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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/29772400/neuro-endoscope-for-skull-base-tumors
#1
REVIEW
Hua Gao, Chunhui Liu, Yazhuo Zhang
The endoscope has traditionally been used in neurosurgery to access a lesion within a natural body cavity. The challenge has been to access and resect deep-seated intraparenchymal lesions using a minimally invasive endoscopic technique. Endoscopic endonasal trans-sphenoidal surgery has gained increasing acceptance by otolaryngologists and neurosurgeons. Surgical procedures of the skull base include exposure, resection, and base reconstruction. These approaches start at the sphenoid sinus, which provides a reference point to important vascular and neural structures...
May 14, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29770288/infrasellar-endoscopic-endonasal-approach-for-a-pituitary-adenoma-extending-into-the-third-ventricle-with-anterior-displacement-of-the-pituitary-gland
#2
Georgios A Zenonos, Eric W Wang, Juan Carlos Fernandez-Miranda
Objectives  The current video presents the nuances of the infrasellar endoscopic endonasal approach for a pituitary adenoma extending into the third ventricle, with anterior displacement of the pituitary gland. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765829/injury-of-the-carotid-artery-during-endoscopic-endonasal-surgery-surveys-of-skull-base-surgeons
#3
Nicholas R Rowan, Meghan T Turner, Benita Valappil, Juan C Fernandez-Miranda, Eric W Wang, Paul A Gardner, Carl H Snyderman
Objectives  This study aimed to review endoscopic skull base surgeon experience with internal carotid artery (ICA) injuries during endoscopic endonasal surgery (EES) to provide an estimate of the incidence of ICA injury, the associated factors and identify the best training modalities for the management of this complication. Design  Anonymous electronic survey of past participants at a well-established endoscopic skull base surgery course and a global online community of skull base surgeons. Main Outcome Measures  Relative incidence of ICA injuries during EES, associated anatomic and intraoperative factors, and surgeon experience...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29757560/-application-of-image-guided-technique-in-rhino-orbital-related-endoscopic-surgery
#4
Jin Mei Xue, Yuan Hui Li, Yan Ting Zhang, Fang Ling Guan, Li He Duan, Chang Qing Zhao
Objective: To review retrospectively six cases of rhino-orbital related endoscopic surgeries aided by Fusion electromagnetic system,to explore the indications and clinical value of image guided technique in endonasal endoscopic surgery. Method: Retrospective research methods were used.In this study,six cases of nasal endoscopic sinus surgery using Fusion electromagnetic system were analyzed,including 1 nasal penetrating foreign body,2 optic nerve decompressions,1 orbital apex hemangioma,1 sieve frontal sinus cyst,1 intraorbital mass biopsy...
January 20, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29754975/endoscopic-endonasal-double-flap-technique-for-reconstruction-of-large-anterior-skull-base-defects-technical-note
#5
Ricardo Landini Lutaif Dolci, Alexandre Bossi Todeschini, Américo Rubens Leite Dos Santos, Paulo Roberto Lazarini
INTRODUCTION: One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. OBJECTIVE: Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy...
April 19, 2018: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29753077/endoscopic-endonasal-reconstruction-of-anterior-skull-base-defects-what-factors-really-affect-the-outcomes
#6
Mario Turri-Zanoni, Jacopo Zocchi, Alessia Lambertoni, Marta Giovannardi, Apostolos Karligkiotis, Paolo Battaglia, Davide Locatelli, Paolo Castelnuovo
OBJECTIVES: Endoscopic endonasal surgery has evolved considerably over the last few decades, requiring comparable advances in reconstructive techniques. The objectives of this study were to retrospectively review the outcomes of endoscopic anterior skull base (ASB) reconstruction and to analyze factors that might be associated with failures. METHODS: Data from patients who underwent endoscopic endonasal ASB reconstruction in a single Institution between 1998 and 2017 were collected...
