11,545 results match your criteria Skull Base Anatomy


Transcavernous Approach to the Upper Basilar and Retroclival Area-Cadaveric Surgical Simulation Video: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 Mar 19. Epub 2019 Mar 19.

Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.

The transcavernous approach (TcA) is an extension of the pterional approach that widens access to the central and lateral skull base regions. Through working between the nerves and vascular structures within the cavernous sinus, the TcA enables enhanced exposure of areas and structures including but not limited to the retrosellar area, Meckel's cave, and the basilar trunk. When the basilar apex and retrosellar regions are targeted, the TcA offers a valuable solution to the problem of the restricted space between the neurovascular structures of the central skull base through opening and widening the 2 major triangles of the cavernous sinus roof: the clinoidal and oculomotor triangles. Read More

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http://dx.doi.org/10.1093/ons/opz031DOI Listing

Imaging of cranial nerves: a pictorial overview.

Insights Imaging 2019 Mar 15;10(1):33. Epub 2019 Mar 15.

Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Genoa, Italy.

The human body has 12 pairs of cranial nerves that control motor and sensory functions of the head and neck. The anatomy of cranial nerves is complex and its knowledge is crucial to detect pathological alterations in case of nervous disorders. Therefore, it is necessary to know the most frequent pathologies that may involve cranial nerves and recognize their typical characteristics of imaging. Read More

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http://dx.doi.org/10.1186/s13244-019-0719-5DOI Listing

Microsurgical Anatomy of the Jugular Process as an Anatomical Landmark to Access the Jugular Foramen: A Cadaveric and Radiological Study.

Oper Neurosurg (Hagerstown) 2019 Apr;16(4):486-495

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: The jugular process forms the posteroinferior surface of the jugular foramen and is an important structure for surgical approaches to the foramen. However, its morphological features have not been well described in modern texts.

Objective: To elucidate the microsurgical anatomy of the jugular process and examine its morphological features. Read More

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http://dx.doi.org/10.1093/ons/opy198DOI Listing

Free-Flap Reconstruction of Skull Base and Orbital Defects.

Semin Plast Surg 2019 Feb 8;33(1):72-77. Epub 2019 Mar 8.

Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.

Orbital and anterior skull base defects present a significant challenge for reconstruction due to the complexity of the anatomy and the need for separation of intracranial and extracranial contents in this area. While endoscopic techniques have revolutionized the treatment of many anterior skull base defects, microvascular free tissue transfer is a viable option for large volume defects not suitable for traditional open approaches or for cases where endoscopic techniques have failed. The various free tissue transfer techniques for anterior skull base and orbit, as well as the advantages and disadvantages, are reviewed. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1677881
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http://dx.doi.org/10.1055/s-0039-1677881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408239PMC
February 2019
1 Read

"Tailored" far lateral approach to anterior foramen magnum meningiomas - The importance of condylar preservation.

Neurol India 2019 Jan-Feb;67(1):142-148

Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Introduction: Anterior and anterolaterally situated foramen magnum meningiomas are a technically complex subgroup of meningiomas. The need for an extensive exposure and bone work and their complex anatomy make them a difficult and challenging group of tumors to resect. The bone work has ranged from an extensive condylar resection to condylar preserving exposures. Read More

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http://dx.doi.org/10.4103/0028-3886.253609DOI Listing
March 2019
1.084 Impact Factor

MRI, CT and high resolution macro-anatomical images with cryosectioning of a Beagle brain: Creating the base of a multimodal imaging atlas.

PLoS One 2019 7;14(3):e0213458. Epub 2019 Mar 7.

University of Kaposvár, Kaposvár, Hungary.

Most common methods that directly show macro- or microscopic anatomy of the brain usually require the removal of the organ from the neurocranium. However, the brain can be revealed in situ by using proper sectioning techniques. Our aim was to both improve the cryosectioning method, test its limits and create a high-resolution macro-anatomical image series of a Beagle brain, which at the time of the study did not exist. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0213458PLOS

Validation of training levels in endoscopic endonasal surgery of the skull base.

Laryngoscope 2019 Mar 7. Epub 2019 Mar 7.

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

Objective: A five-level training program was first proposed 10 years ago for surgeons learning endoscopic endonasal surgery (EES) of the skull base. Levels were based on the complexity of anatomy, risk of neurovascular injury, intradural dissection, technical difficulty and vascularity of tumors.

