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endoscopic skull base anatomy

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https://www.readbyqxmd.com/read/29105367/early-experience-with-a-patient-specific-virtual-surgical-simulation-for-rehearsal-of-endoscopic-skull-base-surgery
#1
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...
November 3, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29075159/endoscopic-endonasal-reconstructive-methods-to-the-anterior-skull-base
#2
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
#3
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
#4
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
#5
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
#6
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.)
https://www.readbyqxmd.com/read/28881251/registration-and-fusion-quantification-of-augmented-reality-based-nasal-endoscopic-surgery
#7
Yakui Chu, Jian Yang, Shaodong Ma, Danni Ai, Wenjie Li, Hong Song, Liang Li, Duanduan Chen, Lei Chen, Yongtian Wang
This paper quantifies the registration and fusion display errors of augmented reality-based nasal endoscopic surgery (ARNES). We comparatively investigated the spatial calibration process for front-end endoscopy and redefined the accuracy level of a calibrated endoscope by using a calibration tool with improved structural reliability. We also studied how registration accuracy was combined with the number and distribution of the deployed fiducial points (FPs) for positioning and the measured registration time...
August 3, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28845040/surgical-anatomy-for-the-endoscopic-endonasal-approach-to-the-ventrolateral-skull-base
#8
Kenichi Oyama, Shigeyuki Tahara, Toshio Hirohata, Yudo Ishii, Daniel M Prevedello, Ricardo L Carrau, Sebastien Froelich, Akira Teramoto, Akio Morita, Akira Matsuno
The authors describe the surgical anatomy for the endoscopic endonasal approach (EEA) to the ventrolateral skull base. The ventrolateral skull base can be divided into two segments: the upper lateral and lower lateral skull base. The upper lateral skull base includes the cavernous sinus and the orbit, while the lower lateral skull base includes the petrous apex, Meckel's cave, parapharyngeal space, infratemporal fossa, etc. To gain access to the upper lateral skull base, a simple opening of the ethmoid sinus provides sufficient exposure of this area...
October 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28838118/efficacy-of-endoscopic-fluorescein-video-angiography-in-aneurysm-surgery-novel-and-innovative-assessment-of-vascular-blood-flow-in-the-dead-angles-of-the-microscope
#9
Koji Hashimoto, Hiroyuki Kinouchi, Hideyuki Yoshioka, Kazuya Kanemaru, Masakazu Ogiwara, Takashi Yagi, Takuma Wakai, Yuichiro Fukumoto
BACKGROUND: In aneurysm surgery, assessment of the blood flow around the aneurysm is crucial. Recently, intraoperative fluorescence video angiography has been widely adopted for this purpose. However, the observation field of this procedure is limited to the microscopic view, and it is difficult to visualize blood flow obscured by the skull base anatomy, parent arteries, and aneurysm. OBJECTIVE: To demonstrate the efficacy of a new small-caliber endoscopic fluorescence video angiography system employing sodium fluorescein in aneurysm surgery for the first time...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28838109/endoscopic-endonasal-interdural-middle-fossa-approach-to-the-maxillary-nerve-anatomic-considerations-and-surgical-relevance
#10
Kumar Abhinav, David Panczykowski, Wei-Hsin Wang, Carl H Synderman, Paul A Gardner, Eric W Wang, Juan C Fernandez-Miranda
BACKGROUND: The maxillary nerve (V2) can be approached via the open middle fossa approach. OBJECTIVE: To delineate the anatomy of V2 and its specific segments with respect to the endonasal landmarks. We present the endoscopic endonasal interdural middle fossa approach to V2 and its potential application for the treatment of perineural spread in sinonasal/skull base tumors. METHODS: Five human head silicon-injected specimens underwent bilateral endoscopic endonasal transpterygoid approaches...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28808799/transorbital-endoscopic-approach-for-exposure-of-the-sylvian-fissure-middle-cerebral-artery-and-crural-cistern-an-anatomical-study
#11
João Paulo Almeida, Armando S Ruiz-Treviño, Sathwik R Shetty, Sacit B Omay, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The availability of minimal access instrumentation and endoscopic visualization has revolutionized the field of minimally invasive skull base surgery. The transorbital endoscopic approach using an eyelid incision has been proposed as a new minimally invasive technique for the treatment of skull base pathology, mostly extradural tumors. Our study aims to evaluate the anatomical aspects and potential role of the transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern...