May 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29750275/endoscopic-endonasal-transclival-approach-to-the-ventral-brainstem-anatomic-study-of-the-safe-entry-zones-combining-fiber-dissection-technique-with-7-tesla-magnetic-resonance-guided-neuronavigation
#7
Alessandro Weiss, Paolo Perrini, Matteo De Notaris, Guadalupe Soria, Alarcon Carlos, Maura Castagna, Lodovico Lutzemberger, Orazio Santo Santonocito, Giuseppe Catapano, Amin Kassam, Alberto Prats Galino
BACKGROUND: Treatment of intrinsic lesions of the ventral brainstem is a surgical challenge that requires complex skull base antero- and posterolateral approaches. More recently, endoscopic endonasal transclival approach (EETA) has been reported in the treatment of selected ventral brainstem lesions. OBJECTIVE: In this study we explored the endoscopic ventral brainstem anatomy with the aim to describe the degree of exposure of the ventral safe entry zones. In addition, we used a newly developed method combining traditional white matter dissection with high-resolution 7T magnetic resonance imaging (MRI) of the same specimen coregistered using a neuronavigation system...
May 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#8
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29747249/-the-surgical-management-of-nasal-skull-base-schwannoma-under-endonasal-endoscope-a-retrospective-review-of-52-cases
#9
L Yang, W D Zhao, Q Liu, H K Zhang, D H Wang
Objective: To discuss the surgical technique and outcome of nasal skull base schwannoma treated under endonasal endoscope. Methods: Fifty-two patients with nasal skull base nonvestibular schwannoma were treated under endonasal endoscope from May 2006 to June 2017 in Shanghai E&ENT Hospital. Of the patients, there were 21 men and 31 women. The age of the patients ranged from 33 to 71 years.Schwannoma mainly came from trigeminal nerve.Clinical symptoms included facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus...
April 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29747247/-the-impact-of-resection-of-skull-base-tumor-via-an-endoscopic-endonasal-approach-on-the-visual-function-of-vision-impaired-patients-and-the-analysis-of-factors-affecting-their-visual-recovery
#10
Z L Wang, Q H Zhang, M C Li, B Yan, T T Wei, S Y Peng, P Li, L J Cao
Objective: To evaluate the visual outcomes of patients with visual impairment after resecting skull base tumor via an endoscopic endonasal approach, and to analyze the factors affecting visual recovery. Methods: One hundred and fifty-three patients with skull base tumor who suffered from preoperative visual impairment from Skull Base Surgery Center of Xuanwu Hospital were operated through an endoscopic endonasal approach. Both preoperative and postoperative visual function outcomes as well as factors that might have affected their visual recovery were analyzed retrospectively by Chi square test and Logistic regression analysis...
April 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29680444/sinonasal-outcome-after-endoscopic-mononostril-transsphenoidal-surgery-a-single-center-cohort-study
#11
Stefan Linsler, Benjamin Prokein, Philipp Hendrix, Joachim Oertel
OBJECTIVE: The endoscopic endonasal approach has been well established for skull base surgery. However, there are only few studies pointing out nasal complaints after surgery. In this study, the authors evaluated postoperative nasal complaints and complications after mononostril endoscopic procedures. METHODS: All patients operated on parasellar and sellar pathologies at our department via an endoscopic mononostril transnasal transsphenoidal approach from January 2011 to May 2015 were analyzed...
April 18, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29676691/defining-the-lateral-limits-of-the-endoscopic-endonasal-transtuberculum-transplanum-approach-anatomical-study-with-pertinent-quantitative-analysis
#12
Alberto Di Somma, Jorge Torales, Luigi Maria Cavallo, Jose Pineda, Domenico Solari, Rosa Maria Gerardi, Federico Frio, Joaquim Enseñat, Alberto Prats-Galino, Paolo Cappabianca
OBJECTIVE The extended endoscopic endonasal transtuberculum transplanum approach is currently used for the surgical treatment of selected midline anterior skull base lesions. Nevertheless, the possibility of accessing the lateral aspects of the planum sphenoidale could represent a limitation for such an approach. To the authors' knowledge, a clear definition of the eventual anatomical boundaries has not been delineated. Hence, the present study aimed to detail and quantify the maximum amount of bone removal over the planum sphenoidale required via the endonasal pathway to achieve the most lateral extension of such a corridor and to evaluate the relative surgical freedom...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29669134/giant-olfactory-groove-meningioma-2-staged-approach-2-dimensional-operative-video
#13
Alexandre B Todeschini, Mostafa Shahein, Alaa S Montaser, Douglas Hardesty, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 42-yr-old female presented with an olfactory groove meningioma causing progressive vision loss and anosmia. Given the size of the tumor, we opted for a 2-stage surgery: endoscopic endonasal approach (EEA) followed by a craniotomy. Stage I surgery was a transcribriform transplanum EEA using a binostril 4-hand/2 surgeons (ENT and neuro) technique, with the patient positioned supine with the head slightly turned to the right side and tilted to the left, fixed in a 3-pin head clamp, under imaging guidance, in which we drilled out all the affected skull base bone, devascularized and debulked the tumor...
