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endoscopic skull base anatomy

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https://www.readbyqxmd.com/read/29765822/minimally-invasive-surgery-for-resection-of-parapharyngeal-space-tumors
#1
Irit Duek, Gill E Sviri, Salem Billan, Ziv Gil
Background  Surgical removal of parapharyngeal space tumors (PPST) poses challenges due to the complex anatomy of the region. PPSTs are routinely resected by a transcervical approach using blind finger dissection. Large PPSTs or those located high at the skull base, often require transmandibular or infratemporal fossa approaches, associated with considerable morbidity. Objective  Here, we describe an approach for PPST removal that comprises transcervical endoscopic, with or without transoral robotic technique...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29760919/anatomy-of-the-posterior-and-middle-ethmoidal-arteries-via-computed-tomography
#2
Hiroki Yamamoto, Kazuhiro Nomura, Hiroshi Hidaka, Yukio Katori, Naohiro Yoshida
Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon. Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured...
2018: SAGE Open Medicine
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
#3
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/29649644/endoscopic-transseptal-approach-with-a-bilateral-nasoseptal-flap-in-challenging-skull-base-tumors
#4
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, Sung Won Kim
OBJECTIVE: To examine the utility of an endoscopic transseptal approach and the creation of a bilateral nasoseptal flap using a two-nostrils/four-hands technique in patients with challenging skull-base tumors. METHODS: The medical records of patients operated on via an endoscopic transseptal approach between 2009 and 2017 were retrospectively reviewed. Two patients with ossifying fibroma, two with orbital hemangioma, two with trigeminal nerve schwannoma, and one patient each with juvenile angiofibroma, meningioma, and myxofibrosarcoma were included in the study...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29520496/endoscopic-transnasal-surgery-of-clival-lesions-our-experience
#5
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
May 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29492113/review-of-surgical-anatomy-of-the-tumors-involving-cavernous-sinus
#6
REVIEW
Silky Chotai, Yi Liu, Songtao Qi
The lesions involving cavernous sinus (CS) and lateral sellar region includes tumors, vascular lesions, infection, inflammation, and trauma. Tumors associated with CS cause significant distortion of the microanatomy posing an additional surgical challenge to the neurosurgeons. The surgical approach and microsurgical anatomy with respect to the origin and growth of the tumor within the CS region have not been comprehensively described in recent years. We conducted a review of literature concerning CS and associated tumors, complied through MEDLINE/OVID and using cross-references of articles on PubMed with the keywords cavernous sinus, CS tumors, pituitary adenoma, meningioma, schwannoma, chordoma, CS hemangiomas, extradural, interdural, intradural, skull base, gamma knife radiosurgery, endoscopic endonasal approach...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29474662/radiographic-analysis-of-the-vidian-canal-and-its-utility-in-petrous-internal-carotid-artery-localization
#7
Eric C Mason, Patricia A Hudgins, Gustavo Pradilla, Nelson M Oyesiku, C Arturo Solares
BACKGROUND: Endoscopic endonasal surgery of the skull base requires expert knowledge of the anatomy and a systematic approach. The vidian canal is regarded as a reliable landmark to localize the petrous internal carotid artery (pICA) near the second genu, which can be used for orientation in deep skull base approaches. There is controversy about the relationship between the vidian canal and the pICA. OBJECTIVE: To further establish the vertical relationship between the vidian canal and the pICA to aid in surgical approaches to the skull base...
February 21, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29456964/anatomical-correlation-between-nasal-vascularisation-and-the-design-of-the-endonasal-pedicle-flaps
#8
Juan R Gras-Cabrerizo, Elena García-Garrigós, Joan R Montserrat-Gili, Juan R Gras-Albert, Rosa Mirapeix-Lucas, Humbert Massegur-Solench, Miquel Quer-Agusti
Arteries that supply the nasal septum and the lateral nasal wall include vessels that originate from the external carotid artery and from the internal carotid artery. A variety of local endonasal pedicle flaps can be used in different anatomical areas for endoscopic skull base reconstruction. The main flaps are based on terminal branches of the sphenopalatine artery and on anterior ethmoidal artery. This study will describe the anatomy of these vessels and their relationship with the main flaps.
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29452829/cribriform-plate-width-is-highly-variable-within-and-between-subjects
#9
Daniel H Coelho, Taylor S Pence, Mostafa Abdel-Hamid, Richard M Costanzo
OBJECTIVE: All successful endonasal surgery, including functional endoscopic sinus surgery (FESS), depends on knowledge of both anatomy and the specific variations that can occur between and within patients. Familiarity with these structures is a critical component in preventing complications from these procedures, and failure to understand subtle variation can have disastrous results. The aim of this study was to characterize the anatomical variations (if any) of the cribriform plate using a large cadaveric sample set...
