12,822 results match your criteria Skull Base Anatomy


Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre.

Korean J Neurotrauma 2021 Apr 18;17(1):15-24. Epub 2021 Mar 18.

Department of Neurosurgery, Faculty of Medicine, Kasr Al-Ainy Medical College, Cairo, Egypt.

Objective: Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons.

Methods: Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Read More

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Does foramen magnum morphometry influence the development of Chiari malformation?

Turk Neurosurg 2020 Dec 15. Epub 2020 Dec 15.

Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Anatomy, Afyonkarahisar, Turkey.

Aim: Chiari malformations are defined as a spectrum of abnormalities of the posterior brain, including the cerebellum, brainstem, skull base, and cervical cord. Although many theories have tried to explain the etiology of Chiari malformation, its cause is still unknown. This study aimed to examine foramen magnum morphometry and shape of Chiari malformation in comparison with a control group and to contribute to the literature on whether Chiari malformation affects foramen magnum morphometry. Read More

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December 2020

Is there a correlation between skull base flexure and palatal anomalies in patients with 22q11 deletion syndrome and velopharyngeal dysfunction?

J Craniomaxillofac Surg 2021 Apr 24. Epub 2021 Apr 24.

Sackler School of Medicine,Tel Aviv University, Tel Aviv, Israel; Communication Disorders Faculty, Hadassah Academic College, Jerusalem, Israel.

The study aimed at assessing the relationship between skull base morphology, represented by skull base and nasopharyngeal angles, and palatal anatomy among patients with 22q11DS and velopharyngeal dysfunction. Retrospective analysis of patients with 22q11DS and velopharyngeal dysfunction. Age, sex, severity of velopharyngeal dysfunction, type of cleft (overt cleft palate, submucous cleft palate, occult submucous cleft palate, or no-CP, and cephalometric skull base angles were reviewed. Read More

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Interracial anatomical differences in the transsphenoidal approach to the sellar region.

Br J Neurosurg 2020 Oct 14:1-4. Epub 2020 Oct 14.

Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany.

Objective: Injury to vascular structures such as the internal carotid artery (ICA) is a rare but catastrophic complication of minimally invasive transsphenoidal surgery. Thorough preoperative planning, and knowledge of anatomical landmarks, such as the intercarotid distance (ICD) reduce this risk. Numerous anatomical studies have been conducted regarding the transsphenoidal approach, but none have taken racial disparities into account. Read More

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October 2020

Extreme Morphology, Functional Trade-offs, and Evolutionary Dynamics in a Clade of Open-Ocean Fishes (Perciformes: Bramidae).

Integr Org Biol 2021 16;3(1):obab003. Epub 2021 Feb 16.

Biology Department, Morrill Science Center, University of Massachusetts, 611 North Pleasant Street, Amherst, MA 01003, USA.

When novel or extreme morphologies arise, they are oft met with the burden of functional trade-offs in other aspects of anatomy, which may limit phenotypic diversification and make particular adaptive peaks inaccessible. Bramids (Perciformes: Bramidae) comprise a small family of 20 extant species of fishes, which are distributed throughout pelagic waters worldwide. Within the Bramidae, the fanfishes ( and ) differ morphologically from the generally stout, laterally compressed species that typify the family. Read More

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February 2021

Tranexamic acid to reduce head injury death in people with traumatic brain injury: the CRASH-3 international RCT.

Health Technol Assess 2021 Apr;25(26):1-76

Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.

Background: Tranexamic acid safely reduces mortality in traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury and can cause brain herniation and death. We assessed the effects of tranexamic acid in traumatic brain injury patients. Read More

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Pterygovaginal artery as a target of embolization before endoscopic skull base surgery.

Neuroradiol J 2021 Apr 30:19714009211013490. Epub 2021 Apr 30.

Department of Neurosurgery, Keio University School of Medicine, Japan.

