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endoscopic endonasal skull base

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https://www.readbyqxmd.com/read/29134171/endoscopic-endonasal-repair-of-internal-carotid-artery-injury-during-endoscopic-endonasal-surgery
#1
Irit Duek, Gill E Sviri, Moran Amit, Ziv Gil
Background  Injury to the cavernous portion of the internal carotid artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication that can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success. Objectives  We provide a detailed technical description of an operative technique for endoscopic management of carotid artery injury. Methods  A case of ICA injury during endoscopic skull base surgery is presented...
October 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29134164/visual-outcomes-after-endoscopic-pituitary-surgery-in-patients-presenting-with-preoperative-visual-deficits
#2
Felipe Fredes, Gabriel Undurraga, Pablo Rojas, Felipe Constanzo, Carolina Lazcano, Jaime Pinto, Thomas Schmidt
Introduction  Pituitary adenomas represent 15% of primary brain tumors. Visual disturbance is a common clinical manifestation of these neoplasms due, among other factors, to local mass effect on the optic system. Objective  To evaluate changes of the visual fields in patients undergoing endoscopic endonasal approach (EEA) for pituitary adenomas and to find predictive factors for successful visual field outcome. Material and Methods  This is a cross-sectional study. A review was conducted of medical records of consecutive patients with tumors of the sellar region undergoing EEA between January 2008 and December 2012 at the Skull Base Unit of Guillermo Grant Benavente Hospital, University of Concepción, Concepción, Chile, and who had undergone pre- and postoperative visual field evaluation...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29127655/the-endoscopic-endonasal-approach-is-not-superior-to-the-microscopic-transcranial-approach-for-anterior-skull-base-meningiomas-a-meta-analysis
#3
Ivo S Muskens, Vanessa Briceno, Tom L Ouwehand, Joseph P Castlen, William B Gormley, Linda S Aglio, Amir H Zamanipoor Najafabadi, Wouter R van Furth, Timothy R Smith, Rania A Mekary, Marike L D Broekman
OBJECT: In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. METHODS: A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values...
November 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29125446/suprasellar-and-recurrent-pediatric-craniopharyngiomas-expanding-indications-for-the-extended-endoscopic-transsphenoidal-approach
#4
Andrew F Alalade, Elizabeth Ogando-Rivas, Jerome Boatey, Mark M Souweidane, Vijay K Anand, Jeffrey P Greenfield, Theodore H Schwartz
OBJECTIVE The expanded endonasal endoscopic transsphenoidal approach has become increasingly used for craniopharyngioma surgery in the pediatric population, but questions still persist regarding its utility in younger children, in recurrent and irradiated tumors, and in masses primarily located in the suprasellar region. The narrow corridor, incomplete pneumatization, and fear of hypothalamic injury have traditionally relegated this approach to application in older children with mostly cystic craniopharyngiomas centered in the sella...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29122086/endonasal-endoscopic-management-of-frontal-sinus-cerebrospinal-fluid-leak
#5
Javaneh Jahanshahi, Mehdi Zeinalizadeh, Hasan Reza Mohammadi, Seyed Mousa Sadrehosseini
BACKGROUND: A frontal sinus leak is uncommon and is seen in ∼15% of cases of patients with cerebrospinal fluid (CSF) rhinorrhea. Now, endonasal endoscopic techniques have been reported to reconstruct skull base defects in the frontal sinus with a favorable outcome. OBJECTIVE: To review our experience in the repair of frontal sinus CSF leaks through an endonasal endoscopic approach. METHODS: Twenty-four patients with a frontal sinus leak who underwent endonasal endoscopic repair entered the study...
November 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29104156/endoscopic-approach-to-clival-chordomas-the-northwestern-experience
#6
Rudy J Rahme, Omar M Arnaout, Olabisi R Sanusi, Kartik Kesavabhotla, James P Chandler
INTRODUCTION: Chordomas are rare primary bone tumors with a low-grade histology but an aggressive clinical behavior characterized by local invasion and recurrence. When occurring in the skull base, their treatment is limited by proximity to critical neurovascular structures. Open surgical approaches can carry high morbidity making the development of alternative approaches desirable. We describe our experience with endoscopic endonasal approaches to clival chordomas over 13 years. MATERIALS AND METHOD: We performed a retrospective chart review of patients diagnosed with clival chordomas and treated with an endoscopic endonasal approach between the years 2003 and 2015 at Northwestern Memorial Hospital...
