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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/28328602/intracranial-anatomic-landmarks-for-endoscopic-endonasal-transcribriform-approach-to-anterior-skull-base
#1
Pinghua Wu, Huikun Zeng, Ying Guan, Ligen Mo, Danke Su
OBJECTIVES: To help surgeons locating anatomic landmarks when performing endoscopic endonasal transcribriform approach to anterior skull base. METHODS: High-resolution axial computed tomography (CT) images at thickness of 0.6 mm, and reconstructed 0.41-mm thick gapless sagittal and coronal CT images were taken from 123 subjects. Using mimics software, first located elementary points and line: nasal spine, midpoint of posterior hard palate and the line between them; then located measured points right/left posterior and anterior points; measured distances between measured points and from measured points to nasal spine and angles between lines connecting measured points to nasal spine and the basic line...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28324181/trigeminocardiac-reflex-during-endoscopic-juvenile-nasopharyngeal-angiofibroma-surgery-an-appraisal
#2
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#3
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#4
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321377/single-layer-repair-of-large-anterior-skull-base-defects-without-vascularized-mucosal-flap
#5
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28314401/combined-endoscopic-and-open-approaches-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#6
REVIEW
James K Liu, Anni Wong, Jean Anderson Eloy
Combined transcranial and endoscopic endonasal approaches remain useful in the treatment of ventral skull base malignancies. The extended bifrontal transbasal approach provides wide access to the anterior ventral skull base and paranasal sinuses without transfacial incisions. In more extensive lesions, the bifrontal transbasal approach can then be combined with an endoscopic endonasal approach (EEA) from below. This article reviews the indications, surgical technique, and operative nuances of combined transbasal and EEA (cranionasal) approaches for the surgical management of ventral skull base malignancies...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28314400/endoscopic-resection-of-clival-malignancies
#7
REVIEW
Adam J Folbe, Peter F Svider, James K Liu, Jean Anderson Eloy
Surgical management of clival lesions presents numerous therapeutic challenges because of the close proximity of surrounding critical structures. With a detailed understanding of the endoscopic endonasal approach and relevant considerations, appropriate lesions can be removed in a safe and minimally invasive manner. Use of this technique as a primary approach represents the standard of care for many lesions at leading skull base centers, although adjunct techniques may be necessary in extensive lesions and those with significant lateral extension...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28293965/endoscopic-approach-for-a-delayed-post-traumatic-ethmoidal-mucocele-a-technical-note
#8
Mahmoud Messerer, Giulia Cossu, Roy Thomas Daniel
OBJECTIVE: Delayed post-traumatic mucoceles are rare. We describe the surgical treatment of a post-traumatic ethmoidal mucocele with intra-orbital extension. METHOD: A uninostril endoscopic endonasal approach (EEA) was performed. The access was contralateral to the lesion to provide a wider lateral view. After a large sphenoid and ethmoid sinuses opening, the collection was drained and the optic nerve precociously identified. The orbital roof was eroded and the frontal dura mater directly visible...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291218/-endoscopic-transnasal-surgery-for-giant-fibrous-dysplasia-of-the-skull-base-spreading-to-the-right-orbital-cavity-and-nasopharynx-a-case-report-and-literature-review
#9
A N Shkarubo, A Yu Lubnin, E Yu Bukharin, L V Shishkina, D N Andreev, K V Koval', I V Chernov, V V Karnaukhov
BACKGROUND: An extended endoscopic endonasal approach is increasingly used in surgical treatment of space-occupying skull base lesions. The international literature reports only 20 cases of surgical treatment for fibrous dysplasia (PD) of the skull base using the endoscopic endonasal approach. We present our experience with the endoscopic endonasal approach in surgical treatment for giant fibrous dysplasia of the skull base, spreading to the right orbital cavity and nasopharynx. CLINICAL CASE: A 26-year-old male patient presented with cranial pain, Vth nerve dysfunction on the right, right keratopathy...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28284576/hemostasis-in-endoscopic-endonasal-skull-base-surgery-using-the-aquamantys-bipolar-sealer-technical-note
#10
Richard Bram, Susan Fiore, Daryl McHugh, Ghassan J Samara, Raphael P Davis
BACKGROUND: A major challenge during endoscopic transsphenoidal surgery is adequate intraoperative hemostasis. The Aquamantys® is a relatively new bipolar sealing device which uses radiofrequency energy and saline. This promotes hemostasis while decreasing charring and thermal spread. In this paper, we describe our experience with the Aquamantys® Mini EVS 3.4 Epidural Vein Sealer Bipolar Electrocautery System (Medtronic Advanced Energy, Portsmouth, NH, USA) during endoscopic surgery for tumors of the skull base with particular attention to ergonomic benefits and technical nuances...
March 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28236049/analysis-of-the-venous-channel-within-the-clivus-using-multidetector-computed-tomography-digital-subtraction-venography
#11
Katsuhiro Mizutani, Masahiro Toda, Jun Kurasawa, Takenori Akiyama, Hirokazu Fujiwara, Masahiro Jinzaki, Kazunari Yoshida
PURPOSE: Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. METHODS: Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. RESULTS: Eighteen emissary veins were identified in 14 (28...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28230588/how-to-expose-the-entire-sella-floor-with-minimal-manipulation-during-an-endoscopic-endonasal-transsphenoidal-approach
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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