Background: The pterygovaginal artery (PtVA), a recurrent branch of the internal maxillary artery (IMA), can be a feeder of skull base tumors. Preoperative embolization can help endoscopic resection of hypervascular lesions, which is performed under a narrow surgical space with restricted instrumental maneuverability.

Methods: We performed preoperative embolization in five cases with hypervascular skull base lesions supplied by the PtVA, four of which were resected via endoscopic endonasal approach. Read More

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A Combined Microsurgical and Endovascular Approach to Giant Paraclinoid Aneurysm: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 May;20(6):E424-E425

Neurosciences Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Giant paraclinoid aneurysm remains a treatment challenge because of their complex anatomy and surgical difficulties stems frequently from a calcified or atherosclerotic aneurysmal neck and compression of the optic pathways.1-9 To improve exposure, facilitate the dissection of the aneurysm, assure vascular control, reduce brain retraction and temporary occlusion time, and enable simultaneous treatment of possible associated aneurysms, we combined the cranio-orbital zygomatic (COZ) approach9 with endovascular balloon occlusion of the internal carotid artery (ICA) and suction decompression of the aneurysm.4 The patient is a 50-yr-old female who presented with headache and hemianopsia. Read More

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Venous Anatomy Influence on the Approach Selection of a Petroclival Clear Cell Meningioma With Associated Multiple Spinal Meningiomas: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 May;20(6):E426-E427

Preoperative careful evaluation of the sigmoid transverse sinus and its tributary veins is paramount for the safe surgical planning of petroclival lesions.1,2 When the vein of Labbé is running within the tentorium, classic petrosal approach involving transection of the tentorium is modified to avoid the risk of postoperative morbid temporal lobe venous infarcts.1-3 Thus, the surgical plan should be tailored to the specific patient anatomy as demonstrated in the presented case during which a transmastoid approach was followed, in the same surgical setting, by a middle fossa approach to resect a large petroclival clear cell meningioma with extension into Meckel cave. Read More

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Evolution and development of the bird chondrocranium.

Front Zool 2021 Apr 29;18(1):21. Epub 2021 Apr 29.

Universität Zürich, Paläontologisches Institut und Museum, Karl-Schmid-Straße 4, 8006, Zürich, Switzerland.

Background: Birds exhibit an enormous diversity in adult skull shape (disparity), while their embryonic chondrocrania are considered to be conserved across species. However, there may be chondrocranial features that are diagnostic for bird clades or for Aves as a whole. We synthesized and analyzed information on the sequence of chondrification of 23 elements in ten bird species and five outgroups. Read More

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Use of Neuroanatomic Knowledge and Neuronavigation System for a Safe Anterior Petrosectomy.

Brain Sci 2021 Apr 12;11(4). Epub 2021 Apr 12.

LINT, Facultad de Medicina, Universidad Nacional de Tucumán, T4000 Tucumán, Argentina.

Introduction: The petroclival region is among the most challenging anatomical areas to deal with in skull base surgery. Drilling of the anterior part of the petrous bone during the anterior transpetrosal approach involves the risk of injury of the cochlea, superior semicircular canal, internal carotid artery, and internal auditory canal. A thorough understanding of the microneurosurgical anatomy of this region is mandatory to execute the transpetrosal approaches, decreasing the risk of complications. Read More

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Selection for increased tibia length in mice alters skull shape through parallel changes in developmental mechanisms.

Elife 2021 Apr 26;10. Epub 2021 Apr 26.

McCaig Institute for Bone and Joint Health, Calgary, Canada.

Bones in the vertebrate cranial base and limb skeleton grow by endochondral ossification, under the control of growth plates. Mechanisms of endochondral ossification are conserved across growth plates, which increases covariation in size and shape among bones, and in turn may lead to correlated changes in skeletal traits not under direct selection. We used micro-CT and geometric morphometrics to characterize shape changes in the cranium of the Longshanks mouse, which was selectively bred for longer tibiae. Read More

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Endoscopic extra-capsular resection of a giant pituitary adenoma: how I do it.

