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endoscopic transpetrosal

Moujahed Labidi, Kentaro Watanabe, Marie-Pier Loit, Shunya Hanakita, Sébastien Froelich
Objectives  To discuss the use of the posterior petrosal approach for the resection of a retrochiasmatic craniopharyngioma. Design  Operative video. Results  In this case video, the authors discuss the surgical management of a large craniopharyngioma, presenting with mass effect on the third ventricle and optic apparatus. A first surgical stage, through an endoscopic endonasal transtubercular approach, allowed satisfactory decompression of the optic chiasma and nerves in preparation for adjuvant therapy...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Douglas A Hardesty, Alaa S Montaser, André Beer-Furlan, Ricardo L Carrau, Daniel M Prevedello
Craniopharyngiomas represent one of the most challenging brain tumors for the neurosurgeon. For most of the 20th century, these parasellar lesions have been approached via the classic open approaches of neurosurgery such as pterional, frontobasal, interhemispheric, and transpetrosal craniotomies. The endoscopic endonasal approach to these tumors, rather than craniotomy, has risen in popularity over the last two decades. Regardless of approach, a detailed knowledge of surgical anatomy and careful preoperative surgical planning are essential to achieve good clinical results; iatrogenic morbidity can potentially be severe due to hypothalamus, optic apparatus, and/or vascular injuries...
January 26, 2018: Journal of Neurosurgical Sciences
Yong Hwy Kim, Chiman Jeon, Young-Bem Se, Sang Duk Hong, Ho Jun Seol, Jung-Ii Lee, Chul-Kee Park, Dong Gyu Kim, Hee-Won Jung, Doo Hee Han, Do-Hyun Nam, Doo-Sik Kong
OBJECTIVE The endoscopic endonasal approach for treating primary skull base malignancies involving the clivus is a formidable task. The authors hypothesized that tumor involvement of nearby critical anatomical structures creates hurdles to endoscopic gross-total resection (GTR). The aim of this study was to retrospectively review the clinical outcomes of patients who underwent an endoscopic endonasal approach to treat primary malignancies involving the clivus and to analyze prognostic factors for GTR. METHODS Between January 2009 and November 2015, 42 patients underwent the endoscopic endonasal approach for resection of primary skull base malignancies involving the clivus at 2 independent institutions...
June 2, 2017: Journal of Neurosurgery
Maria Koutourousiou, Juan C Fernandez-Miranda, Francisco Vaz-Guimaraes Filho, John R de Almeida, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE: Transpetrosal approaches for the treatment of petroclival meningiomas are often associated with substantial morbidity and long recovery. With the goal of early clinical improvement, we have used less invasive surgical approaches for petroclival meningiomas. METHODS: We retrospectively reviewed 32 patients with petroclival meningiomas. Eleven patients (34.4%) were managed with lateral approaches (retrosigmoid or far lateral approach), 17 (53.1%) with anterior midline approaches (endoscopic endonasal approach [EEA]), and 4 (12...
March 2017: World Neurosurgery
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
A Zoghlami, N Bon Mardion, F Callonnec, D Dehesdin, F Proust, J-P Marie
INTRODUCTION: Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele. CASE REPORTS: Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Both cases presented with clinical features of recurrent meningitis. Surgical management of case 1 was performed via an intradural infratemporal fossa craniotomy with reoperation 2years later...
December 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Eric Mason, Jason Van Rompaey, C Arturo Solares, Ramon Figueroa, Daniel Prevedello
Background The petroclival region seats many neoplasms. Traditional surgical corridors to the region can result in unacceptable patient morbidity. The combined subtemporal retrolabyrinthine transpetrosal (posterior petrosal) approach provides adequate exposure with hearing preservation; however, the facial nerve and labyrinth are put at risk. Approaching the petroclival region with an endoscopic endonasal approach (EEA) could minimize morbidity. Objective To provide an anatomical and computed tomography (CT) comparison between the posterior petrosal approach and EEA to the petroclival region...
June 2016: Journal of Neurological Surgery. Part B, Skull Base
Jie Yang, Fang Zhang, Aiguo Xu, Huadong Li, Zihai Ding
BACKGROUND: The retrolabyrinthine and transcrusal approaches (RLA and TCA, respectively) are the two most often used posterior transpetrosal approaches that are used to treat lesions in the retrochiasmatic region. Endoscopes are increasingly used in neurosurgical practice. To determine whether a difference exists between the two transpetrosal approaches in the retrochiasmatic region, we evaluated and compared the exposure and maneuverability associated with the microscope and the endoscope in these approaches...