Method: A three-phase validation concept is proposed: 1) face validity (the classification is related to clinically significant elements), 2) construct validity (the classification predicts the outcome), and 3) inter-team validation (the classification applies to other surgical teams). Read More

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http://dx.doi.org/10.1002/lary.27895DOI Listing
March 2019
4 Reads

Pediatric Diffuse Large B-Cell Lymphoma of the Frontal Sinus: A Case Report.

Cleft Palate Craniofac J 2019 Mar 5:1055665619831165. Epub 2019 Mar 5.

2 Department of Craniofacial and Pediatric Plastic Surgery, Dell Children's Medical Center of Central Texas, The University of Texas at Austin Dell Medical School, Austin, TX, USA.

An 11-year-old male presented with right proptosis, bulbar conjunctivitis, and diplopia. Computerized tomography (CT) and magnetic resonance imaging revealed an enhancing mass involving the superio-medial orbit, ethmoids, frontal sinus, and anterior cranial fossa with skull base destruction. Diffuse large B-cell lymphoma was diagnosed via CT-guided biopsy. Read More

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http://dx.doi.org/10.1177/1055665619831165DOI Listing
March 2019
2 Reads

The fascial layers attached to the skull base: A cadaveric study.

World Neurosurg 2019 Feb 27. Epub 2019 Feb 27.

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Object: A profound understanding of the relationship between deep cervical fasciae and the skull base is essential for skull base surgery. To our knowledge, there has been little research on the relationship between the deep cervical fasciae and inferior surface of the skull base; thus, this study aims to examine the fascial network of the skull base.

Methods: Cadaveric study. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193048
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http://dx.doi.org/10.1016/j.wneu.2019.02.078DOI Listing
February 2019
4 Reads

"Side door"-temporoparietal fascia flap: a novel strategy for anterior skull base reconstruction.

World Neurosurg 2019 Feb 26. Epub 2019 Feb 26.

Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

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http://dx.doi.org/10.1016/j.wneu.2019.02.056DOI Listing
February 2019
1 Read

The endoscopic transpterional port approach: anatomy, technique, and initial clinical experience.

J Neurosurg 2019 Feb 22:1-11. Epub 2019 Feb 22.

1Division of Neurosurgery, Toronto Western Hospital, Krembil Brain Institute, University Health Network, and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

OBJECTIVEThe evolution of microsurgical and endoscopic techniques has allowed the development of less invasive transcranial approaches. The authors describe a purely endoscopic transpterional port craniotomy to access lesions involving the cavernous sinus and the anterolateral skull base.METHODSThrough single- or dual-port incisions and with direct endoscopic visualization, the authors performed an endoscopic transpterional port approach (ETPA) using a 4-mm straight endoscope in 8 sides of 4 formalin-fixed cadaveric heads injected with colored latex. Read More

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http://dx.doi.org/10.3171/2018.10.JNS171898DOI Listing
February 2019
1 Read
3.737 Impact Factor

A new variant ligament of the atlantooccipital joint: the lateral oblique atlantooccipital ligament.

Eur Spine J 2019 Feb 19. Epub 2019 Feb 19.

Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA.

Purpose: During routine dissection of the anterior craniocervical junction (CCJ), a variant ligament just anterior to the articular capsule of the atlantooccipital joint was observed. To our knowledge, no literature has previously described this ligament. Therefore, the aim of this study was to clarify the anatomy, incidence, and biomechanics of this undescribed structure of the anterior atlantooccipital joint. Read More

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http://link.springer.com/10.1007/s00586-019-05919-0
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http://dx.doi.org/10.1007/s00586-019-05919-0DOI Listing
February 2019
4 Reads

Cranial anatomy of the early cynodont Galesaurus planiceps and the origin of mammalian endocranial characters.

J Anat 2019 Feb 17. Epub 2019 Feb 17.

Museum für Naturkunde, Leibniz-Institut für Evolutions- und Biodiversitätsforschung, Berlin, Germany.

The cranial anatomy of the early non-mammalian cynodont Galesaurus planiceps from the South African Karoo Basin is redescribed on the basis of a computed tomographic reconstruction of the skull. Previously, little was known about internal skull morphology and the nervous and sensory system of this taxon. The endocranial anatomy of various cynodonts has been intensively studied in recent years to understand the origin of mammalian characters in the nasal capsule, brain and ear. Read More

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http://dx.doi.org/10.1111/joa.12958DOI Listing
February 2019
2 Reads

Pathology of the carotid space.

