164 results match your criteria Skull Base Petrous Apex Tumors


Chondrosarcoma in the Petrous Apex: Case Report and Review.

J Neurol Surg Rep 2018 Oct 18;79(4):e83-e87. Epub 2018 Oct 18.

Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Canada.

 Surgical treatment of petrous apex chondrosarcoma is challenging due to the location of the tumor. Using an endoscopic technique for tumor resection is favored since it provides a minimally invasive approach.  A 57 years old female was admitted for acute onset of left abducens nerve palsy and occasional headache mainly on the left side of the retro-orbital area with some radiation to the left occiput. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673627
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http://dx.doi.org/10.1055/s-0038-1673627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193802PMC
October 2018
15 Reads

Stereoscopic Surgical Video of Combined Petrosectomy With Virtual Reality Headset: 3-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 May;16(5):638-639

Department of Neurosurgery, CHU, Angers, France.

The use of 3-dimensional (3D) videos allows students to visualize surgical procedures from the perspective of the surgeon without missing the essential parts.1 This 3D commented video demonstrates the operative technique and surgical nuances of the combined petrosectomy, visualize using virtual reality headsets. Historically, traditional intradural cisternal routes using suboccipital and pterional approaches have been proposed to remove petroclival tumors. Read More

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https://academic.oup.com/ons/advance-article/doi/10.1093/ons
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http://dx.doi.org/10.1093/ons/opy228DOI Listing
May 2019
4 Reads

Supratotal Resection of Residual Clival Chordoma With Combined Endoscopic Endonasal and Contralateral Transmaxillary Approaches: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 Mar;16(3):E88-E89

Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

The optimal treatment for skull base chordomas is gross total resection followed by radiotherapy and not radiation of partially resected tumors. Supratotal resection, defined as removal beyond all involved bone and dura, is ideal but difficult to achieve.  In this video, we present the case of a 37-yr-old man with new onset of progressive cranial nerve sixth palsy and a skull base lesion compatible with clival chordoma. Read More

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http://dx.doi.org/10.1093/ons/opy220DOI Listing
March 2019
3 Reads

Comprehensive review of the extended middle cranial fossa approach.

Curr Opin Otolaryngol Head Neck Surg 2018 Oct;26(5):286-292

Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine.

Purpose Of Review: To review the current literature on the extended middle cranial fossa (xMCF) approach and to provide a comprehensive description of the relevant anatomy, indications, surgical technique, results, and complications.

Recent Findings: The xMCF approach expands the surgical exposure provided by the sMCF approach, allowing access to the internal auditory canal, cerebellopontine angle, prepontine cistern, anterior petrous apex, petrous carotid artery, Meckel's cave, cavernous sinus, mid and upper clivus, and posterior lesions approaching the jugular foramen. Preservation of serviceable hearing is possible with success rates approximating 50% in vestibular schwannoma and meningioma resection, and facial nerve outcome is excellent. Read More

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http://dx.doi.org/10.1097/MOO.0000000000000471DOI Listing
October 2018
3 Reads

How to perform microscopic/endoscopic resection of large petrous apex lesions.

Eur Ann Otorhinolaryngol Head Neck Dis 2018 Dec 20;135(6):443-447. Epub 2018 Jun 20.

Service d'ORL et de chirurgie cervico-faciale, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; UniCaen, UFR de médecine, 14000 Caen, France.

The endoscope and microscope can be used conjointly in certain sites, such as middle ear cholesteatoma or for resection of cerebellopontine angle tumours. Petrous apex tumours are classically accessed via a lateral otological approach, or, for the most anterior tumours, via an endonasal endoscopic approach. Surgical access via a lateral incision is limited inferiorly by the superior bulb of the internal jugular vein, medially by the labyrinth, facial nerve and internal auditory canal, superiorly by the dura mater, and laterally by the internal carotid artery. Read More

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http://dx.doi.org/10.1016/j.anorl.2018.06.002DOI Listing
December 2018
3 Reads

An Infratemporal Dermoid Cyst That Expanded the Foramen Ovale: A Case Report.

