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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/27906848/calculation-of-an-optic-nerve-injury-risk-profile-before-sphenoid-sinus-surgery
#1
Erdem Atalay Cetinkaya, Koray Koc, Mehmet Fatih Kucuk, Pinar Koc, Nuray Bayar Muluk, Cemal Cingi
OBJECTIVES: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. METHODS: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#2
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27890179/expanded-endonasal-endoscopic-approaches-to-the-skull-base-for-the-radiologist
#3
REVIEW
Christopher R Roxbury, Masaru Ishii, Ari Meir Blitz, Douglas D Reh, Gary L Gallia
The cranial base is a complex 3-D region that contains critical neurovascular structures. Pathologies affecting this region represent some of the most challenging lesions to manage due to difficulty with access and risk of significant postoperative morbidity. With the development of expanded endonasal endoscopic approaches, skull base surgeons use the nose and paranasal sinuses as a corridor to access selected ventral skull base lesions. This review discusses high-resolution imaging in the evaluation of patients with skull base lesions considered for endonasal endoscopic surgery, summarizes various expanded endonasal endoscopic approaches, and provides examples of commonly used expanded endonasal endoscopic procedures...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27857875/dual-endoscopic-endonasal-transsphenoidal-and-precaruncular-transorbital-approaches-for-clipping-of-the-cavernous-carotid-artery-a-cadaveric-simulation
#4
Jeremy Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin S Cetas, William E Cameron
Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27857870/persistent-trigeminal-artery-in-endonasal-resection-of-skull-base-tumors-a-systematic-review
#5
Jasper Shen, James Tourje, Elena E Chang, Adam N Mamelak, Arthur W Wu
Background Primitive persistent trigeminal artery (PTA) is an uncommon embryologic vascular communication between the carotid and basilar arteries, which can be intimately involved by skull base tumors (SBT). Owing to its rarity, skull base surgeons should familiarize themselves with the anatomical variations of PTA to avoid catastrophic complications. Objective To appraise and summarize the available evidence of PTA involved by SBTs while advocating a standardized algorithm for the surgical planning of these patients...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27846635/multilayered-closure-of-cerebrospinal-fluid-rhinorrhea-with-inlay-fascia-lata-autologous-fat-and-outlay-fascia-lata-our-experience
#6
Mehmet Akif Eryılmaz, Mitat Arıcıgil, Mehmet Akif Alan
BACKGROUND/AIMS: Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition. METHODS: In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (CSF) rhinorrhea...
November 16, 2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/27771110/image-guided-transoral-approach-in-severe-craniovertebral-junction-malformations-at-the-golden-age-of-endoscopy-regarding-2%C3%A2-cases
#7
E Mazerand, N Karmani, L Le Fournier, L Laccourreye, H-D Fournier
INTRODUCTION: The image-guided transoral approach (IGTOA) provides a safe exposure to skull base midline lesions and the ventral aspect of the craniovertebral junction (CVJ). The IGTOA has several advantages: the head being placed in the extended position, it decreases the brainstem angulation during surgery; the approach being done through the avascular median pharyngeal raphe, not only lowers the bleeding risk but also provides a direct access to the bony pathology and granulation tissue accessible only via the ventral route...
October 19, 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27767395/endoscopic-endonasal-transclival-resection-of-a-ventral-pontine-cavernous-malformation-technical-case-report
#8
Juan Luis Gómez-Amador, Luis Alberto Ortega-Porcayo, Isaac Jair Palacios-Ortíz, Alexander Perdomo-Pantoja, Felipe Eduardo Nares-López, Alfredo Vega-Alarcón
Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27766473/endoscopic-transnasal-skull-base-surgery-pushing-the-boundaries
#9
Nathan T Zwagerman, Georgios Zenonos, Stefan Lieber, Wei-Hsin Wang, Eric W Wang, Juan C Fernandez-Miranda, Carl H Snyderman, Paul A Gardner
The endoscopic endonasal approach (EEA) has significantly evolved since its initial uses in pituitary and sinonasal surgery. The literature is filled with reports and case series demonstrating efficacy and advantages for the entire ventral skull base. With competence in 'minimally invasive' parasellar approaches, larger and more complex approaches were developed to utilize the endonasal corridor to create maximally invasive endoscopic skull base procedures. The challenges of these more complex endoscopic procedures include a long learning curve and navigating in a narrow corridor; reconstruction of defects presented new challenges and early experience revealed a significantly higher risk of cerebrospinal fluid leak...
