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petroclival tumors

Sohum K Desai, Da'Marcus Baymon, Eric Sieloff, Kenneth Maynard, Marc Moisi, Achal P Patel, Joel T Patterson
AIMS: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children...
April 2016: Journal of Pediatric Neurosciences
Tanya E Sassun, Andrea G Ruggeri, Roberto Delfini
BACKGROUND: The evolution of Petroclival Meningiomas (PMs) surgical treatment has lead nowadays to a tendency to abandon complex petrous approaches and return to "less aggressive" skull base approaches. OBJECTIVE: To propose a PMs classification and establish the role of the Combined Supra-Infratentorial Presigmoid Retrolabyrinthine (CSIPR) approach in the treatment of PMs rigorously matching the anatomical definition. METHODS: A retrospective analysis was conducted of 51 cases of PMs strictly adhering to the anatomical definition, operated on from January 1990 to December 2011...
August 24, 2016: World Neurosurgery
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Walter C Jean, Daniel R Felbaum, Amjad Anaizi, Timothy R DeKlotz
The endoscopic endonasal transclival approach has been widely described for its use to resect clivus chordomas, but there have only been isolated reports of its use for petroclival meningiomas. These tumors are most often resected utilizing open transpetrosal approaches, but these operations, difficult even in the hands of dedicated skull base surgeons, are particularly challenging if the meningiomas are medially-situated and positioned mainly behind the clivus. For this subset of petroclival meningiomas, a transclival approach may be preferable...
2016: Curēus
Aurel Hasanbelliu, Norberto O Andaluz, Alberto Di Somma, Jeffrey T Keller, Lee Zimmer, Myles L Pensak, Ravi Samy, Mario Zuccarello
INTRODUCTION: Petroclival tumors and ventrolateral lesions of the pons present a unique surgical challenge. We aimed to provide qualitative and quantitative anatomic analyses of anterior petrous apicectomy through the transcranial middle fossa (TMF) and the extended endoscopic transphenoidal-transclival (EETT) approaches. METHODS: Ten cadaveric silicon-injected cadaver heads were used for this study. The petrous apex and the clivus were drilled extradurally through both middle fossa and endonasal approaches...
August 2016: Neurosurgery
G Chen, W W Zhai, Z Q Yu
OBJECTIVE: To investigate varying patterns of intracranial pressure(ICP)after giant meningioma resection and analyze the causes of the variation of ICP in different postoperative phases. METHODS: Clinical data, surgical approachs and the ICP monitoring data of 7 patients with giant meningioma in different positions who were admitted to the First Affiliated Hospital of Soochow University from October 2013 to July 2014 and received microsurgical resection via different approachs were analysed retrospectively...
June 28, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Caroline Hayhurst, Michael E Sughrue, Pankaj A Gore, Phillip A Bonney, Joshua D Burks, Charles Teo
AIM: Reconstruction technique advances have created renewed enthusiasm for the expanded endonasal approach (EEA). However, as with any new technique, early experiences inevitably lead to more selective use of these techniques. We reviewed our experience of the expanded endonasal endoscopic approach for skull base meningiomas and place it in context of the literature. MATERIAL AND METHODS: We performed retrospective review of all endonasal cases performed at our center for histologically proven meningioma...
2016: Turkish Neurosurgery
Ramsey Ashour, Stephen Reintjes, Michael S Park, Sananthan Sivakanthan, Harry van Loveren, Siviero Agazzi
BACKGROUND: Although intraoperative magnetic resonance imaging (iMRI) increasingly is used during glioma resection, its role in skull base surgery has not been well documented. In this study, we evaluate our experience with iMRI for skull base surgery. METHODS: Medical records were reviewed retrospectively on all neurosurgical cases performed at our institution in the IMRIS iMRI suite between April 2014 and July 2015. RESULTS: During the study period, the iMRI suite was used for 71 skull base tumors...
