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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/28736350/antibiotic-prophylaxis-in-endoscopic-endonasal-pituitary-and-skull-base-surgery
#1
Laura Milanese, Matteo Zoli, Giacomo Sollini, Chiara Martone, Corrado Zenesini, Carmelo Sturiale, Paolo Farneti, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study is to assess the efficacy of our intraoperative antibiotic prophylaxis, analyzing the risk factors of postoperative meningitis in our series. METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days have been included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction, no postoperative administrations have been performed after 2005...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731399/expanding-the-endoscopic-transpterygoid-corridor-to-the-petroclival-region-anatomical-study-and-volumetric-comparative-analysis
#2
Jacob L Freeman, Raghuram Sampath, Steven Craig Quattlebaum, Michael A Casey, Zach A Folzenlogen, Vijay R Ramakrishnan, A Samy Youssef
OBJECTIVE The endoscopic endonasal transmaxillary transpterygoid (TMTP) approach has been the gateway for lateral skull base exposure. Removal of the cartilaginous eustachian tube (ET) and lateral mobilization of the internal carotid artery (ICA) are technically demanding adjunctive steps that are used to access the petroclival region. The gained expansion of the deep working corridor provided by these maneuvers has yet to be quantified. METHODS The TMTP approach with cartilaginous ET removal and ICA mobilization was performed in 5 adult cadaveric heads (10 sides)...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#3
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28725518/preferences-and-utilities-for-health-states-after-treatment-of-olfactory-groove-meningioma-endoscopic-versus-open
#4
Christopher M Yao, Alyssa Kahane, Eric Monteiro, Fred Gentili, Gelareh Zadeh, John R de Almeida
Objectives  The purpose of this study is to report health utility scores for patients with olfactory groove meningiomas (OGM) treated with either the standard transcranial approach, or the expanded endonasal endoscopic approach. Design  The time trade-off technique was used to derive health utility scores. Setting  Healthy individuals without skull base tumors were surveyed. Main Outcome Measures  Participants reviewed and rated scenarios describing treatment (endoscopic, open, stereotactic radiation, watchful waiting), remission, recurrence, and complications associated with the management of OGMs...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#5
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28666364/-live-cadaver-model-for-internal-carotid-artery-injury-simulation-in-endoscopic-endonasal-skull-base-surgery
#6
Paolo Pacca, Sukhdeep S Jhawar, Daniel V Seclen, Eric Wang, Carl Snyderman, Paul A Gardner, Emad Aboud, Juan C Fernandez-Miranda
Background: Intraoperative injury of the internal carotid artery (ICA) is the most dreaded complication in endoscopic endonasal surgery (EES) of skull base. Training for ICA injury is practically impossible in live operative settings. Objective: To evaluate a pulsatile perfusion-based live cadaveric model for ICA injury simulation in a laboratory setting. The major emphasis of the study was to evaluate various means of controlling acute bleeding and evaluating the practical utility of this model for training purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28665391/-tactics-of-reconstructive-closure-of-basal-defects-after-resection-of-midline-tumors-of-the-anterior-skull-base-a-literature-review
#7
D A Gol'bin, S N Mindlin
The purpose of this review is to analyze the techniques used to reconstruct midline defects in the anterior skull base after transcranial and endoscopic endonasal resection of skull base tumors. We provide brief information on the technique for preparing various flaps, indications and contraindications, and advantages and disadvantages. We analyze the international experience in the use of vascularized and non-vascularized flaps as well as the existing algorithms for reconstruction of complex defects of the midline structures of the skull base...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28643170/predictors-and-incidence-of-orthostatic-headache-associated-with-lumbar-drain-placement-following-endoscopic-endonasal-skull-base-surgery
#8
Buqing Liang, Sathwik R Shetty, Sacit Bulent Omay, Joao Paulo Almeida, Shilei Ni, Yu-Ning Chen, Armando S Ruiz-Treviño, Vijay K Anand, Theodore H Schwartz
BACKGROUND: Orthostatic headache (OH) is a potential complication of lumbar drainage (LD) usage. The incidence and risk factors for OH with the use of lumbar drainage during endoscopic endonasal procedures have not been documented. OBJECTIVE: To investigate the incidence of post-procedure OHs associated with placement of LD in patients undergoing endoscopic endonasal procedures. METHODS: We prospectively noted the placement of LDs in a consecutive series of endoscopic endonasal skull base surgeries...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28623412/long-term-follow-up-after-endoscopic-trans-sphenoidal-surgery-or-initial-observation-in-clivus-chordomas
#9
Jon Ramm-Pettersen, Radek Frič, Jon Berg-Johnsen
BACKGROUND: Resection of clivus chordomas through extensive skull base approaches is associated with high mortality and morbidity even in experienced hands. We report our experience with endoscopic trans-sphenoidal surgery, or a "wait-and-scan" strategy in selected patients. METHOD: Ten patients were diagnosed with clivus chordomas during an 8-year period. Six patients underwent primary treatment with endoscopic trans-sphenoidal surgery, followed by adjuvant proton-beam therapy in three of these patients...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#10
R Alex Harbison, Yangming Li, Angelique M Berens, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives  Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design  Case series. Setting  Tertiary academic center. Participants  A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures  Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#11
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28593111/phantosmia-and-dysgeusia-following-endoscopic-transcribriform-approaches-to-olfactory-groove-meningiomas
#12
Andrew S Venteicher, Jay I Kumar, Emma A Murphy, Stacey T Gray, Eric H Holbrook, William T Curry
The endoscopic, endonasal transcribriform approach (EETA) is an important technique used to directly access the anterior skull base and is increasingly being used in the management of olfactory groove meningiomas (OGMs). As this approach requires removal of the cribriform plate and olfactory epithelium en route to the tumor, patients are anosmic postoperatively. Here, we report the development of phantosmia and dysgeusia in two patients who underwent EETAs for OGMs, which has not yet been reported in the literature...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593110/endoscopic-endonasal-transclival-approach-versus-dual-transorbital-port-technique-for-clip-application-to-the-posterior-circulation-a-cadaveric-anatomical-and-cerebral-circulation-simulation-study
#13
Jeremy N Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin Cetas, William Cameron
Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28593109/extent-of-endoscopic-resection-for-anterior-skull-base-tumors-an-mri-based-volumetric-analysis
#14
Ian J Koszewski, Gregory Avey, Azam Ahmed, Lucas Leonhard, Matthew R Hoffman, Timothy M McCulloch
Objective  To determine the volume of ventral skull base tumor removed following endoscopic endonasal (EEA) resection using MRI-based volumetric analysis and to evaluate the inter-rater reliability of such analysis. Design  Retrospective case series. Setting  Academic tertiary care hospital. Participants  EEA patients November 2012 to August 2015. Main Outcome Measures  Volumetric analysis of pre- and immediately postoperative MR imaging was performed independently by two investigators. The percentage of total tumor resected was evaluated according to resection goal and tumor type...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28582956/endoscopic-endonasal-transsphenoidal-approach-from-the-surgeon-point-of-view
#15
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...
