonstrates the use of the expanded endoscopic endonasal approach for the resection of a retrochiasmatic craniopharyngioma. These tumors are notoriously difficult to treat, and many approaches have been tried to facilitate safe and effective resection. The endoscopic endonasal approach has been increasingly utilized for selected sellar/suprasellar pathology. We present the case of a 39-year-old man who was found to have a cystic, partially calcified suprasellar mass consistent with a craniopharyngioma...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Zeng-Hui Qian, Xu Feng, Yang Li, Ke Tang
OBJECTIVE: Surgical operation within the region of the jugular foramen presents a great challenge. The authors characterized the quantitative impact of surgical window parameters on the exposure of the jugular foramen via a trans-mastoidal approach. METHODS: Computed tomography and magnetic resonance imaging data were used to establish a 3-dimensional model of the jugular foramen region. The mastoidale, posterior edge of the mastoid, and the superior edge of the bony external acoustic meatus were selected as points a, b, and c...
January 19, 2018: Journal of Craniofacial Surgery
Umit Kocaman, Tayfun Dalbasti, Mehmet Haluk Ozer, Hakan Yilmaz, Muhammet Bahadir Yilmaz, Ibrahim Burak Atci, Servet Celik
PURPOSE: Lateral supraorbital approach is a simpler and quicker method than pterional approach. It provides a more anterior projection when compared to the pterional approach. There are some minor differences of the modified lateral supraorbital approach when compared to lateral supraorbital approach. It is directed more subfrontally and anterior than the pterional and lateral supraorbital approach. MATERIAL AND METHODS: We used modified lateral supraorbital approach in 100 cases between 2012 and 2015 in Medical Park İzmir Hospital/Turkey...
December 6, 2017: British Journal of Neurosurgery
Sudha Menon, Girish Menon
Postoperative visual loss is a dreaded complication following transcranial excision of tuberculum sella meningioma. Visual deterioration is commonly noticed immediately after surgery, and delayed deterioration after 72 h is uncommon. We report a case of delayed postoperative deterioration in a 48-year-old female and discuss the possible mechanisms.
October 2017: Journal of Neurosciences in Rural Practice
Eric W Recktenwald, Elizabeth A Dudkin, Laura K Skorina, William M Saidel, Edward R Gruberg
The amphibian retina projects to two discrete regions of neuropil in the anterior thalamus: the neuropil of Bellonci and the corpus geniculatum. These retinorecipient areas are encompassed within a larger zone of surrounding neuropil we call the NCZ (for neuropil of Bellonci/corpus geniculatum zone). The NCZ is characterized electrophysiologically by a distinctive tonic oscillatory response to blue light; it appears to be a visual module involved in processing the stationary visual environment. Using horseradish peroxidase (HRP), we mapped the connections of the NCZ...
November 16, 2017: Brain, Behavior and Evolution
Frédéric Laberge, Allison Smith
The habenular complex and its associated axonal pathways are often thought of as phylogenetically conserved features of the brain among vertebrates despite the fact that detailed studies of this brain region are limited to a few species. Here, the gross morphology and axonal projection pattern of the habenular complex of an anuran amphibian, the fire-bellied toad Bombina orientalis, was studied to allow comparison with the situation in other vertebrates. Axonal pathways were traced using biocytin applications in dissected brain preparations...
November 2, 2017: Brain, Behavior and Evolution
Ivo S Muskens, Vanessa Briceno, Tom L Ouwehand, Joseph P Castlen, William B Gormley, Linda S Aglio, Amir H Zamanipoor Najafabadi, Wouter R van Furth, Timothy R Smith, Rania A Mekary, Marike L D Broekman
OBJECT: In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. METHODS: A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values...
November 10, 2017: Acta Neurochirurgica
Meriç Çırpar, Birhan Oktaş, Bülent Dağlar
In this article, we report a case of bilateral posterior shoulder instability, having reverse Hill-Sachs lesions of 25 to 50% of the articular surface on the right side, and of 50% on the left side. The defects were anatomically reconstructed after tuberculum minus osteotomy by elevation of the articular surface and buttressing with raft screws without graft usage. Early rehabilitation with pendulum shoulder exercises was started at third postoperative day. At postoperative sixth week, patient had full range of motion without instability and pain...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Wei Liu, Chuanfeng Li, Xianming Liu, Zhiming Xu, Lu Kong
In this paper, we report a case of intracranial tuberculum with adjacent intracerebral inflammatory aneurysm, and include a brief discussion of the developmental mechanism of these pathologies. A 28-year-old man presented with sudden onset of severe headache. He was diagnosed with h pulmonary tuberculosis 8 year ago, and had been treated with anti-tuberculosis medications for 6 months. Head computed tomography (CT) showed a small hematoma in the left Sylvian fissure with subarachnoid hemorrhage. Cerebral digital subtraction angiograph (DSA) was performed and no aneurysm was found...
October 30, 2017: World Neurosurgery
Filippo Gagliardi, Anthony M Chau, Pietro Mortini, Anthony J Caputy, Cristian Gragnaniello
The Myriad is an innovative, high precision tool for tumor resection, designed to work within narrow endoscopic corridors. Due to its application in technically demanding situations, the learning curve associated with its use might be extremely challenging and time-consuming.The authors describe the application of an already validated training model, the skull base injectable tumor model (ITM), to allow trainees to practice with the use of the Myriad during endoscopic skull base procedures.A formalin embalmed cadaveric head was used for technical assessment...
October 18, 2017: Journal of Craniofacial Surgery
Cristian Ferrareze Nunes, André Beer-Furlan, Francesco Doglietto, Ricardo Luis Carrau, Daniel Monte-Serrat Prevedello
BACKGROUND: The McConnell's capsular arteries (MCCA) were first described in 1953. They consist of medial branches of the cavernous internal carotid artery (ICA) and are divided in anterior and inferior capsular arteries. OBJECTIVE: To highlight the anatomy of the MCCA and its importance in the surgical treatment of tuberculum sellae and planum sphenoidale tumors through an endoscopic endonasal approach. METHODS: Ten cadaveric specimens fixed in formalin and perfused with colored silicone were dissected...
October 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
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