April 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29619106/an-analysis-of-anatomic-variations-of-the-sphenoid-sinus-and-its-relationship-to-the-internal-carotid-artery
#14
Myrian Marajó Dal Secchi, Ricardo Landini Lutaif Dolci, Reginaldo Teixeira, Paulo Roberto Lazarini
Introduction  The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective  To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods  Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively)...
April 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29617919/combined-nasoseptal-and-inferior-turbinate-flap-for-reconstruction-of-large-skull-base-defect-after-expanded-endonasal-approach-operative-technique
#15
Julien Boetto, Moujahed Labidi, Kentaro Watanabe, Shunya Hanakita, Schahrazed Bouazza, Thibault Passeri, Anne-Laure Bernat, Sebastien Froelich
BACKROUND: Increasing indications for endoscopic endonasal approaches have led neurosurgeons to develop new reconstruction techniques for larger skull base defects. Vascularized grafts have been a great adjunction to reduce the rate of cerebrospinal fluid leak and can also be used to cover exposed critical structures such as the internal carotid artery. The nasoseptal flap and the inferior or middle turbinate flap are thus widely used in endoscopic skull base surgery, but may be insufficient for very large defects...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29607683/petroclival-tension-pneumocephalus-an-unrivalled-life-threatening-complication-linked-to-molecular-targeted-therapy
#16
Alhusain Nagm, Toshihiro Ogiwara, Akihiro Nishikawa, Shunsuke Ichinose, Kazuhiro Hongo
A 73-year-old man with a petroclival tumor (metastatic renal cell carcinoma) presented with a progressive consciousness disturbance attributed to tension pneumocephalus during molecular-targeted therapy following low-dose fractionated radiotherapy for a petroclival tumor. The skull base defect was successfully reconstructed vi an endoscopic endonasal approach.
April 2, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29606040/decision-making-algorithm-for-minimally-invasive-approaches-to-anterior-skull-base-meningiomas
#17
Malte Ottenhausen, Kavelin Rumalla, Andrew F Alalade, Prakash Nair, Emanuele La Corte, Iyan Younus, Jonathan A Forbes, Atef Ben Nsir, Matei A Banu, Apostolos John Tsiouris, Theodore H Schwartz
OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the possibility of reducing brain and nerve retraction, minimizing incision size, and speeding patient recovery; however, appropriate case selection and results in large series are lacking. METHODS The authors developed an algorithm for selecting a supraorbital keyhole minicraniotomy (SKM) for olfactory groove meningiomas or an expanded endoscopic endonasal approach (EEA) for tuberculum sella (TS) or planum sphenoidale (PS) meningiomas based on the presence or absence of olfaction and the anatomical extent of the tumor...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29588905/endoscopic-endonasal-resection-of-a-suprasellar-pituitary-adenoma-mimicking-tuberculum-sellae-meningioma-in-a-patient-with-an-intrasellar-persistent-trigeminal-artery
#18
Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Mostafa Shahein, E Antonio Chiocca, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588903/endoscopic-endonasal-transoculomotor-triangle-approach-for-the-resection-of-a-pituitary-adenoma-with-ambient-cistern-extension
#19
Georgios Andrea Zenonos, Eric Wesley Wang, Juan C Fernandez-Miranda
Objectives  The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588901/endoscopic-endonasal-transtuberculum-sellae-approach-for-the-resection-of-suprasellar-intrainfundibular-epidermoid-cyst
#20
Alaa S Montaser, Juan M Revuelta Barbero, Mostafa Shahein, Alexandre B Todeschini, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 49-year-old female presented with intense headaches of 3 months duration. Brain magnetic resonance imaging (MRI) was performed and showed a sellar-suprasellar lesion extending into the third ventricle. A presumptive diagnosis of a craniopharyngioma was made. Since the patient did not have any visual deficits, she opted for conservative management. Four months later, she started to have progressive deterioration of vision; thus, surgery was indicated. The patient underwent endoscopic endonasal resection of the lesion through a transtuberculum sellae approach...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
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