World Neurosurg 2018 Aug 1;116:305-308. Epub 2018 Jun 1.

Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Background: Dermoid cysts are rare tumors usually seen in the midline structure of the brain but rarely arise in the petrous apex and cavernous sinus. There have been very few reports of dermoid cysts arising in the infratemporal fossa, with scarce anatomic descriptions. Here we report the case of a patient with a dermoid cyst in the left infratemporal fossa. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.05.169DOI Listing
August 2018
31 Reads

[Experience of successful rescue from 5 cases of internal carotid artery injury during transnasal endoscopic skull base surgery].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Apr;53(4):251-256

Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of University of Science of Technology of China, Anhui Provincial Hospital, Hefei 230001, China.

To investigate the cause and urgent management of internal carotid artery injury during transnasal endoscopic skull base surgery. Five cases of internal carotid artery injury encountered during transnasal endoscopic skull base surgery in Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of University of Science of Technology of China, Anhui Provincial Hospital from December 2010 to July 2017 were analysed retrospectively. There were 2 cases of adenoid cystic carcinoma, 1 case of salivary gland-type adenocarcinoma, 1 case of petrous apex cholesterol granulomas and 1 case of squamous carcinoma. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1673-0860.2018.04.003DOI Listing
April 2018
3 Reads

Endoscopic endonasal transpterygoid approach to petrous pathologies: technique, limitations and alternative approaches.

J Neurosurg Sci 2018 Jun 10;62(3):339-346. Epub 2018 Jan 10.

Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA -

The endoscopic endonasal transpterygoid approach is a versatile technique, providing direct access to the petrous apex through an anterior surgical corridor. In this review we detail the transpterygoid approach to the petrous apex and highlight its relative indications. Although this approach is a useful strategy for many lesions of the petrous apex, disease extension into lateral, superior, or posterior compartments may limit extent of resection afforded by an anterior approach alone. Read More

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https://www.minervamedica.it/index2.php?show=R38Y2018N03A033
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http://dx.doi.org/10.23736/S0390-5616.18.04302-3DOI Listing
June 2018
8 Reads

Iatrogenic seeding of skull base chordoma following endoscopic endonasal surgery.

J Neurosurg 2018 Oct 22;129(4):947-953. Epub 2017 Dec 22.

Departments of1Neurological Surgery and.

Objective: Iatrogenic tumor seeding after open surgery for chordoma has been well described in the literature. The incidence and particularities related to endoscopic endonasal surgery (EES) have not been defined.

Methods: The authors retrospectively reviewed their experience with EES for clival chordoma, focusing on cases with iatrogenic seeding. Read More

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http://dx.doi.org/10.3171/2017.6.JNS17111DOI Listing
October 2018
15 Reads

Surgical Anatomy for the Endoscopic Endonasal Approach to the Ventrolateral Skull Base.

Neurol Med Chir (Tokyo) 2017 Oct 25;57(10):534-541. Epub 2017 Aug 25.

Department of Neurosurgery, Pituitary & Endoscopic Surgery Center, Teikyo University School of Medicine.

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. Read More

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http://dx.doi.org/10.2176/nmc.ra.2017-0039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638780PMC
October 2017
11 Reads

Radiological Study of the Carotid-Clival Window and Its Application in Endoscopic Endonasal Expanded Approaches.

World Neurosurg 2017 Aug 17;104:356-360. Epub 2017 May 17.

Department of Neurosurgery, Hospital U. i P. La Fe. Fernando Abril Martorell, Valencia, Spain.