Acta Neurochir (Wien) 2021 Jun 16;163(6):1711-1715. Epub 2021 Apr 16.

Division of Neurosurgery, Toronto Western Hospital/University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.

Background: Giant pituitary adenomas are characterized by their large size and potential to invade parasellar and suprasellar regions leading to visual decline and hypopituitarism. Thus, they remain a significant surgical challenge, and gross total removal is only achieved in the minority of cases.

Method: We aim to describe the key surgical steps for endoscopic extra-capsular resection of a giant pituitary adenoma with the aim of achieving complete tumor resection with description of the relevant surgical anatomy, indications and limitations. Read More

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Microsurgical Anatomy of the Inferior Petroclival Vein and its Relation to Surrounding Structures: A Cadaveric and Radiological Study.

Oper Neurosurg (Hagerstown) 2021 Apr 16. Epub 2021 Apr 16.

Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

Background: The inferior petroclival vein (IPV) courses along the extracranial surface of the petroclival fissure. It is occasionally involved in vascular diseases and has recently been used for vascular access to the cavernous sinus. However, detailed descriptions of its anatomy are currently lacking. Read More

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Radiologic evaluation of the fossa navicularis: incidence, morphometric features, and clinical implications.

Surg Radiol Anat 2021 Apr 16. Epub 2021 Apr 16.

Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey.

Introduction: The aim of this study was to determine the incidence and morphometric and morphological characteristics of fossa navicularis (FN) on cone beam computed tomography (CBCT) images of healthy adults MATERIALS AND METHODS: CBCT images of 900 individuals (450 males, 450 females, over the age of 18) admitted to Gaziantep University, Dentistry Faculty were retrospectively examined. The incidence and shape of FN were determined. Transverse diameter (TDFN), sagittal diameter (SDFN), depth in transverse section (DFNT), depth in sagittal section (DFNS), and the shortest distance between the deepest point of FN and intracranial cavity (FNI) were measured. Read More

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Petrosal Approach With Preservation of the Superior Petrosal Sinus (the Graceful Petrosal) for Resection of Giant Trigeminal Schwannoma: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Apr;20(5):E342-E343

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Trigeminal schwannomas are benign tumors amendable to curative surgical resection.1 Excellent outcomes, with preservation and improvement of cranial nerve function, including trigeminal nerve function, have been reported with microsurgical resection through skull base approaches.2 Dumbell shaped tumors, involving the middle and posterior fossa, are more challenging. Read More

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Techniques and challenges of the expanded endoscopic endonasal sellar and parasellar approaches to invasive pituitary tumors.

Acta Neurochir (Wien) 2021 Jun 7;163(6):1717-1723. Epub 2021 Apr 7.

Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th Avenue, Columbus, OH, 43210, USA.

Background: Superb knowledge of surgical anatomy and nuances to remove the natural barriers preventing full access to the paramedian skull base determines the ease of using the expanded sellar/parasellar approaches as the main gateway for all the parasagittal modules during endoscopic endonasal access (EEA) to pituitary tumors with cavernous sinus (CS) invasion.

Methods: Throughout stepwise-cadaveric dissections and pertinent intraoperative analysis, we describe surgical pearls and pitfalls of the parasellar-EEA with special references to the utility of various lines/classifications on neuroimaging correlated with strategies to enhance surgical safety and tumor resection.

Conclusion: EEA to invasive parasellar pathologies needs to address strict bleeding control and displacement of neurovascular structures inside the CS, posing a chance for neurologic morbidities/ICA injury. Read More

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Endovascular Management of a Giant Skull Base Cavernous Aneurysm: Parent Artery Occlusion Is Still a Relevant Strategy.

Cureus 2021 Mar 1;13(3):e13643. Epub 2021 Mar 1.

Department of Neurological Surgery, Medical University of South Carolina, Charleston, USA.