September 2016: World Neurosurgery
Ariyan Pirayesh, Ioannis Petrakakis, Peter Raab, Manolis Polemikos, Joachim K Krauss, Makoto Nakamura
OBJECTIVE: Despite advances in skull base surgery, surgical removal of petroclival meningiomas (PCM) still poses a considerable neurosurgical challenge with regard to postoperative morbidity and the patients' long-term outcome. Knowledge of imaging features for PCM that might help to predict common risk factors encountered with tumor resection preoperatively is limited. The aim of this study was to clarify whether MRI features of PCM might predict tumor resectability and clinical outcome...
August 2016: Clinical Neurology and Neurosurgery
André Beer-Furlan, Ralph Abi-Hachem, Ali O Jamshidi, Ricardo L Carrau, Daniel M Prevedello
Petroclival meningiomas are challenging lesions to manage independently of the selected surgical approach and are unique tumors in the type of pathological displacement of the surrounding anatomy. They also represent one of the most controversial entities with regard to approach selection, especially when deciding between an open versus endonasal route. When choosing an approach to the intradural portion of the petroclival region, the location of critical neurovascular structures relative to the lesion must be anticipated, including the abducens and trigeminal nerves...
December 2016: Journal of Neurosurgical Sciences
Matthew L Carlson, Brendan P O'Connell, Joseph T Breen, Cameron C Wick, Colin L Driscoll, David S Haynes, Reid C Thompson, Brandon Isaacson, Paul W Gidley, J Walter Kutz, Jamie J Van Gompel, George B Wanna, Shaan M Raza, Franco DeMonte, Samuel L Barnett, Michael J Link
OBJECTIVE: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. STUDY DESIGN: Retrospective case review, 1995 to 2015. SETTING: Multicenter study. PATIENTS: Consecutive patients with histopathologically proven petroclival chondrosarcoma. INTERVENTION(S): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. MAIN OUTCOME MEASURES: Disease- and treatment-associated morbidity, recurrence, mortality...
August 2016: Otology & Neurotology
Thomas John Muelleman, Jeremy Peterson, Naweed Iffat Chowdhury, Jason Gorup, Paul Camarata, James Lin
Objectives To determine the utility of three-dimensional (3D) printed models in individualized petroclival tumor resection planning by measuring the fidelity of printed anatomical structures and comparing tumor exposure afforded by different approaches. Design Case series and review of the literature. Setting Tertiary care center. Participants Three patients with petroclival lesions. Main Outcome Measures Subjective opinion of access by neuro-otologists and neurosurgeons as well as surface area of tumor exposure...
June 2016: Journal of Neurological Surgery. Part B, Skull Base
Zhou Xu, Xingruo Zeng, Daofeng Tian, Qianxue Chen
AIM: To study and summarize our experience with the subtemporal transtentorial approach for resection of petroclival tumors. MATERIAL AND METHODS: Twenty-eight patients who suffered from petroclival tumors and underwent tumor resection via a subtemporal transtentorial approach between October 2010 and July 2013 were retrospectively reviewed. RESULTS: Total resection was performed in 22 cases, at a rate of 78.57%, subtotal resection in 5 cases, and large portion resection in 1 case...
2016: Turkish Neurosurgery
Masanori Yoshino, Kumar Abhinav, Fang-Cheng Yeh, Sandip Panesar, David Fernandes, Sudhir Pathak, Paul A Gardner, Juan C Fernandez-Miranda
BACKGROUND: Recent studies have demonstrated diffusion tensor imaging tractography of cranial nerves (CNs). Spatial and angular resolution, however, is limited with this modality. A substantial improvement in image resolution can be achieved with high-angle diffusion magnetic resonance imaging and atlas-based fiber tracking to provide detailed trajectories of CNs. OBJECTIVE: To use high-definition fiber tractography to identify CNs in healthy subjects and patients with brain tumors...