Insights Imaging 2019 Feb 15;10(1):21. Epub 2019 Feb 15.

Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, P.O. Box 648, Rochester, NY, 14642, USA.

The complex anatomy of the carotid space within a small confined area is unique to the head and neck and allows for a vast array of pathology. This paper will review the anatomy of the carotid space from the skull base to the thorax, defining its borders at multiple levels, as well as its contents. The paper will also describe the myriad of mass lesions and vascular pathologies that may occur within the carotid space. Read More

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http://dx.doi.org/10.1186/s13244-019-0704-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377693PMC
February 2019
7 Reads

Endoscopic transorbital transtentorial approach to middle incisural space: preclinical cadaveric study.

Acta Neurochir (Wien) 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurological Surgery, National Defense Medical Center, Tri-Service General Hospital, No 325, Section 2, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan, Republic of China.

Background: Endoscopic transorbital approach is a novel development of minimally invasive skull base surgery. Recently, anatomical studies have started to discuss the expanded utilization of endoscopic transorbital route for intracranial intradural lesions. The goal of this cadaveric study is to assess the feasibility of endoscopic transorbital transtentorial approach for exposure of middle incisural space. Read More

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http://link.springer.com/10.1007/s00701-019-03831-6
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http://dx.doi.org/10.1007/s00701-019-03831-6DOI Listing
February 2019
3 Reads

Skull Base 3D Modeling of Rigid Buttress for Gasket-Seal Closure Using Operative Endoscopic Imaging: Cadaveric Feasibility.

J Neurol Surg B Skull Base 2019 Feb 20;80(1):67-71. Epub 2018 Jul 20.

Department of Radiology, Weill Cornell Medicine, Cornell University, New York, New York, United States.

Surgical defect closure following endonasal transsphenoidal tumor resection is a critical component of procedural success. Three-dimensional (3D) modeling of relevant skull base anatomy during resection can potentially facilitate design of a custom rigid buttress for gasket-seal closure; however, access to conventional cross-sectional imaging intraoperatively is limited and cumbersome. Endoscopic imaging, by contrast, is always available. Read More

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http://dx.doi.org/10.1055/s-0038-1667023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365293PMC
February 2019
1 Read

Augmented Reality, Surgical Navigation, and 3D Printing for Transcanal Endoscopic Approach to the Petrous Apex.

OTO Open 2018 Oct-Dec;2(4):2473974X18804492. Epub 2018 Oct 29.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.

Otolaryngologists increasingly use patient-specific 3-dimensional (3D)-printed anatomic physical models for preoperative planning. However, few reports describe concomitant use with virtual models. Herein, we aim to (1) use a 3D-printed patient-specific physical model with lateral skull base navigation for preoperative planning, (2) review anatomy virtually via augmented reality (AR), and (3) compare physical and virtual models to intraoperative findings in a challenging case of a symptomatic petrous apex cyst. Read More

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http://dx.doi.org/10.1177/2473974X18804492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348519PMC
October 2018

A new segmentation algorithm for measuring CBCT images of nasal airway: a pilot study.

PeerJ 2019 28;7:e6246. Epub 2019 Jan 28.

Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands.

Background: Three-dimensional (3D) modeling of the nasal airway space is becoming increasingly important for assessment in breathing disorders. Processing cone beam computed tomography (CBCT) scans of this region is complicated, however, by the intricate anatomy of the sinuses compared to the simpler nasopharynx. A gold standard for these measures also is lacking. Read More

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http://dx.doi.org/10.7717/peerj.6246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354662PMC
January 2019

Variations of the 6 cranial nerve (nervus abducens) in the petroclival region: A microsurgical study.

Morphologie 2019 Feb 1. Epub 2019 Feb 1.

Department of Anatomy-Chair, School of Medicine, Bahcesehir University, Istanbul, Turkey. Electronic address:

The aim of this study is to present the variations of nervus abducens in localization and number as it pierces the clival dura mater. The calvaria of 16 cadaveric heads were removed by making horizontal incisions from Glabella to Inion in both sides of the head. The dura mater was dissected. Read More

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http://dx.doi.org/10.1016/j.morpho.2019.01.001DOI Listing
February 2019
1 Read

Infratemporal fossa approach: the modified zygomatico-transmandibular approach.