Background: The surgical approach to the petrous apex (PA) and petroclival junction (PCJ) remains a challenge. The carotid-clival window (CCW) represents the widest window available to approach the PCJ from a mediolateral endoscopic route. Here we define the CCW radiologically in nonpathological conditions, to establish the anatomic variability of the PCJ, relate this variability to pneumatization patterns, and evaluate some technical concerns conditioned by the CCW. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.05.038DOI Listing
August 2017
18 Reads

Endoscopic endonasal approach to the ventral brainstem: anatomical feasibility and surgical limitations.

J Neurosurg 2017 Nov 13;127(5):1139-1146. Epub 2017 Jan 13.

Department of Neurological Surgery, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York.

OBJECTIVE Sporadic cases of endonasal intraaxial brainstem surgery have been reported in the recent literature. The authors endeavored to assess the feasibility and limitations of endonasal endoscopic surgery for approaching lesions in the ventral portion of the brainstem. METHODS Five human cadaveric heads were used to assess the anatomy and to record various measurements. Read More

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http://dx.doi.org/10.3171/2016.9.JNS161503DOI Listing
November 2017
9 Reads

Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.

J Neurol Surg B Skull Base 2016 Feb 19;77(1):6-13. Epub 2015 Jun 19.

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

 Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1555137
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http://dx.doi.org/10.1055/s-0035-1555137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192549PMC
February 2016
10 Reads

A blue middle ear mass: Cholesterol granuloma mimicking a glomus tumor and endolymphatic sac tumor.

Am J Otolaryngol 2017 Jan - Feb;38(1):100-102. Epub 2016 Sep 28.

Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, 600 Gresham Drive Suite 1100, VA, Norfolk, VA, United States.

Cholesterol granuloma (CG) is the most common benign lesion of the petrous apex, however, it can grow significantly large and become destructive causing a diagnostic dilemma. This case presents a 25-year-old female with 2-year history of left-sided progressive and profound hearing loss, a transient left-sided facial paralysis and cranial nerve 10 palsy who presented with a blue middle ear mass. Her diagnosis did not become apparent until direct visualization intraoperatively. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01960709163016
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http://dx.doi.org/10.1016/j.amjoto.2016.09.013DOI Listing
October 2017
5 Reads

Surgical resection of skull-base chordomas: experience in case selection for surgical approach according to anatomical compartments and review of the literature.

Acta Neurochir (Wien) 2017 10 6;159(10):1835-1845. Epub 2016 Dec 6.

Department of Neurosurgery, Tel-Aviv Medical Center, 6 Weizman Street, Tel-Aviv, 6423906, Israel.

Background: Chordoma is a rare bony malignancy known to have a high rate of local recurrence after surgery. The best treatment paradigm is still being evaluated. We report our experience and review the literature. Read More

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http://dx.doi.org/10.1007/s00701-016-3032-9DOI Listing
October 2017
12 Reads

Comparative analysis of the anterior transpetrosal approach with the endoscopic endonasal approach to the petroclival region.

J Neurosurg 2016 11 5;125(5):1171-1186. Epub 2016 Feb 5.

Departments of 1 Neurosurgical Surgery and.

OBJECTIVE The endoscopic endonasal approach (EEA) offers direct access to midline skull base lesions, and the anterior transpetrosal approach (ATPA) stands out as a method for granting entry into the upper and middle clival areas. This study evaluated the feasibility of performing EEA for tumors located in the petroclival region in comparison with ATPA. METHODS On 8 embalmed cadaver heads, EEA to the petroclival region was performed utilizing a 4-mm endoscope with either 0° or 30° lenses, and an ATPA was performed under microscopic visualization. Read More

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http://dx.doi.org/10.3171/2015.8.JNS15302DOI Listing
November 2016
25 Reads

Intracranial Angiomatoid Fibrous Histiocytoma: Case Report and Literature Review.

World Neurosurg 2016 Dec 22;96:403-409. Epub 2016 Sep 22.

Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA. Electronic address:

Background: Angiomatoid fibrous histiocytoma (AFH) is a rare and low-grade soft tissue lesion that typically arises from subcutaneous and deep dermal tissue of extremities. The first case was reported in 1979 by Enzinger and has since become known as a distinct entity. AFH has been increasingly reported in different organ systems, with rare reports of primary intracranial AFH. Read More

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http://dx.doi.org/10.1016/j.wneu.2016.09.059DOI Listing
December 2016
6 Reads

Endoscopic Management of Middle Ear and Temporal Bone Lesions.

Otolaryngol Clin North Am 2016 Oct 26;49(5):1205-14. Epub 2016 Jul 26.

Hospital Geral de Fortaleza, Fortaleza, Brazil.

Tantamount to the management of temporal bone neoplasms is the ability to visualize the pathology and its relationship with the numerous critical structures housed therein. Transcanal endoscopic ear surgery provides the surgeon with an unparalleled view of the entire middle ear. This article presents the latest information on the usefulness of transcanal endoscopic ear surgery in the management of middle ear and temporal bone neoplasms. Read More

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http://dx.doi.org/10.1016/j.otc.2016.05.011DOI Listing
October 2016
9 Reads

Extended Suboccipital Retrosigmoid Surgical Approach Is Effective for Resection of Petrous Apex Meningioma.

J Craniofac Surg 2016 Jul;27(5):e429-33

Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Objective: The aim of this study was to evaluate the clinical features, treatment strategies, and outcomes of patients presented with petrous apex meningiomas.

Methods: In this retrospective clinical study, 17 patients with petrous apex meningiomas were treated microsurgically via an extended suboccipital retrosigmoid approach. Data regarding the general characteristics of the patients, surgical management, and surgery-related outcomes were obtained by reviewing patients' medical records. Read More

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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1097/SCS.0000000000002705DOI Listing
July 2016
11 Reads

Detailed anatomy knowledge: first step to approach petroclival meningiomas through the petrous apex. Anatomy lab experience and surgical series.

Neurosurg Rev 2017 Apr 19;40(2):231-239. Epub 2016 May 19.

Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy.

Petroclival meningiomas are a challenge for neurosurgeons due to the complex anatomy of the region that is rich of vessels and nerves. A perfect and detailed knowledge of the anatomy is very demanding in neurosurgery, especially in skull base surgery. The authors describe the microsurgical anatomy to perform an anterior petrosectomy based on their anatomical and surgical experience and perform a literature review. Read More

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http://dx.doi.org/10.1007/s10143-016-0754-3DOI Listing
April 2017
25 Reads

Intradural anterior transpetrosal approach.

Neurosurg Rev 2016 Oct 4;39(4):625-31. Epub 2016 Apr 4.

Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

The standard anterior transpetrosal approach (ATPA) for petroclival lesions is fundamentally an epidural approach and has been practiced for many decades quite successfully. However, this approach has some disadvantages, such as epidural venous bleeding around foramen ovale. We describe here our experience with a modified technique for anterior petrosectomy via an intradural approach that overcomes these disadvantages. Read More

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http://dx.doi.org/10.1007/s10143-016-0711-1DOI Listing
October 2016
6 Reads

Endoscopic transsphenoidal anterior petrosal approach for locally aggressive tumors involving the internal auditory canal, jugular fossa, and cavernous sinus.

J Neurosurg 2017 Jan 1;126(1):212-221. Epub 2016 Apr 1.

Departments of 1 Neurosurgery and.

OBJECTIVE Reports about endoscopic endonasal surgery for skull base tumors involving the lateral part of petrous apex remain scarce. The authors present their experience with the endoscopic transsphenoidal anterior petrosal (ETAP) approach through the retrocarotid space for tumors involving the internal auditory canal, jugular fossa, and cavernous sinus. METHODS The authors performed the ETAP approach in 10 patients with 11 tumors (bilateral in 1 patient) that extensively occupied the lateral part of petrous apex, e. Read More

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http://dx.doi.org/10.3171/2016.1.JNS151979DOI Listing
January 2017
23 Reads

Plasmacytoma of the Skull Base: A Meta-Analysis.