October 20, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27762178/role-of-targeted-magnetic-resonance-imaging-sequences-in-the-surgical-management-of-anterior-skull-base-pathology
#10
S Chawla, J Bowman, M Gandhi, B Panizza
BACKGROUND: The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage...
October 20, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27714466/how-i-do-it-the-pedicled-temporoparietal-fascia-flap-for-skull-base-reconstruction-after-endonasal-endoscopic-approaches
#11
Mathieu Veyrat, Benjamin Verillaud, Philippe Herman, Damien Bresson
BACKGROUND: Endoscopic endonasal approaches (EEA) are an alternative for removing challenging nasopharyngeal or skull base lesions. In some cases, a nasoseptal flap (NSF) is not always available and such complex procedures may lead to carotid arteries exposition and/or dura mater (DM) wide opening. Meticulous carotid coverage and DM reconstruction are crucial for preventing early and delayed complications. METHOD: We propose a step-by-step description of the pedicled temporoparietal fascia flap (TPFF) technique, with a focus on its pitfalls, advantages and limits...
October 7, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27695249/the-use-of-intraoperative-computed-tomography-navigation-in-pituitary-surgery-promises-a-better-intraoperative-orientation-in-special-cases
#12
Stefan Linsler, Sebastian Antes, Sebastian Senger, Joachim Oertel
OBJECTIVE: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. MATERIALS AND METHODS: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated...
October 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/27677601/efficacy-of-perioperative-lumbar-drainage-following-endonasal-endoscopic-cerebrospinal-fluid-leak-repair-a-meta-analysis
#13
Omar H Ahmed, Sonya Marcus, Jenna R Tauber, Binhuan Wang, Yixin Fang, Richard A Lebowitz
OBJECTIVE: Perioperative lumbar drain (LD) use in the setting of endoscopic cerebrospinal fluid (CSF) leak repair is a well-established practice. However, recent data suggest that LDs may not provide significant benefit and may thus confer unnecessary risk. To examine this, we conducted a meta-analysis to investigate the effect of LDs on postoperative CSF leak recurrence following endoscopic repair of CSF rhinorrhea. DATA SOURCES: A comprehensive search was performed with the following databases: Ovid MEDLINE (1947 to November 2015), EMBASE (1974 to November 2015), Cochrane Review, and PubMed (1990 to November 2015)...
September 27, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27650322/the-turbinal-flap-an-additional-option-for-anterior-skull-base-reconstruction-cadaveric-feasibility-study-and-case-report
#14
Alberto Schreiber, Davide Mattavelli, Marco Ferrari, Vittorio Rampinelli, Davide Lancini, Francesco Belotti, Luigi Fabrizio Rodella, Piero Nicolai
BACKGROUND: Over the past decade, the treatment of complex intradural and extradural pathologies via expanded endonasal approaches has been made possible by progresses and refinements in skull base reconstruction techniques. The aim of this anatomic study is to describe a novel endonasal flap, the turbinal flap (TF), based on the middle and superior turbinate mucosa and pedicled on the ethmoidal arteries system. METHODS: Three fresh-frozen (6 sides) cadaver heads previously injected with colored silicone were dissected...
September 21, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27588370/combined-approaches-to-the-skull-base-for-intracranial-extension-of-tumors-via-perineural-spread-can-improve-patient-outcomes
#15
Sheri K Palejwala, Jonnae Y Barry, Crystal N Rodriguez, Chandni A Parikh, Stephen A Goldstein, G Michael Lemole
Many neoplasms of the head and neck extend centripetally, gaining access to the central nervous system via nerves through the skull base foramina. Often patients with perineural spread have been excluded from aggressive interventions given the overall poor prognosis and technical difficulty when addressing the perineural components. However, in carefully selected patients combined surgical approaches can provide the greatest potential for disease control as well as neural decompression for symptom relief. We performed a retrospective chart review of 20 consecutive patients who underwent skull base approaches for resection of tumors with intracranial extension via perineural spread from 2011 to 2014...