August 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28799880/a-morphometric-survey-of-the-parasellar-region-in-more-than-2700-skulls-emphasis-on-the-middle-clinoid-process-variants-and-implications-in-endoscopic-and-microsurgical-approaches
#12
Akshay Sharma, Gabrielle E Rieth, Joseph E Tanenbaum, James S Williams, Nakao Ota, Srikant Chakravarthi, Sunil Manjila, Amin Kassam, Bulent Yapicilar
OBJECTIVE The middle clinoid process (MCP) is a bony projection that extends from the sphenoid bone near the lateral margin of the sella turcica. The varied prevalence and morphological features of the MCP in populations stratified by age, race, and sex are unknown; however, the knowledge of its anatomy and preoperative recognition on CT scans can aid greatly in complication avoidance and management. The aim of this study was to further illustrate the surgical anatomy of the parasellar region and to quantify the incidence of MCP and caroticoclinoid rings (CCRs) in dried preserved human anatomical specimens...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#13
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/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
#14
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/28583236/complete-response-of-skull-base-inverted-papilloma-to-chemotherapy-case-report
#15
Edward C Kuan, John W Frederick, Miguel F Palma Diaz, Dean W Lim, Jeffrey D Suh
BACKGROUND: Inverted papilloma (IP) is the most common benign sinonasal neoplasm. Endoscopic techniques, improved understanding of pathophysiology, and novel surgical approaches have allowed rhinologists to treat IPs more effectively, with surgery being the mainstay of therapy. Frontal sinus IP poses a challenge for surgical therapy due to complex anatomy and potentially difficult surgical access. OBJECTIVES: We reported a unique case of a massive frontal sinus IP that presented with intracranial and orbital extension, with near resolution after chemotherapy...
June 1, 2017: Allergy & Rhinology
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
#16
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/28490402/international-frontal-sinus-anatomy-classification-and-anatomic-predictors-of-low-lying-anterior-ethmoidal-arteries
#17
Phayvanh P Sjogren, Rajendra Waghela, Shaelene Ashby, Richard H Wiggins, Richard R Orlandi, Jeremiah A Alt
BACKGROUND: The International Frontal Sinus Anatomy Classification (IFAC) was introduced to more accurately characterize ethmoid and frontal sinus pneumatization patterns. The prevalence of IFAC cells and their anatomic associations have not been described. OBJECTIVE: The goal was to examine the prevalence of IFAC cells and determine radiologic features associated with a low-lying anterior ethmoidal artery (LAEA). METHODS: Imaging of adult patients who underwent computed tomographies from January 2015 to March 2016 were retrospectively reviewed by using the IFAC classification...
May 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28468205/a-rare-concha-variation-coronal-cleft
#18
Serap Yucel, Hediye Pinar Gunbey, Emre Gunbey, Asli Tanrivermis Sayit, Kerim Aslan
Nasal turbinates are embryologically derived from a series of outgrowths from the foetal lateral nasal wall. These outgrowths form a series of ridges, referred to as "ethmoturbinals" and have several vital functions. Several different turbinate variations have been reported so far. The authors presented 3 patients of coronal clefted concha who were diagnosed with magnetic resonance imaging. Computed tomography scans and nasal endoscopic examinations are also performed subsequently. These patients are the first coronal clefted concha cases in the literature and also the first radiological study defining concha cleft...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28392037/next-generation-surgical-navigation-systems-in-sinus-and-skull-base-surgery
#19
REVIEW
Martin J Citardi, William Yao, Amber Luong
Over the past 25 years, rhinologists have adopted surgical navigation technology for endoscopic sinus and skull base procedures. Navigation systems often produce a wide target registration error (TRE). Ideally, next-generation systems will include a leap in target registration error reduce TRE through innovative hardware and software. Incorporation of microsensors will be another important innovation. Future systems are likely to include augmented reality, which can project overlays of critical anatomy on real-world endoscopic images...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28359922/first-application-of-7-t-magnetic-resonance-imaging-in-endoscopic-endonasal-surgery-of-skull-base-tumors
#20
Thomas F Barrett, Hadrien A Dyvorne, Francesco Padormo, Puneet S Pawha, Bradley N Delman, Raj K Shrivastava, Priti Balchandani
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care...
July 2017: World Neurosurgery
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