J Neurol Surg B Skull Base 2016 Feb 20;77(1):61-5. Epub 2015 Aug 20.

Oncology Department, Rambam Medical Campus, Haifa, Israel.

Objective Extramedullary plasmacytomas are rare tumors. In the current study we aim to characterize its clinical course at the skull base and define the most appropriate therapeutic protocol. Methods We conducted a meta-analysis of articles in the English language that included data on the treatment and outcome of plasmacytoma of the base of skull. Read More

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http://dx.doi.org/10.1055/s-0035-1560047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777620PMC
February 2016
28 Reads

Differentiating Pediatric Rhabdomyosarcoma and Langerhans Cell Histiocytosis of the Temporal Bone by Imaging Appearance.

AJNR Am J Neuroradiol 2016 Jun 11;37(6):1185-9. Epub 2016 Feb 11.

From the Division of Otolaryngology, Head and Neck Surgery (K.M.C. R.H.W., N.Q., R.K.G.), University of Utah, Salt Lake City, Utah.

Background And Purpose: Rhabdomyosarcoma and Langerhans cell histiocytosis are malignant lesions that can affect the skull base with similar radiographic characteristics on CT and MR imaging. We hypothesized that location within the temporal bone determined radiographically can provide useful adjunctive information in differentiating these distinct neoplasms.

Materials And Methods: We identified patients with Langerhans cell histiocytosis and rhabdomyosarcoma by using an imaging data base and International Classification of Diseases, Ninth Revision codes at a tertiary care academic medical center. Read More

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http://dx.doi.org/10.3174/ajnr.A4676DOI Listing
June 2016
8 Reads

Rectal carcinoid tumor metastasis to a skull base meningioma.

Neuroradiol J 2016 Feb 29;29(1):49-51. Epub 2016 Jan 29.

Department of Radiology, Section of Neuroradiology, University Hospitals Case Medical Center, Cleveland, USA.

Carcinoid tumors are rare, slow-growing neuroendocrine tumors that most frequently develop in the gastrointestinal tract or lungs and have high potential for metastasis. Metastasis to the brain is rare, but to another intracranial tumor is extremely rare. Of the intracranial tumors, meningiomas are the most common to host metastases, which may be related to its rich vascularity and E-cadherin expression. Read More

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http://dx.doi.org/10.1177/1971400915624113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978345PMC
February 2016
9 Reads
1 Citation

Anterior petrosal approach: The safety of Kawase triangle as an anatomical landmark for anterior petrosectomy in petroclival meningiomas.

Clin Neurol Neurosurg 2015 Dec 28;139:282-7. Epub 2015 Oct 28.

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

Object: Anterior petrosectomy through the middle fossa is a well-described option for addressing cranial base lesions of the petroclival region. To access posterior fossa through middle fossa, we quantitatively evaluate the safety of Kawase triangle as an anatomical landmark.

Method: We reviewed pre- and postoperative Multi-Slice CT scan (1mm thickness) of patients with petroclival meningioma between Jan 2009 and Sep 2013 in which anterior petrosectomy was performed to access the posterior fossa part of the tumor. Read More

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http://dx.doi.org/10.1016/j.clineuro.2015.10.032DOI Listing
December 2015
14 Reads

Endoscopic endonasal translacerum approach to the inferior petrous apex.

J Neurosurg 2016 Apr 7;124(4):1032-8. Epub 2015 Aug 7.

Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Objective: The surgical approach to lesions involving the inferior petrous apex (IPA) is still challenging. The purpose of this study is to demonstrate the anatomical features of the IPA and to assess the applicability of an endoscopic endonasal approach through the foramen lacerum (translacerum approach) to the IPA.