November 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29099299/perfusion-based-human-cadaveric-specimen-as-a-simulation-training-model-in-repairing-cerebrospinal-fluid-leaks-during-endoscopic-endonasal-skull-base-surgery
#7
Eisha A Christian, Joshua Bakhsheshian, Ben A Strickland, Vance L Fredrickson, Ian A Buchanan, Martin H Pham, Andrew Cervantes, Michael Minneti, Bozena B Wrobel, Steven Giannotta, Gabriel Zada
OBJECTIVE Competency in endoscopic endonasal approaches (EEAs) to repair high-flow cerebrospinal fluid (CSF) leaks is an essential component of the neurosurgical training process. The objective of this study was to demonstrate the feasibility of a simulation model for EEA repair of anterior skull base CSF leaks. METHODS Human cadaveric specimens were utilized with a perfusion system to simulate a high-flow CSF leak. Neurological surgery residents (postgraduate year 3 or greater) performed a standard EEA to repair a CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29084008/delayed-complications-from-expanded-endonasal-surgery-for-intracranial-tumors
#8
Mathew N Geltzeiler, Eric W Wang
PURPOSE OF REVIEW: Delayed complications after endoscopic endonasal approaches to the skull base, defined as complications greater than 1 month postoperatively, are uncommon. These complications are divided into categories including sinonasal, neuroanatomic, endocrine and vascular. This review highlights the most up-to-date advancements and reviews the management of delayed complications for skull base patients. RECENT FINDINGS: Over the last 10 years, the field of endoscopic endonasal skull base surgery has expanded with new data highlighting the long-term patient outcomes...
October 27, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#9
REVIEW
Srikant Chakravarthi, Lior Gonen, Alejandro Monroy-Sosa, Sammy Khalili, Amin Kassam
The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF)...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29066231/antibiotic-prophylaxis-and-infection-prevention-for-endoscopic-endonasal-skull-base-surgery-our-protocol-results-and-review-of-the-literature
#10
Stephen J Johans, Daniel J Burkett, Kevin N Swong, Chirag R Patel, Anand V Germanwala
Endoscopic endonasal approaches to the skull base provide minimally invasive corridors to intracranial lesions; however, enthusiasm for this new approach is always tempered by the recognition that this route requires passage through a nonsterile sinonasal corridor. Despite an increasing number of patients undergoing these surgeries, there remains no consensus on the use of perioperative antibiotics. A retrospective review of consecutive patients undergoing endoscopic endonasal skull base surgery (EESBS) at Loyola University Medical Center by the same neurosurgeon and otolaryngologist team between February 2015 and October 2016 was performed...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29049148/skull-base-neuroendoscopic-training-model-using-a-fibrous-injectable-tumor-polymer-and-the-nico-myriad
#11
Filippo Gagliardi, Anthony M Chau, Pietro Mortini, Anthony J Caputy, Cristian Gragnaniello
The Myriad is an innovative, high precision tool for tumor resection, designed to work within narrow endoscopic corridors. Due to its application in technically demanding situations, the learning curve associated with its use might be extremely challenging and time-consuming.The authors describe the application of an already validated training model, the skull base injectable tumor model (ITM), to allow trainees to practice with the use of the Myriad during endoscopic skull base procedures.A formalin embalmed cadaveric head was used for technical assessment...
October 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28967314/endoscopic-endonasal-pituitary-gland-hemi-transposition-for-resection-of-a-dorsum-sellae-meningioma
#12
Alaa S Montaser, Juan M Revuelta Barbero, Alexandre Todeschini, André Beer-Furlan, Russell R Lonser, Ricardo L Carrau, Daniel M Prevedello
A 69-year-old female with incidental diagnosis of a dorsum sellae meningioma had shown significant tumor growth after initial conservative management. The procedure started with a microscopic sublabial transsphenoidal approach to the sella and the suprasellar space. Due to limitations to a safe dissection and removal of the retrosellar component, the surgery was converted to a purely endoscopic endonasal approach with left hemi-transposition of the pituitary gland, followed by drilling of the dorsum sellae and removal of the left posterior clinoid process...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967307/introduction-surgical-management-of-skull-base-meningiomas
#13
Gabriel Zada, Mustafa K Başkaya, Mitesh V Shah
Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962038/site-specific-considerations-in-the-surgical-management-of-skull-base-chondrosarcomas
#14
Shaan M Raza, Paul W Gidley, Michael E Kupferman, Ehab Y Hanna, Shirley Y Su, Franco DeMonte
BACKGROUND: Numerous approaches have been reported in the management of skull base chondrosarcomas. Data are lacking for surgical outcomes by the tumor site of origin. OBJECTIVE: To provide insight into outcomes by site of origin and factors affecting resection in order to aid in surgical approach selection. METHODS: A retrospective review was conducted of 49 patients with chondrosarcoma treated at our institution. Charts were reviewed for tumor- and treatment-related factors...