Maxillofac Plast Reconstr Surg 2019 Dec 11;41(1). Epub 2019 Jan 11.

2Department of Oral and Maxillofacial Surgery, Dental Research Institute, Clinical Trial Center and Oral Cancer Center, School of Dentistry, Seoul National University, Seoul, South Korea.

Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Read More

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http://dx.doi.org/10.1186/s40902-018-0185-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331346PMC
December 2019
1 Read

Extended exposure of the petroclival junction: The combined anterior transpetrosal and subtemporal/transcavernous approach.

Surg Neurol Int 2018 24;9:259. Epub 2018 Dec 24.

Department of Anatomy, Histology and Embryology, Medical University of Innsbruck (MUI), 6020 Innsbruck/Austria.

Background: The combined anterior transpetrosal and subtemporal/transcavernous (atsta) approach to the petroclival junction provides a wide exposure facilitating resection of large tumor lesions such as petroclival mengiomas, chondrosarcomas, or chordomas. In this article we provide technical instructions on the approach with anatomical consideration and a literature review of previous applications of this approach.

Methods: The combined approach was performed in two cadaveric specimen and relevant anatomical aspects were studied. Read More

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http://dx.doi.org/10.4103/sni.sni_298_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322168PMC
December 2018

Sex estimation from skull base radiographs in a contemporary Colombian population.

J Forensic Leg Med 2019 Feb 20;62:77-81. Epub 2019 Jan 20.

University Antonio Nariño, Career 3 E, No. 47A-15, Block 5, Bogotá, Colombia.

The aim is to study the sexual dimorphism of the base of the skull in radiographs of a bone collection of contemporary Colombian adults, with the intention of formulating discriminant functions capable of classifying sex in this population. The sample consisted of 115 skull base radiographs, (44 females and 71 males), which originated from the Colombian Human Skeletals Collection. Radiographs with good contrast were selected. Read More

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http://dx.doi.org/10.1016/j.jflm.2019.01.006DOI Listing
February 2019
1 Read

Malignant peripheral nerve sheath tumor of the nasal cavity and nasopharynx in a child: A case report.

Medicine (Baltimore) 2019 Jan;98(4):e14223

Department of Radiology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.

Rationale: Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms with only a few reported cases affecting the nasal cavity, paranasal sinuses, and anterior skull base.

Patient Concerns: A 12-year-old girl with a mass in her nose was admitted to the Department of Otorhinolaryngology of Shenzhen Children's Hospital. She had a 4-month history of progressive, unilateral right nasal obstruction, unilateral mucopurulent rhinorrhea, foul nasal odor, snoring, hyposmia, occasional epistaxis, and no headache, no facial numbness, without eye swelling and vision loss. Read More

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http://dx.doi.org/10.1097/MD.0000000000014223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358413PMC
January 2019
7 Reads
5.723 Impact Factor

The carotico-clinoid bar: A systematic review and meta-analysis of its prevalence and potential implications in cerebrovascular and skull base surgery.

World Neurosurg 2019 Jan 21. Epub 2019 Jan 21.

Athens Microneurosurgery Laboratory, Athens, Greece; Department of Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.

Background: The caroticoclinoid bar (CCB) is implicated in both transcranial and endonasal surgery. Its morphology reflects differences in the microsurgical anatomy of the parasellar area while its manipulation during an anterior or middle clinoidectomy can result in ICA injury. Although safe surgical access to the paraclinoidal region is related to adjustment of surgical technique according to CCB anatomical variants, a review of the literature indicates the lack of a systematic assortment of published data regarding the prevalence of this variable structure. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.017DOI Listing
January 2019
2 Reads

Grading of MRI-detected skull-base invasion in nasopharyngeal carcinoma with skull-base invasion after intensity-modulated radiotherapy.

Radiat Oncol 2019 Jan 17;14(1):10. Epub 2019 Jan 17.

Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, China.

Background: The aim of this study is to evaluate the prognostic value of grading MRI-detected skull-base invasion in nasopharyngeal carcinoma (NPC) with skull-base invasion after intensity-modulated radiotherapy (IMRT).

