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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/28230588/how-to-expose-the-entire-sella-floor-with-minimal-manipulation-during-an-endoscopic-endonasal-transsphenoidal-approach
#1
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Yong Jin Park, Soo Whan Kim, Jin Hee Cho, Boo-Young Kim, Sung Won Kim
OBJECTIVE: A method of opening the posterior ethmoid air cells with minimal manipulation is important for adequate exposure of the sella floor and minimal nasal morbidity. METHODS: Between February 2009 and August 2016, 373 patients with skull-base tumors underwent surgery via endoscopic endonasal transsphenoidal approach with the 2-nostrils/4-hands technique using this technique. RESULTS: A linear incision was made laterally toward one-third of the superior turbinate along the superior border of the sphenoid sinus ostium...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28180054/anterior-skull-base-glomangioma-induced-osteomalacia
#2
Malia S Gresham, Steven Shen, Yi J Zhang, Kelly Gallagher
Oncogenic osteomalacia (OO) is an uncommon but treatable cause of osteomalacia related to tumor production of FGF23, usually caused by benign mesenchymal neoplasms. Paranasal sinus glomangiomas are a rare cause of OO, with only one previously reported case. Here we describe a second case (first reported in English) of paranasal sinus glomangioma-induced osteomalacia in a 42-year-old man. He presented with weakness and multiple spontaneous fractures, and was found to have an ethmoid sinus glomangioma with intracranial extension...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28180051/region-specific-objective-signatures-of-endoscopic-surgical-instrument-motion-a-cadaveric-exploratory-analysis
#3
R Alex Harbison, Angelique M Berens, Yangming Li, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives The objective of this study was to evaluate region-specific surgical instrument kinematics among novice and experienced surgeons performing endoscopic endonasal skull base surgery. Design Cadaveric experimental study. Setting Tertiary academic center. Participants Two novice and two experienced surgeons performed eight endoscopic total ethmoidectomies and sphenoidotomies using an optically tracked microdebrider. Main Outcome Measures Time-stamped Euclidian coordinates were recorded. Cumulative instrument travel, mean linear velocity and acceleration, and mean angular velocities were calculated in the anterior ethmoid, posterior ethmoid, and sphenoid sinus regions...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180047/the-pedicled-buccal-fat-pad-anatomical-study-of-the-new-flap-for-skull-base-defect-reconstruction-after-endoscopic-endonasal-transpterygoid-surgery
#4
Denis A Golbin, Nikolay V Lasunin, Vasily A Cherekaev, Georgiy A Polev
Objectives To evaluate the efficacy and safety of using a buccal fat pad for endoscopic skull base defect reconstruction. Design Descriptive anatomical study with an illustrative case presentation. Setting Anatomical study was performed on 12 fresh human cadaver specimens with injected arteries (24 sides). Internal carotid artery was exposed in the coronal plane via the endoscopic transpterygoid approach. The pedicled buccal fat pad was used for reconstruction. Participants: 12 human cadaver head specimens; one patient operated using the proposed technique...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180045/juvenile-nasal-angiofibromas-a-comparison-of-modern-staging-systems-in-an-endoscopic-era
#5
Nicholas R Rowan, Nathan T Zwagerman, Molly E Heft-Neal, Paul A Gardner, Carl H Snyderman
Objectives To compare the clinical utility of four juvenile nasal angiofibroma (JNA) staging systems in a large cohort of patients. Design Retrospective case series. Setting Tertiary referral academic center. Participants Pediatric patients undergoing surgical resection of JNAs between January 2008 and June 2015. Main Outcome Measures Intraoperative blood loss and transfusions, number of staged operations, postoperative residual disease, and recurrent disease. Results In total, 34 patients were identified; all underwent preoperative embolization followed by surgery...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28180044/role-of-leukocyte-platelet-rich-fibrin-in-endoscopic-endonasal-skull-base-surgery-defect-reconstruction
#6
Liuba Soldatova, Raewyn G Campbell, Ahmad H Elkhatib, Thomas W Schmidt, Nelson R Pinto, Jaime M Pinto, Daniel M Prevedello, Leo F Ditzel Filho, Bradley A Otto, Ricardo L Carrau
Objective Advancements in endoscopic endonasal approaches have increased the extent and complexity of skull base resections, in turn demanding the development of novel techniques for skull base defect reconstruction. The objective of this pilot study was to investigate the effect of leukocyte-platelet-rich fibrin (L-PRF) on the postoperative healing after endoscopic skull base surgery. Methods Between January and May of 2015, 47 patients underwent endoscopic endonasal resection of sellar, parasellar, and suprasellar lesions with the application of L-PRF membranes during the skull base reconstruction at two surgical centers...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#7
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28145931/endoscopic-endonasal-transsphenoidal-approach-from-the-otolaryngologist-point-of-view
#8
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Dong-Jun Lim, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, YulGyun Kim, Sung Won Kim
OBJECTIVE: In February 2009, the authors' center formed a team of neurosurgeons, otolaryngologists, endocrinologists, and radiologists to perform pituitary surgery using the endoscopic endonasal transsphenoidal approach (EETSA). This paper reviews the authors' experience with the technique, pathological outcomes, hormone profiles, and postoperative complications. METHODS: Between February 2009 and December 2015, 535 patients underwent the EETSA with 2-nostrils/4-hands surgery...