November 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27586390/free-middle-turbinate-mucosal-graft-reconstruction-after-primary-endoscopic-endonasal-pituitary-surgery
#16
Samuel J C Fishpool, Anthony Amato-Watkins, Caroline Hayhurst
The objective is to assess whether free middle turbinate (FMT) graft reconstruction, after endoscopic endonasal pituitary surgery, combines an acceptably low post-operative cerebrospinal fluid (CSF) leak rate with acceptable rhinological morbidity. This study identified 50 patients who underwent endoscopic endonasal pituitary surgery by the senior author in our teaching hospital between May 2011 and June 2012. FMT graft reconstruction was used in 32 cases. 18 patients were judged pre-operatively as not suitable for FMT reconstruction according to a novel skull base reconstructive algorithm...
September 1, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27564072/endonasal-endoscopic-resection-and-radiotherapy-in-skull-base-chordomas
#17
Huan-Kang Zhang, Xi-Cai Sun, Li Hu, Jing-Jing Wang, De-Hui Wang
OBJECTIVES: This study evaluates the impact combined endonasal endoscopic resection and radiotherapy for skull base chordomas. METHODS: Thirty-two patients with skull base chordomas between July 2006 and June 2015 were divided into 2 groups: the surgery alone group and the surgery with radiation therapy group. RESULTS: Gross total resection was achieved in 9 (28.1%) patients with skull base chordoma, subtotal resection was achieved in 16 (50...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27562683/unilateral-endonasal-transcribriform-approach-with-septal-transposition-for-olfactory-groove-meningioma-can-olfaction-be-preserved
#18
A Samy Youssef, Raghuram Sampath, Jacob L Freeman, Jameson K Mattingly, Vijay R Ramakrishnan
BACKGROUND: Loss of olfaction has been considered inevitable in endoscopic endonasal resection of olfactory groove meningiomas. Olfaction preservation may be feasible through an endonasal unilateral transcribriform approach, with the option for expansion using septal transposition and contralateral preservation of the olfactory apparatus. METHODS: An expanded unilateral endonasal transcribriform approach with septal transposition was performed in five cadaver heads...
October 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27546341/endoscope-assisted-trans-maxillo-sphenoidal-approach-to-sellar-and-parasellar-regions-anatomic-study
#19
Filippo Gagliardi, Carmine A Donofrio, Alfio Spina, Michele Bailo, Cristian Gragnaniello, Alberto L Gallotti, Samer K Elbabaa, Anthony J Caputy, Pietro Mortini
OBJECTIVE: Anterolateral skull base surgery to sellar and parasellar region has always represented a technical challenge for neurosurgeons. The microscopic endoscope-assisted trans-maxillo-sphenoidal approach (MEMSA) affords a direct surgical corridor free from critical skull base structures. The aim of this study is to describe and critically evaluate its application to access the sellar and parasellar areas in terms of surgical exposure and operability. METHODS: Six cadaveric heads were examined...
August 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27544339/suction-filter-in-endoscopic-endonasal-surgery-technical-note
#20
Matteo Zoli, Gianluca Marucci, Laura Milanese, Rocco Bonfatti, Carmelo Sturiale, Ernesto Pasquini, Giorgio Frank, Diego Mazzatenta
BACKGROUND: The collection of the greatest possible amount of pathological tissue is of paramount importance in neurosurgery to achieve the most accurate histopathological diagnosis, by performing all the necessary biomolecular tests on the pathological specimen, and to collect biological material for basic or translational science studies. This problem is particularly relevant in pituitary surgery due to the possible small size and soft consistency of tumors, which make them suitable for removal through suction, reducing the amount of available pathological tissue...
August 17, 2016: World Neurosurgery
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