Methods: This study is a retrospective chart review of 469 non-metastatic NPC patients with skull-base invasion. Patients were classified as extensive skull-base invasion (ESBI) group and limited skull-base invasion (LSBI) group. Read More

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http://dx.doi.org/10.1186/s13014-019-1214-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335845PMC
January 2019
1 Read

Proximal Branches of the Anterior Cerebral Artery: Anatomic Study and Applications to Endoscopic Endonasal Surgery.

Oper Neurosurg (Hagerstown) 2019 Jan 12. Epub 2019 Jan 12.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Background: The endoscopic endonasal approach is a surgical alternative for midline anterior skull base tumors. A detailed understanding of the proximal anterior cerebral artery (ACA) branches' anatomy from an endonasal perspective is essential for avoiding vascular complications.

Objective: To evaluate, from an endonasal perspective, the anatomic variations of the ACA and its proximal branches, specifically the recurrent artery of Heubner (RAH), and the fronto-orbital (FOA) and frontopolar (FPA) arteries. Read More

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http://dx.doi.org/10.1093/ons/opy308DOI Listing
January 2019

A Combined Extradural-Intradural Technique for an En Bloc Anterior Petrosectomy: A Cadaveric Feasibility Study.

World Neurosurg 2019 Jan 9. Epub 2019 Jan 9.

Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California, USA; Department of Neurological Surgery, University of California, San Francisco, California, USA; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA. Electronic address:

Introduction: The anterior petrosectomy approach is among the most popular for exposure of the petroclival region. However, the complexity of the anatomy, drilling time required, and risk of injury to neurovascular structures have made this procedure especially challenging. We have proposed a novel combined extradural-intradural technique for en bloc anterior petrosectomy-or one-piece Kawase-and have charted the landmarks that define its surgical boundaries. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750183291
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http://dx.doi.org/10.1016/j.wneu.2018.12.089DOI Listing
January 2019
6 Reads

Differentiation of human mesenchymal stem cells (MSC) to dopaminergic neurons: A comparison between Wharton's Jelly and olfactory mucosa as sources of MSCs.

J Chem Neuroanat 2019 Mar 10;96:126-133. Epub 2019 Jan 10.

Applied Biophotonics Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran. Electronic address:

The generation of dopaminergic neurons from stem cells is a potential therapeutic approach to treat neurodegenerative disorders, such as Parkinson's disease. The current study aims to investigate the potential of two different types of mesenchymal stem cells derived from human Wharton's jelly and nasal cavity for differentiation into dopaminergic neurons. The differentiation capacities of both cell types were evaluated using real-time PCR, immunocytochemistry, flow cytometry and HPLC. Read More

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http://dx.doi.org/10.1016/j.jchemneu.2019.01.003DOI Listing
March 2019
2 Reads
2.520 Impact Factor

Understanding Anatomy of the Petrous Pyramid-A New Compartmental Approach.

World Neurosurg 2019 Jan 5. Epub 2019 Jan 5.

Department of Anatomy, University of Lyon 1, Lyon, France; Skull Base Multi-disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon Cedex, France.

Background: Learning surgical anatomy of the petrous pyramid can be a challenge, especially in the beginning of the training process. Providing an easier, holistic approach can be of help to everyone with interest in learning and teaching skull base anatomy. We present the complex organization of petrous pyramid anatomy using a new compartmental approach that is simple to understand and remember. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750183279
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http://dx.doi.org/10.1016/j.wneu.2018.11.234DOI Listing
January 2019
10 Reads

Surgical Highways to the Craniovertebral Junction: Is It Time for a Reappraisal?

Acta Neurochir Suppl 2019 ;125:17-23

Neurosurgical Clinic, AOUP "Paolo Giaccone", Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, 90127, Palermo, Italy.

Background: The craniovertebral junction (CVJ) can be affected by a variety of congenital or acquired anomalies. Because of its complexity, a careful evaluation of bones and ligamentous structures in all three planes is required. This can be achieved by studying the CVJ in terms of several anatomical and radiological lines that have been visualized to facilitate understanding of its surgical anatomy. Read More

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http://dx.doi.org/10.1007/978-3-319-62515-7_4DOI Listing
January 2019

Why the Craniovertebral Junction?

Acta Neurochir Suppl 2019 ;125:3-8

Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.