January 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28133560/endoscopic-resection-of-skull-base-teratoma-in-klippel-feil-syndrome-through-use-of-combined-ultrasonic-and-bipolar-diathermy-platforms
#9
Justin A Edward, Alkis J Psaltis, Ryan A Williams, Gregory W Charville, Robert L Dodd, Jayakar V Nayak
Klippel-Feil syndrome (KFS) is associated with numerous craniofacial abnormalities but rarely with skull base tumor formation. We report an unusual and dramatic case of a symptomatic, mature skull base teratoma in an adult patient with KFS, with extension through the basisphenoid to obstruct the nasopharynx. This benign lesion was associated with midline palatal and cerebral defects, most notably pituitary and vertebrobasilar arteriolar duplications. A multidisciplinary workup and a complete endoscopic, transnasal surgical approach between otolaryngology and neurosurgery were undertaken...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28124655/role-of-lumbar-drains-in-contemporary-endonasal-skull-base-surgery-meta-analysis-and-systematic-review
#10
Brian D'Anza, Duc Tien, Janalee K Stokken, Pablo F Recinos, Troy R Woodard, Raj Sindwani
BACKGROUND: Historically, lumbar drains (LD) have played a prominent role in endonasal skull base surgery. Over the past few decades, advancements in techniques have augmented our ability to successfully reconstruct complex skull base defects and often obviates the need for cerebrospinal fluid (CSF) diversion. Clarity on the appropriate use of LDs is needed. OBJECTIVE: To examine the literature for the need for LDs in contemporary skull base reconstruction after resection of skull base tumors...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28109490/risk-factors-for-cerebrospinal-fluid-leak-in-pediatric-patients-undergoing-endoscopic-endonasal-skull-base-surgery
#11
Amanda L Stapleton, Elizabeth C Tyler-Kabara, Paul A Gardner, Carl H Snyderman, Eric W Wang
OBJECTIVES: To determine the risk factors associated with cerebrospinal fluid (CSF) leak following endoscopic endonasal surgery (EES) for pediatric skull base lesions. METHODS: Retrospective chart review of pediatric patients (ages 1 month to 18 years) treated for skull base lesions with EES from 1999 to 2014. Five pathologies were reviewed: craniopharyngioma, clival chordoma, pituitary adenoma, pituitary carcinoma, and Rathke's cleft cyst. Fisher's exact tests were used to evaluate the different factors to determine which had a statistically higher risk of leading to a post-operative CSF leak...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28106514/endonasal-management-of-pediatric-congenital-transsphenoidal-encephaloceles-nuances-of-a-modified-reconstruction-technique-technical-note-and-report-of-3-cases
#12
Mehdi Zeinalizadeh, Seyed Mousa Sadrehosseini, Zohreh Habibi, Farideh Nejat, Harley Brito da Silva, Harminder Singh
OBJECTIVE Congenital transsphenoidal encephaloceles are rare malformations, and their surgical treatment remains challenging. This paper reports 3 cases of transsphenoidal encephalocele in 8- to 24-month-old infants, who presented mainly with airway obstruction, respiratory distress, and failure to thrive. METHODS The authors discuss the surgical management of these lesions via a minimally invasive endoscopic endonasal approach, as compared with the traditional transcranial and transpalatal approaches. A unique endonasal management algorithm for these lesions is outlined...