February 13, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29404253/the-posterior-transpetrosal-approach-in-a-case-of-large-retrochiasmatic-craniopharyngioma-operative-video-and-technical-nuances
#10
Moujahed Labidi, Kentaro Watanabe, Marie-Pier Loit, Shunya Hanakita, Sébastien Froelich
Objectives  To discuss the use of the posterior petrosal approach for the resection of a retrochiasmatic craniopharyngioma. Design  Operative video. Results  In this case video, the authors discuss the surgical management of a large craniopharyngioma, presenting with mass effect on the third ventricle and optic apparatus. A first surgical stage, through an endoscopic endonasal transtubercular approach, allowed satisfactory decompression of the optic chiasma and nerves in preparation for adjuvant therapy...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404250/extended-endoscopic-endonasal-approach-for-craniopharyngioma-removal
#11
Mahmoud Messerer, Rodolfo Maduri, Roy Thomas Daniel
Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404235/developmental-considerations-in-pediatric-skull-base-surgery
#12
REVIEW
Melissa A LoPresti, Jonathan N Sellin, Franco DeMonte
Objectives  To review developmental surgical anatomy and technical nuances related to pediatric skull base surgery. Design  Retrospective, single-center case series with literature review. Setting  MD Anderson Cancer Center. Participants  Patients undergoing pediatric skull base surgery. Main Outcome Measures  Review developmental anatomy of the pediatric skull base as it relates to technical nuance of various surgical approaches and insight gained from a 25-year institutional experience with this unique patient population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29325963/surgical-anatomy-of-the-eustachian-tube-for-endoscopic-transnasal-skull-base-surgery-a-cadaveric-and-radiologic-study
#13
Noritaka Komune, Satoshi Matsuo, Koichi Miki, Yojiro Akagi, Ryota Kurogi, Koji Iihara, Takashi Nakagawa
OBJECTIVE: The endoscopic endonasal approach to the anatomically complex lateral skull base presents technical challenges. The use of the eustachian tube as a landmark to identify the petrous internal carotid artery has recently been reported, and this study aims to define the anatomic relationship between the eustachian tube and its surrounding structures using cadaveric dissection and radiologic analysis. METHODS: To clarify the relationship of the eustachian tube with its surrounding structures, we performed endoscopic and microscopic dissection of 4 adult cadaveric heads and analyzed computed topography scans from 20 patients...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29166425/anatomy-of-the-sphenopalatine-artery-and-its-implications-for-transnasal-neurosurgery
#14
M Eordogh, A Grimm, I Gawish, L Patonay, R Reisch, H R Briner, G Baksa
BACKGROUND: The knowledge of sinonasal vasculature is inevitable in transnasal neurosurgery. We performed an anatomical study on the sphenopalatine artery from the perspective of skull base procedures. METHODOLOGY: To analyse the anatomical landmarks of the sphenopalatine artery, arterial skull corrosion casts (26 head halves) underwent endoscopic transnasal phantom surgery. Furthermore, we performed microsurgical dissection on formaldehyde-fixated cadavers with arterial perfusion (14 head halves) as well as studied Cone Beam CT-scans of anonymised patients and cadavers (115 head sides)...
March 1, 2018: Rhinology
https://www.readbyqxmd.com/read/29105367/early-experience-with-a-patient-specific-virtual-surgical-simulation-for-rehearsal-of-endoscopic-skull-base-surgery
#15
Tae-Bin Won, Peter Hwang, Jae Hyun Lim, Sung-Woo Cho, Sun Ha Paek, Steven Losorelli, Yona Vaisbuch, Sonny Chan, Kenneth Salisbury, Nikolas H Blevins
BACKGROUND: With the help of contemporary computer technology it is possible to create a virtual surgical environment (VSE) for training. This article describes a patient-specific virtual rhinologic surgical simulation platform that supports rehearsal of endoscopic skull-base surgery. We also share our early experience with select cases. METHODS: A rhinologic VSE was developed, featuring a highly efficient direct 3-dimensional (3D) volume renderer with simultaneous stereoscopic feedback during surgical manipulation of the virtual anatomy, as well as high-fidelity haptic feedback...
January 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#16
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/29075156/skull-base-trauma-clinical-considerations-in-evaluation-and-diagnosis-and-review-of-management-techniques-and-surgical-approaches
#17
REVIEW
Jacob S Feldman, Soroush Farnoosh, Robert M Kellman, Sherard A Tatum
Traumatic injuries to the skull base can involve critical neurovascular structures and present with symptoms and signs that must be recognized by physicians tasked with management of trauma patients. This article provides a review of skull base anatomy and outlines demographic features in skull base trauma. The manifestations of various skull base injuries, including CSF leaks, facial paralysis, anosmia, and cranial nerve injury, are discussed, as are appropriate diagnostic and radiographic testing in patients with such injuries...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28985669/establishment-of-next-generation-neurosurgery-research-and-training-laboratory-with-integrated-human-performance-monitoring
#18
Antonio Bernardo
Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28967307/introduction-surgical-management-of-skull-base-meningiomas
#19
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/28931257/morphometric-analysis-of-the-middle-clinoid-process-using-maxillofacial-computed-tomography-scans
#20
Christopher Miller, Roukoz Chamoun, David Beahm
BACKGROUND: The interest in detailed anatomy of the sella and parasellar regions has resurged recently due to the wide clinical applications of the expanded endoscopic approaches to the skull base. The middle clinoid process (MCP) is a bony structure that can affect wide endoscopic exposure of the sella and parasellar region. OBJECTIVE: To study and analyze the anatomic variations of the MCP in the general population using computed tomography scans. METHODS: A total of 150 maxillofacial computed tomography scans were reviewed to characterize the MCP...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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