The craniovertebral junction (CVJ) has unique anatomical bone and neurovascular structure architecture. It not only separates the skull base from the subaxial cervical spine but also provides a special cranial flexion, extension and axial rotation pattern. Stability is provided by a complex combination of osseous and ligamentous supports, which allow a large degree of motion. Read More

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http://dx.doi.org/10.1007/978-3-319-62515-7_1DOI Listing
January 2019

Nasal branch of the anterior ethmoid artery: a consistent landmark for a midline approach to the frontal sinus.

Int Forum Allergy Rhinol 2019 Jan 4. Epub 2019 Jan 4.

Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, FL.

Background: Frontal sinusotomy can be challenging when significant scarring or distorted anatomy is present. Identifying a reliable anatomic structure, when traditional landmarks or navigation are absent, may assist the surgeon in revision and complicated frontal sinusotomies via a midline approach. We aimed to characterize the anatomic relationship of the nasal branch of the anterior ethmoid artery (NBAEA) to the frontal infundibulum, specifically the first olfactory fili, posterior frontal infundibulum, and anterior cribriform plate. Read More

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http://dx.doi.org/10.1002/alr.22278DOI Listing
January 2019
1 Read

Multiple bioabsorbable corticosteroid-eluting stent placement with associated skull base injury.

Laryngoscope 2018 Dec 30. Epub 2018 Dec 30.

Section of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland, Ohio, U.S.A.

Bioabsorbable corticosteroid-eluting sinus stents (BCES) are used to optimize healing after sinus surgery. We report a patient with BCES placed through a dural defect. A 70 year old underwent sinus surgery. Read More

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http://dx.doi.org/10.1002/lary.27659DOI Listing
December 2018
1 Read

Surgical anatomy of the parapharyngeal space: Multiperspective, quantification-based study.

Head Neck 2019 Mar 28;41(3):642-656. Epub 2018 Dec 28.

Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Background: Several surgical approaches to the parapharyngeal space (PPS) have been proposed. An objective description of advantages and limitations of the surgical routes is lacking.

Methods: Ten cadaver heads were dissected using the transnasal (medial, lateral), sublabial, transoral (transpharyngeal, transvestibular, transmandibular), transcervical (transcervical, transparotid, transmandibular, transmastoid), and type C and D infratemporal approaches. Read More

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http://doi.wiley.com/10.1002/hed.25378
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http://dx.doi.org/10.1002/hed.25378DOI Listing
March 2019
17 Reads

The modified retrosigmoid approach: a how I do it.

Acta Neurochir (Wien) 2019 Feb 19;161(2):417-423. Epub 2018 Dec 19.

Department of Neurosurgery, North University Hospital, APHM, 13015, Marseille, France.

Background: The traditional retrosigmoid (RS) approach provides limited exposure of the inferior compartment of the CPA, while radical skull base approaches are demanding and associated with significant morbidity.

Methods: This study outlines the relevant surgical anatomy and the different surgical steps of a modified retrosigmoid (MRS) approach.

Results: The MRS provides enhanced exposure of the CPA and deep vascular structures resulting from a modified RS craniotomy and limited exposure of the sigmoid sinus. Read More

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http://dx.doi.org/10.1007/s00701-018-3764-9DOI Listing
February 2019
1 Read

Bilateral blunt cerebrovascular injury resulting in direct carotid-cavernous fistulae: A case report and review of the literature.

Surg Neurol Int 2018 19;9:229. Epub 2018 Nov 19.

Department of Neurosurgery, Clinical Neurosciences Center, Salt Lake City, Utah, USA.

Background: Bilateral blunt cerebrovascular injury (BCVI) has been documented in 32 patients in the English-language literature and bilateral carotid-cavernous fistulae (CCFs) have been reported in only 1 patient. Here, we present a case of severe, unexpected bilateral BCVI with bilateral direct CCF and review the literature of BCVI, particularly cases of bilateral injury.

Case Description: A 65-year-old woman with episodic bradycardia presented after a motor vehicle accident. Read More

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http://dx.doi.org/10.4103/sni.sni_210_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262944PMC
November 2018
2 Reads

The foramen lacerum: surgical anatomy and relevance for endoscopic endonasal approaches.

J Neurosurg 2018 Nov 1:1-12. Epub 2018 Nov 1.