September 9, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28943419/severe-cerebral-complications-secondary-to-perforation-injury-of-the-anterior-skull-base-during-sinonasal-surgery-an-underappreciated-problem
#15
Shadi Al-Afif, Elvis J Hermann, Gökce Hatipoglu Majernik, Makoto Nakamura, Peter Raab, Thomas Lenarz, Joachim K Krauss
OBJECTIVE: Functional endonasal sinus surgery (FESS) is widely practiced and is considered a generally safe procedure. Skull base injuries occur in less than 1% of procedures and are typically associated with cerebrospinal fluid leaks. Rarely, skull base injuries might result in cerebral lesions. Here we present a series of four patients with iatrogenic perforating injuries of the anterior skull base and cerebral lesions after routine FESS. METHODS: Four patients with iatrogenic perforating cerebral lesions after routine FESS performed at other institutions were referred to a tertiary neurosurgery department within a 10-year period...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28931251/managing-arterial-injury-in-endoscopic-skull-base-surgery-case-series-and-review-of-the-literature
#16
Alicia Del Carmen Becerra Romero, Jagath Lal Gangadharan, Evan D Bander, Yves Pierre Gobin, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The most feared complications following endoscopic endonasal skull base surgery are arterial vascular injuries. Previously published literature is restricted to internal carotid artery injuries. The ideal method for controlling arterial bleeding during this kind of procedure is debated, and a variety of techniques have been advocated. OBJECTIVE: To evaluate the management and outcome following intraoperative arterial injury during endoscopic endonasal skull base surgery...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28914866/-extended-endoscopic-endonasal-posterior-transclival-approach-to-tumors-of-the-clival-region-and-ventral-posterior-cranial-fossa-part-1-topographic-and-anatomical-features-of-the-clivus-and-adjacent-structures
#17
A N Shkarubo, K V Koval', G F Dobrovol'skiy, M A Shkarubo, V V Karnaukhov, B A Kadashev, D N Andreev, I V Chernov, O A Gadzhieva, O Yu Aleshkina, E A Anisimova, P L Kalinin, M A Kutin, D V Fomichev, O I Sharipov, D B Ismailov, E S Selivanov
OBJECTIVE: to describe the main topographic and anatomical features of the clival region and its adjacent structures for improvement and optimization of the extended endoscopic endonasal posterior (transclival) approach for resection of tumors of the clival region and ventral posterior cranial fossa. MATERIAL AND METHODS: We performed a craniometric study of 125 human skulls and a topographic anatomical study of heads of 25 cadavers, the arterial and venous bed of which was stained with colored silicone (the staining technique was developed by the authors) to visualize bed features and individual variability...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28887281/cerebrospinal-fluid-leak-rhinorrhea-after-systemic-erlotinib-chemotherapy-for-metastatic-lung-cancer-a-familiar-problem-from-an-unfamiliar-culprit
#18
Blake Priddy, Douglas A Hardesty, André Beer-Furlan, Bradley Otto, Daniel M Prevedello
BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea after medical therapy for pituitary prolactinoma is a rare but well-described phenomenon. To our knowledge, no CSF leaks have been reported after targeted medical treatment of pituitary or anterior skull base metastases. We report this unusual case to raise awareness of spontaneous CSF leaks in the setting of skull base metastatic disease. CASE PRESENTATION: A 66-year-old woman presented with epidermal growth factor receptor-mutant stage IV adenocarcinoma of the lung...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882714/combined-minimally-invasive-supraciliary-and-transfacial-approach-for-large-tumors-with-skull-base-and-sinonasal-involvement
#19
Pal Barzo, Zsolt Zador, Mihaly Bodosi, Zsolt Bella, Daniel Jambor, Bela Fulop, Jeno Czigner
BACKGROUND: Tumors invading both the anterior skull base and the sinonasal area have been traditionally accessed via largely invasive open craniofacial approaches. Minimally invasive extended endoscopic endonasal approaches have recently become increasingly available, but have anatomical limitations and require incremental experience and thus high patient volume. Our objective was to assess the applicability of a novel combination of the minimally invasive supraciliary incision and the limited maxillofacial osteotomy as a combined surgical approach for large tumors invading both the anterior skull base and the sinonasal area...
September 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28868197/combined-simultaneous-transcranial-and-endoscopic-endonasal-resection-of-sphenoorbital-meningioma-extending-into-the-sphenoid-sinus-pterygopalatine-fossa-and-infratemporal-fossa
#20
Masahide Matsuda, Hiroyoshi Akutsu, Shuho Tanaka, Akira Matsumura
BACKGROUND: Sphenoorbital meningiomas are surgically challenging because of their nature to extend to adjacent structures. Here, we describe a case of recurrent sphenoorbital meningioma extending into the sphenoid sinus, pterygopalatine fossa, and infratemporal fossa, which was resected using combined simultaneous transcranial and endoscopic endonasal approaches. CASE DESCRIPTION: A 62-year-old man who had 15 years earlier undergone partial resection of a left sphenoorbital meningioma presented with a 1-year history of progressive proptosis of the left eye...
2017: Surgical Neurology International
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