Cavernous carotid aneurysms (CCAs) are usually considered benign as the natural history of the condition is often asymptomatic; however, CCAs can reach giant proportions and become symptomatic, thus requiring treatment. The introduction of flow diverters has revolutionized management of this condition. However, the parent artery geometry in giant lesions may prove exceedingly difficult to navigate and deploy stents satisfactorily. Read More

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Deficiency of TMEM53 causes a previously unknown sclerosing bone disorder by dysregulation of BMP-SMAD signaling.

Nat Commun 2021 04 6;12(1):2046. Epub 2021 Apr 6.

Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan.

Bone formation represents a heritable trait regulated by many signals and complex mechanisms. Its abnormalities manifest themselves in various diseases, including sclerosing bone disorder (SBD). Exploration of genes that cause SBD has significantly improved our understanding of the mechanisms that regulate bone formation. Read More

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Chordoma-Current Understanding and Modern Treatment Paradigms.

J Clin Med 2021 Mar 4;10(5). Epub 2021 Mar 4.

Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA.

Chordoma is a low-grade notochordal tumor of the skull base, mobile spine and sacrum which behaves malignantly and confers a poor prognosis despite indolent growth patterns. These tumors often present late in the disease course, tend to encapsulate adjacent neurovascular anatomy, seed resection cavities, recur locally and respond poorly to radiotherapy and conventional chemotherapy, all of which make chordomas challenging to treat. Extent of surgical resection and adequacy of surgical margins are the most important prognostic factors and thus patients with chordoma should be cared for by a highly experienced, multi-disciplinary surgical team in a quaternary center. Read More

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CT of Skull Base Fractures: Classification Systems, Complications, and Management.

Radiographics 2021 May-Jun;41(3):762-782. Epub 2021 Apr 2.

From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., K.C., D.G., R.E.M.), R. Adams Cowley Shock Trauma Center (D.D., B.A., A.J.N.), Department of Neurosurgery (B.A.), Division of Plastic Surgery (A.J.N.), and Department of Otorhinolaryngology-Head and Neck Surgery (D.J.E.), University of Maryland Medical Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, Mass (O.S.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD (K.C.).

As advances in prehospital and early hospital care improve survival of the head-injured patient, radiologists are increasingly charged with understanding the myriad skull base fracture management implications conferred by CT. Successfully parlaying knowledge of skull base anatomy and fracture patterns into precise actionable clinical recommendations is a challenging task. The authors aim to provide a pragmatic overview of CT for skull base fractures within the broader context of diagnostic and treatment planning algorithms. Read More

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The Endoscopic Transnasal Approach to Orbital Tumors: A Review.

Semin Ophthalmol 2021 May 31;36(4):232-240. Epub 2021 Mar 31.

Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Historically, surgical access to orbital tumors has required a transcutaneous, transconjunctival or transcranial approach. Resection of orbital tumors is notoriously challenging due to the surrounding dense network of critical structures in a confined bony cavity. Advances in endoscopic endonasal surgery, initially used for sinonasal and skull base conditions, have allowed for expansion of its applications beyond the sinorbital interface. Read More

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New proposal to revise the classification for squamous cell carcinoma of the external auditory canal and middle ear.

J Laryngol Otol 2021 Apr 31;135(4):297-303. Epub 2021 Mar 31.

Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Background: The prognosis of patients with advanced squamous cell carcinoma of the external auditory canal and middle ear has been improved by advances in skull base surgery and multidrug chemoradiotherapy during the last two decades.

Methods: Ninety-five patients with squamous cell carcinoma of the external auditory canal and middle ear who were treated between 1998 and 2017 were enrolled. The number of patients with tumour stages T1, T2, T3 and T4 was 15, 22, 24 and 34, respectively. Read More

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Middle Cranial Fossa Approach: Anatomical Study on Skull Base Triangles as a Landmark for a Safe Anterior Petrosectomy.

J Neurol Surg B Skull Base 2021 Apr 12;82(2):202-207. Epub 2019 Sep 12.