1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

OBJECTIVEThe foramen lacerum is a relevant skull base structure that has been neglected for many years. From the endoscopic endonasal perspective, the foramen lacerum is a key structure due to its location at the crossroad between the sagittal and coronal planes. The objective of this study was to provide a detailed investigation of the surgical anatomy of the foramen lacerum and its adjacent structures based on anatomical dissections and imaging studies, propose several relevant key surgical landmarks, and demonstrate the surgical technique for its full exposure with several illustrative cases. Read More

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https://thejns.org/view/journals/j-neurosurg/aop/article-10.
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http://dx.doi.org/10.3171/2018.6.JNS181117DOI Listing
November 2018
4 Reads
3.737 Impact Factor

Anatomical variations of anterior ethmoidal artery and their significance in endoscopic sinus surgery: a systematic review.

Surg Radiol Anat 2018 Dec 12. Epub 2018 Dec 12.

Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.

Purpose: Anterior ethmoidal artery (AEA) is at risk of injury in endoscopic sinus surgery due to its location. The aim of this review was to assess the anatomical variations of AEA and their significance.

Methods: A literature search was performed on PUBMED, SCOPUS AND EMBASE. Read More

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http://dx.doi.org/10.1007/s00276-018-2165-3DOI Listing
December 2018
6 Reads

Preservation of Venous Drainage in Middle Fossa During Combined Transpetrosal Approach for Petroclival Meningioma.

World Neurosurg 2019 Mar 6;123:67. Epub 2018 Dec 6.

Department of Neurosurgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.

The combined transpetrosal approach enables wide exposure around the petroclival region by lifting of the middle fossa dura and cutting of the tentorium. However, interruption of the venous drainage on the middle skull base during the transpetrosal approach has been reported to lead to temporal lobe damage.Video 1 demonstrates a microsurgical technique for the preservation of various venous drainage in the middle fossa including the sphenobasal and sphenopetrosal veins during the combined transpetrosal approach for treatment of a petroclival meningioma. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.11.215DOI Listing
March 2019
2 Reads

Lack of Sphenoid Pneumatization Does Not Affect Endoscopic Endonasal Pediatric Skull Base Surgery Outcomes.

Laryngoscope 2019 Apr 5;129(4):832-836. Epub 2018 Dec 5.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

Objectives/hypothesis: Currently, due to the rarity of pathology, there are limited data surrounding outcomes of pediatric skull base surgery. Traditionally, surgeons have proceeded with caution when electing endonasal endoscopic transsellar/transplanum approaches to the skull base in pediatric patients due to poor sphenoid pneumatization. In this study, we review outcomes of endoscopic pediatric skull base surgery based on sphenoid pneumatization patterns. Read More

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http://dx.doi.org/10.1002/lary.27600DOI Listing
April 2019
5 Reads

Multiple Variations at the Base of an Adult Skull: Implications in Radiology and Skull Base Surgery.

J Craniofac Surg 2019 Jan;30(1):254-255

Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India.

Knowledge of variations at the base of the skull may be important for academic, anthropological, forensic, and clinical purposes, especially in computed tomography and magnetic resonance imaging and while performing safe radical surgery. This report presents multiple variations at the base of an adult Indian skull. The variations noted include the presence of foramen of Civinini bilaterally, absence of carotid canal on the left side, reduced size of foramen lacerum on the left side, presence of petro-occipital foramen bilaterally, asymmetry between the jugular fossae, and asymmetrical occipital condyles. Read More

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http://dx.doi.org/10.1097/SCS.0000000000005135DOI Listing
January 2019
1 Read

Braincase and endocranial anatomy of two thalattosuchian crocodylomorphs and their relevance in understanding their adaptations to the marine environment.

PeerJ 2018 26;6:e5686. Epub 2018 Nov 26.

CONICET. División Paleontología Vertebrados, Museo de La Plata, Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina.

Thalattosuchians are a group of Mesozoic crocodylomorphs known from aquatic deposits of the Early Jurassic-Early Cretaceous that comprises two main lineages of almost exclusively marine forms, Teleosauridae and Metriorhynchoidea. Teleosaurids were found in shallow marine, brackish and freshwater deposits, and have been characterized as semiaquatic near-shore forms, whereas metriorhynchids are a lineage of fully pelagic forms, supported by a large set of morphological characters of the skull and postcranial anatomy. Recent contributions on Thalattosuchia have been focused on the study of the endocranial anatomy. Read More

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http://dx.doi.org/10.7717/peerj.5686DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263203PMC
November 2018
2 Reads

Role of transcranial sphenoidotomy in skull base surgery: classification of surgical techniques based on the surgical anatomy of the sphenoid sinus.