January 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28097430/how-i-do-it-the-mononostril-endonasal-transethmoidal-paraseptal-approach
#13
Robert Reisch, Hans Rudolf Briner, Anne-Katrin Hickmann
BACKGROUND: The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach. METHODS: The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28089805/surgical-outcomes-of-endoscopic-endonasal-skull-base-surgery-of-craniopharyngiomas-evaluated-according-to-the-degree-of-hypothalamic-extension
#14
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Sparing the hypothalamus following craniopharyngiomas treatment is a prerequisite to ensure a good quality of life. In this study, the functional prognosis of craniopharyngioma following Endoscopic endonasal skull base surgery (EES) was examined in function of the degree of hypothalamic extension. MATERIALS AND METHODS: Twenty cases of craniopharyngioma treated by EES were categorized according to Puget's classification using preoperative and postoperative MRI...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28045816/risk-factors-predicting-nasoseptal-flap-failure-in-the-endoscopic-endonasal-transsphenoidal-approach
#15
Boo-Young Kim, Ji Hyeon Shin, Sung Won Kim, Yong Kil Hong, Sin-Soo Jeun, Soo Whan Kim, Jin Hee Cho, Yong Jin Park
OBJECTIVE: Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure. STUDY DESIGN: Patient series. SETTING: Retrospective review of medical records at a tertiary referral center...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28032687/transnasal-endoscopic-partial-maxillectomy-operative-nuances-and-proposal-for-a-comprehensive-classification-system-based-on-1378-cases
#16
Mario Turri-Zanoni, Paolo Battaglia, Apostolos Karligkiotis, Davide Lepera, Jacopo Zocchi, Iacopo Dallan, Maurizio Bignami, Paolo Castelnuovo
BACKGROUND: Despite the development of functional endoscopic endonasal surgery, there are still areas of the maxillary sinus that remain technically difficult to access using a standard middle meatal antrostomy as well as deep-seated skull base lesions requiring expanded transmaxillary approaches. METHODS: All patients who underwent transnasal endoscopic partial maxillectomy (TEPM) in a single institution from 2000 to 2014 were retrospectively reviewed. The TEPM was classified into 5 types according to the anatomic structures progressively removed and to the access provided...
December 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#17
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27993737/bolstering-the-nasoseptal-flap-using-sphenoid-sinus-fat-packing-a-technical-case-report
#18
Hussam Abou-Al-Shaar, Hasan A Zaidi, David J Cote, Edward R Laws
BACKGROUND: Resection of extensive skull base lesions often necessitates relatively large dural openings and arachnoid, resulting in skull base defects with the potential for a post-operative cerebrospinal fluid (CSF) leak. A nasoseptal flap (NSF) is a vascularized graft which has greatly diminished the incidence of CSF leak. Annealing of flaps against the ventral skull base can be tenuous within the first few days after surgery. We report the use of sphenoid sinus fat packing as a buttress to support the nasoseptal flap during skull base reconstruction...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989971/neurophysiological-identification-of-cranial-nerves-during-endoscopic-endonasal-surgery-of-skull-base-tumors-a-pilot-study-technical-report
#19
Alexey Nikolaevich Shkarubo, Anna Anatolievna Ogurtsova, Dmitry Aleksandrovich Moshchev, Andrew Jurievich Lubnin, Dmitry Nicolaevich Andreev, Konstantin Vladimirovich Koval, IliaValerievich Chernov
INTRODUCTION: Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, there is only a small number of published papers describing the technique of t-EMG in endoscopic endonasal removal of such tumors. OBJECTIVE: To assess the effectiveness of trigger electromyography in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. MATERIALS AND METHODS: Nine patients were operated on using the endoscopic endonasal approach within a one-year period...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27975017/endoscopic-adipofascial-radial-forearm-flap-reconstruction-of-a-clival-defect
#20
Trevor G Hackman
Skull base surgical defects present unique challenges to anatomic and functional reconstruction. Fortunately, many endonasal skull base defects are successfully managed with a variety of local and regional reconstructive techniques. However, when prior surgery or radiotherapy eliminates the use of these local and regional reconstructive options, more elaborate free tissue transfer techniques are required. Managing endoscopic skull base defects of the anterior cranial fossa and clivus is further complicated by the limited access afforded for flap inset...
November 2016: Plastic and Reconstructive Surgery. Global Open
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