Neurosurgery, Hospital de la Santa Creu I Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.

 The Kawase approach provides access to the petroclival and posterior cavernous sinus regions, cerebellopontine angle, and upper basilar artery territory. Nevertheless, it remains one of the most challenging approach for neurosurgeons, due to the considerable related morbidity and mortality. The goal of this study was to evaluate the relationship between anatomical landmarks and their possible variations, and to measure the extension of the Kawase space, to define the reliability of these landmarks while performing an anterior petrosectomy. Read More

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Pedicle Corridors and Vessel Options for Free Flap Reconstruction following Endoscopic Endonasal Skull Base Surgery: A Systematic Review.

J Neurol Surg B Skull Base 2021 Apr 12;82(2):196-201. Epub 2019 Sep 12.

Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, Saint Louis, Missouri, United States.

 Microvascular free flaps offer an alternative to local and regional flaps for coverage of complex or large skull base defects. Routes and approaches to these reconstructive options are complicated and require an understanding of complex head and neck anatomy.  A systematic review of the literature was performed using a set of search terms with the help of a qualified librarian. Read More

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Surgical Approaches to the Orbit: Transpalpebral.

J Neurol Surg B Skull Base 2021 Feb 2;82(1):149-153. Epub 2021 Feb 2.

Department of Ophthalmology, Virginia Commonwealth University Health System, Richmond, Virginia, United States.

The aim of this study is to provide an overview of the safe and effective incisional transpalpebral approaches to the orbit. The location of each approach and pertinent anatomy in each respective area, suggested approach techniques, recommended specialties, reconstruction options, intraoperative neurophysiology, complications, and approach limitations are discussed in detail. Read More

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February 2021

Orbital Surgical Guidelines: Pediatric Considerations.

J Neurol Surg B Skull Base 2021 Feb 1;82(1):142-148. Epub 2021 Mar 1.

Oculoplastic and Orbital Surgery, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, United States.

Pediatric orbital and skull base surgery comprises a wide array of tumors. An understanding of the location of the lesion, nature of the disease, and surrounding anatomy is paramount to surgical planning in these small spaces. The goals of pediatric skull base surgery are to avoid injury to the surrounding structures, minimize cosmetic deformities, and remove some or all of the tumors based on anticipated pathology and biologic cost of removal. Read More

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February 2021

Embryology of the Orbit.

J Neurol Surg B Skull Base 2021 Feb 2;82(1):2-6. Epub 2021 Feb 2.

Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, Michigan; Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, Michigan, United States.

The orbit houses and protects the ocular globe and the supporting structures, and occupies a strategic position below the anterior skull base and adjacent to the paranasal sinuses. Its embryologic origins are inextricably intertwined with those of the central nervous system, skull base, and face. Although the orbit contains important contributions from four germ cell layers (surface ectoderm, neuroectoderm, neural crest, and mesoderm), a significant majority originate from the neural crest cells. Read More

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February 2021

The translabyrinthine approach in residency training. "Step by step" surgical anatomy from the dissection laboratory to the operative room.

J Otol 2021 Apr 10;16(2):99-108. Epub 2020 Sep 10.

Dept. of Neurological Surgery, The George Washington University, Washington DC, USA.

Surgical anatomy training in a dedicated research laboratory and attendance to focused "hands-on" dissection courses are of high educational importance in order to acquire and maintain surgical expertise in skull base surgery, both for young and more experienced surgeons. Nevertheless, transitioning surgical skills and anatomic knowledge from the laboratory to the operative room it is not free of challenges, especially during skull base approaches where the three-dimensional surgical orientation can be quite complex. We present a "step-by-step" and "side-by-side" surgical anatomy report on a translabyrinthine approach that was practiced in the laboratory then performed in the operative room by the surgical team, and we compare surgical anatomy exposures while discussing intraoperative techniques, nuances and challenges, both in the laboratory and the operative room. Read More

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