J Neurosurg 2018 Nov 1:1-10. Epub 2018 Nov 1.

2Department of Neurosurgery, Fukushima Medical University, Fukushima; and.

OBJECTIVEAlthough sphenoidotomy is more commonly performed via the transnasal approach than via the transcranial approach, transcranial sphenoidotomy (TCS) remains indispensable for en bloc resection of locally advanced sinonasal malignant tumors (SNMTs) extending to the skull base. TCS also enables transsphenoidal transposition of the temporoparietal galeal flap (TPGF) to compensate for the lack of vascularized reconstructive tissue after endoscopic transnasal skull base surgery. The objective of this study was to review the authors' surgical experience using TCS with an emphasis on the surgical anatomy of the sphenoid sinus and on the purpose of TCS. Read More

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http://dx.doi.org/10.3171/2018.6.JNS181013DOI Listing
November 2018
1 Read

Computational fluid dynamics after endoscopic endonasal skull base surgery-possible empty nose syndrome in the context of middle turbinate resection.

Int Forum Allergy Rhinol 2019 Feb 29;9(2):204-211. Epub 2018 Nov 29.

Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Columbus, OH.

Background: Empty nose syndrome (ENS) is a rare and debilitating disease with a controversial definition, etiology, and treatment. One puzzling fact is that patients who undergo an endoscopic endonasal approach (EEA) often have resection of multiple anatomic structures, yet seldom develop ENS. In this pilot study, we analyzed and compared the computational fluid dynamics (CFD) and symptoms among post-EEA patients, ENS patients, and healthy subjects. Read More

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http://dx.doi.org/10.1002/alr.22236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358472PMC
February 2019
6 Reads

Endoscopic and Radiologic Findings in Failed Dacryocystorhinostomy: Teaching Pearls for Success.

Am J Rhinol Allergy 2018 Nov 28:1945892418815044. Epub 2018 Nov 28.

4 Department of Otolaryngology-Head & Neck Surgery, Albaha University, Al Bahah, Saudi Arabia.

Background: Although several studies have commented on causes of dacryocystorhinostomy (DCR) failure, detailed description of anatomical findings in such cases remains insufficient.

Objective: Our objective was primarily to analyze radiologic, endoscopic, and intraoperative findings in patients presenting with failed DCR and secondarily to assess the outcome of revision endoscopic DCR (endo-DCR) carried out at our institution.

Methods: Twenty-four failed DCRs presenting to our tertiary care center were retrospectively analyzed. Read More

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http://journals.sagepub.com/doi/10.1177/1945892418815044
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http://dx.doi.org/10.1177/1945892418815044DOI Listing
November 2018
12 Reads

Intraoral Endoscopic Ligation of Maxillary Artery in the Infratemporal Fossa.

J Craniofac Surg 2019 Jan;30(1):137-140

Department of Otolaryngology - Head and Neck Surgery, Endoscopic Sinus Surgery and Skull Base Surgery, Autonomous University of Veracruz, Xalapa, Mexico.

Ligation of the sphenopalatine and posterior nasal arteries is indicated for posterior epistaxis as initial treatment or when conservative measures fail. In some patients, a transnasal approach or its alternative transantral approach are not possible due to tumor filling the nasal corridor, pterygopalatine fossa, or maxillary sinus. Aim of this study was to evaluate feasibility of endoscopically assisted transoral approach for the ligation of the maxillary artery (MA). Read More

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http://dx.doi.org/10.1097/SCS.0000000000004981DOI Listing
January 2019
21 Reads

Anatomical Variation in Morphometry and Morphology of the Foramen Magnum and Occipital Condyle in Dried Adult Skulls.

J Craniofac Surg 2019 Jan;30(1):256-259

School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: The foramen magnum (FM) is the largest opening and is outlet through which medulla oblongata and spinal cord along with meninges, vertebral arteries, anterior and posterior spinal arteries, tectorial membrane, alar ligaments, and spinal branch of the accessory nerve. Occipital condyle (OC) is an important part of craniovertebral or craniocervical junction located anterolaterally on either side of the FM. The objective of the study was to assess variations of FM and OC in Ethiopian dried adult skulls. Read More

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http://dx.doi.org/10.1097/SCS.0000000000004925DOI Listing
January 2019
3 Reads