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...
November 2016: Journal of Neurosurgery
Shunsuke Shibao, Masahiro Toda, Kazunari Yoshida
BACKGROUND: Clival giant cell tumors (GCTs) are extremely rare with only eight cases reported to date, and malignant transformation is quite rare. Herein, we report a case of an uncontrolled clival GCT, which was transformed malignant, and review the literature. CASE DESCRIPTION: A 25-year-old man experienced double vision for 1 month. Computed tomography and magnetic resonance imaging revealed a clival tumor. The endonasal endoscopic transsphenoidal approach (EEA) was used, and partial resection was performed because of massive bleeding...
2015: Surgical Neurology International
Sayuru Miyamura, Satoshi Yamaguchi, Atsushi Tominaga, Yasuyuki Kinoshita, Masaaki Takeda, Satoshi Usui, Mizuki Morishige, Kazuhiko Sugiyama, Kaoru Kurisu
A transcranial approach in combination with a transpetrosal setting has been the mainstream of surgical treatment of cholesterol granulomas in the petrous apex. However, endoscopic endonasal surgery has become a choice of treatment for these lesions with recent advancements in surgical techniques and instruments. We report a successful case of cholesterol granuloma managed with endoscopic endonasal surgery. A 45-year-old woman, who had a long-standing history of otitis media, presented with left abducens nerve palsy and discomfort around the left eye...
December 2014: Hiroshima Journal of Medical Sciences
Kenichi Oyama, Daniel M Prevedello, Leo F S Ditzel Filho, Jun Muto, Ramazan Gun, Edward E Kerr, Bradley A Otto, Ricardo L Carrau
OBJECT: The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern...
2014: Neurosurgical Focus
Elena d'Avella, Flavio Angileri, Matteo de Notaris, Joaquin Enseñat, Vita Stagno, Luigi Maria Cavallo, Joan Berenguer Gonzales, Alessandro Weiss, Alberto Prats-Galino
Advances in endoscopic endonasal skull base surgery have led to the development of new routes to areas beyond the midline skull base. Recently, feasible surgical corridors to the lateral skull base have been described. The aim of this study was to describe the anatomical exposure of the ventrolateral brainstem and posterior fossa through an extended endoscopic endonasal transclival transpetrosal and transcondylar approach. Six human heads were used for the dissection process. The arterial and venous systems were injected with red- and blue-colored latex, respectively...
April 2014: Neurosurgical Review
Matthew R Sanborn, Michael J Kramarz, Philip B Storm, Nithin D Adappa, James N Palmer, John Y K Lee
BACKGROUND AND IMPORTANCE: Hemorrhagic, symptomatic cavernous malformations in the brainstem are difficult to access. Conventional approaches such as the transpetrosal approach often require significant brain retraction. We present the successful purely endoscopic, endonasal, transclival resection of a symptomatic cavernoma located in the ventromedial pons. CLINICAL PRESENTATION: A 17-year-old male patient presented with acute onset of headache, facial numbness, and tingling...
September 2012: Neurosurgery
Geoffrey Peters, Moises A Arriaga, Daniel W Nuss, Anna M Pou, Michael DiLeo, Kelly Scrantz
OBJECTIVE: To present a case of mucosal melanoma of the Eustachian tube with a focus on surgical technique and to review the literature on treatment of mucosal melanoma of the head and neck, and review cases involving the middle ear and/or Eustachian tube. PATIENT: A 67-year-old man was diagnosed with mucosal melanoma of the middle ear and Eustachian tube. INTERVENTION: The patient underwent primary surgical resection including transtemporal/transpetrosal approach, endoscopic nasopharyngectomy, infratemporal fossa dissection, temporomandibular joint resection, ipsilateral neck dissection (levels II-IV), and superficial parotidectomy...
February 2012: Otology & Neurotology
Borimir J Darakchiev, Myles L Pensak
PURPOSE OF REVIEW: This review examines disturbances of cerebrospinal fluid (CSF) dynamics after skull base surgical and endoscopic approaches. Despite the continuing advancements and the effectiveness of skull base surgery, the incidence of postoperative rhinorrhea remains problematic. This adverse event carries a significant potential for major neurologic insult related to infection of the central nervous system. RECENT FINDINGS: The contemporary literature provides excellent reports that summarize the management of this important clinical entity focusing on particular aspects of its diagnosis and treatment...
October 2004: Current Opinion in Otolaryngology & Head and Neck Surgery
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