June 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28578115/2d-hd-versus-3d-endoscopy-in-endonasal-skull-base-surgery-a-comparative-pre-clinical-study
#16
Vittorio Rampinelli, Francesco Doglietto, Davide Mattavelli, Jimmy Qiu, Elena Raffetti, Alberto Schreiber, Andrea Bolzoni Villaret, Walter Kucharczyk, Francesco Donato, Marco Maria Fontanella, Piero Nicolai
BACKGROUND: Three-dimensional (3D) endoscopy has been recently introduced in endonasal skull base surgery. Only a relatively limited number of studies have compared it to two-dimensional, high definition (2D-HD) technology. OBJECTIVE: To analyze, in a preclinical setting for endonasal endoscopic surgery, surgical maneuverability comparing 2D-HD and 3D endoscopy. METHODS: A group of 68 volunteers, both novice and experienced surgeons, were asked to perform two tasks, namely simulating grasping and dissection surgical maneuvers, in a model of the nasal cavities...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28574308/clinical-outcomes-of-an-endoscopic-transclival-and-transpetrosal-approach-for-primary-skull-base-malignancies-involving-the-clivus
#17
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
https://www.readbyqxmd.com/read/28531285/paratrigeminal-paraclival-precavernous-or-all-of-the-above-a-circumferential-anatomical-study-of-the-c3-c4-transitional-segment-of-the-internal-carotid-artery
#18
Eleonora Marcati, Norberto Andaluz, Sebastien C Froelich, Lee A Zimmer, James L Leach, Juan Carlos Fernandez-Miranda, Almaz Kurbanov, Jeffrey T Keller
BACKGROUND: Although the term paraclival carotid pervades recent skull base literature, no clear consensus exists regarding boundaries or anatomical segments. OBJECTIVE: To reconcile various internal carotid artery (ICA) nomenclatures for transcranial and endoscopic-endonasal perspectives, we reexamined the transition between lacerum (C3) and cavernous (C4) segments using a C1-C7 segments schema. In this cadaveric study, we obtained a 360°-circumferential view integrating histological, microsurgical, endoscopic, and neuroradiological analyses of this C3-C4 region and identified a distinct transitional segment...
May 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28524124/-endoscopic-endonasal-diagnosis-and-treatment-of-skull-base-meningoencephalocele
#19
D N Kapitanov, E V Shelesko, A A Potapov, A D Kravchuk, D N Zinkevich, M V Nersesyan, L A Satanin, A V Sakharov, G V Danilov
PURPOSE: The study purpose was to determine the successful outcome rate of endoscopic endonasal reconstruction of skull base CSF fistulas with removal of meningocele as well as analyze disease relapses. The second purpose of the study was to describe the treatment outcomes, depending on the type, location, and size of meningocele as well as on a technique used to reconstruct the skull base defect. MATERIAL AND METHODS: Three hundred and eleven patients diagnosed with cerebrospinal fluid (CSF) rhinorrhea who underwent surgery at the Burdenko Neurosurgical Institute in the period between 2007 and 2014 were retrospectively analyzed...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28512043/endoscopic-assisted-supraorbital-keyhole-approach-or-endoscopic-endonasal-approach-in-cases-of-tuberculum-sellae-meningioma-which-surgical-route-should-be-favored
#20
Stefan Linsler, Gerrit Fischer, Volodymyr Skliarenko, Axel Stadie, Joachim Oertel
OBJECTIVE: Keyhole approaches are under investigation for skull base tumor surgery. They are expected to have a low complication rate with the same successful resection rate compared with endoscopic endonasal procedures. In this study, we compare our current series of tuberculum sellae meningiomas resected via an endoscopic endonasal or microsurgical supraorbital keyhole approach. METHODS: Between 2011 and 2016, 16 patients were treated using the supraorbital keyhole procedure and 6 patients received an endoscopic endonasal procedure...
August 2017: World Neurosurgery
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