July 2016: Neurosurgery
Kosuke Kondo, Naoyuki Harada, Hiroyuki Masuda, Nobuo Sugo, Sayaka Terazono, Shinichi Okonogi, Yuki Sakaeyama, Yutaka Fuchinoue, Syunpei Ando, Daisuke Fukushima, Jun Nomoto, Masaaki Nemoto
BACKGROUND: Deep regions are not visible in three-dimensional (3D) printed rapid prototyping (RP) models prepared from opaque materials, which is not the case with translucent images. The objectives of this study were to develop an RP model in which a skull base tumor was simulated using mesh, and to investigate its usefulness for surgical simulations by evaluating the visibility of its deep regions. METHODS: A 3D printer that employs binder jetting and is mainly used to prepare plaster models was used...
June 2016: Acta Neurochirurgica
Shyamal C Bir, Tanmoy Kumar Maiti, Papireddy Bollam, Anil Nanda
Objective Petroclival meningioma (PM) presents with trigeminal neuralgia (TN) in < 5% of cases. Neurosurgeons often face the dilemma of formulating a treatment protocol when TN recurs. In this study, we sought to set up a protocol in patients with PM who had a recurrent TN. Materials and Methods We performed a retrospective review of 57 patients with PM. Of the 57 patients, only 7 patients presented with TN, and six patients experienced recurrent TN. The study population was evaluated clinically and radiographically after treatment...
February 2016: Journal of Neurological Surgery. Part B, Skull Base
Jaejoon Lim, Kyunggi Cho
Various surgical approaches for the removal of meningioma and trigeminal schwannoma in the petroclival junction (PCJ) and anterior cerebellopontine area (CPA) have been described previously. In this study, we compared the surgical outcomes of the combined petrosal approach and a modified lateral supraorbital (MLSO) approach and evaluated the reliability and safety of the MLSO approach. Fifty patients underwent surgical treatment using the combined petrosal or MLSO approach between 1996 and 2011. We retrospectively analyzed the clinical data and compared the two approaches...
May 2016: Journal of Neuro-oncology
Constantine L Karras, Isaac Josh Abecassis, Zachary A Abecassis, Joseph G Adel, Esther N Bit-Ivan, Rakesh K Chandra, Bernard R Bendok
Background. Purely ectopic pituitary adenomas are exceedingly rare. Here we report on a patient that presented with an incidental clival mass thought to be a chordoma. Endonasal resection, tumor pathology, and endocrinology workup revealed a prolactinoma. Case Presentation. A 41-year-old male presented with an incidental clival lesion presumed to be a chordoma. On MRI it involved the entire clivus, extended laterally to the petroclival junction, and invaded the cavernous sinuses bilaterally, encasing both internal carotid arteries, without direct extension into the sella...
2016: Case Reports in Neurological Medicine
Lucas Troude, Matthieu Carissimi, Jean-Pierre Lavieille, Pierre-Hugues Roche
BACKGROUND: Petroclival and ventral brain stem tumors require a complex approach. METHOD: The combined petrosectomy is an epidural transtentorial-transpetrosal otoneurosurgical approach to achieve a retrolabyrinthine presigmoidal approach and an anterior petrosectomy in one single procedure. The different steps of this approach are described and illustrated by figures and a video. The indications and limitations of the technique are presented. CONCLUSION: The combined petrosectomy offers multiple corridors to the petroclival region and ventral brainstem while preserving the intrapetrous neurotological structures...
April 2016: Acta Neurochirurgica
Jun Muto, Daniel M Prevedello, Leo F S Ditzel Filho, Ing Ping Tang, Kenichi Oyama, Edward E Kerr, Bradley A Otto, Takeshi Kawase, Kazunari Yoshida, Ricardo L Carrau
OBJECTIVE The endoscopic endonasal approach (EEA) offers direct access to midline skull base lesions, and the anterior transpetrosal approach (ATPA) stands out as a method for granting entry into the upper and middle clival areas. This study evaluated the feasibility of performing EEA for tumors located in the petroclival region in comparison with ATPA. METHODS On 8 embalmed cadaver heads, EEA to the petroclival region was performed utilizing a 4-mm endoscope with either 0° or 30° lenses, and an ATPA was performed under microscopic visualization...
February 5, 2016: Journal of Neurosurgery
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