Methods: The surgical simulation of the endoscopic endonasal translacerum approach was conducted in 3 cadaver heads. Read More

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http://dx.doi.org/10.3171/2015.1.JNS142526DOI Listing
April 2016
20 Reads

Endoscopic Endonasal Infrapetrous Transpterygoid Approach to the Petroclival Junction for Petrous Apex Chondrosarcoma: Technical Report.

J Neurol Surg Rep 2015 Jul 27;76(1):e113-6. Epub 2015 Apr 27.

Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States ; Oklahoma Comprehensive Brain Tumor Clinic, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States.

Chondrosarcomas of the skull base are rare tumors that present difficult management considerations due to the pathoanatomical relationships of the tumor to adjacent structures. We present the case of a 25-year-old female patient presenting with a chondrosarcoma of the right petrous apex extending inferiorly, medial to the cranial nerves. The tumor was resected via an endoscopic endonasal infrapetrous transpterygoid approach that achieved complete resection and an excellent long-term outcome with no complications. Read More

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http://dx.doi.org/10.1055/s-0035-1549222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520964PMC
July 2015
6 Reads

Endoscopic-Assisted Posterior Intradural Petrous Apicectomy in Petroclival Meningiomas: A Clinical Series and Assessment of Perioperative Morbidity.

World Neurosurg 2015 Dec 23;84(6):1708-18. Epub 2015 Jul 23.

Department of Neurosurgery, Eberhard-Karls-Universität Tübingen, Tubingen, Germany; Department of Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates. Electronic address:

Objective: To describe the clinical feasibility and outcome of the endoscopic-assisted posterior intradural petrous apicectomy approach (PIPA) for petroclival meningiomas extending into the supratentorial space.

Methods: From 2005-2013, 29 patients with a petroclival meningioma underwent tumor removal through a PIPA approach. The approach consists of a retrosigmoid approach, intradural anterior resection of the petrous apex and microsurgical removal of the tumor, followed by endoscopic-assisted visualization and removal of tumor parts in the middle fossa or anterior to the brainstem. Read More

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http://dx.doi.org/10.1016/j.wneu.2015.07.033DOI Listing
December 2015
12 Reads

The Microsurgical Anatomy of the Modified Presigmoid Trans-Partial Bony Labyrinth Approach.

J Craniofac Surg 2015 Jul;26(5):1619-23

Department of Neurosurgery, The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China.

Objective: To investigate the surgical techniques of the modified presigmoid trans-partial bony labyrinth approach and the advantages in the exposure of the petroclival region and in the treatment of lesions in this area.

Methods: Between April and October of 2012, a study on modification of the surgical approach was performed on 15 cadaveric heads. On the basis of the traditional presigmoid approach, semicircular canals, and the petrous apex were partially resected. Read More

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http://dx.doi.org/10.1097/SCS.0000000000001838DOI Listing
July 2015
2 Reads

Anatomic comparison of anterior petrosectomy versus the expanded endoscopic endonasal approach: interest in petroclival tumors surgery.

Surg Radiol Anat 2015 Dec 12;37(10):1199-207. Epub 2015 Jun 12.

Skull Base Multi-disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, 59 Bd Pinel, 69677, Lyon Cedex, France.

Purpose: Since the petroclival region is deep-seated with close neurovascular relationships, the removal of petroclival tumors still represents a fascinating surgical challenge. Although the classical anterior petrosectomy (AP) offers a meaningful access to this petroclival region, the expanded endoscopic endonasal approach (EEEA) recently leads to overcome difficulties from trans-cranial approaches. Herein, we present an anatomic comparison of AP versus EEEA. Read More

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http://link.springer.com/content/pdf/10.1007%2Fs00276-015-14
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http://link.springer.com/10.1007/s00276-015-1497-5
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http://dx.doi.org/10.1007/s00276-015-1497-5DOI Listing
December 2015
8 Reads

Petroclival Tumors: A Paternalistic Challenge.

World Neurosurg 2015 Aug 15;84(2):231-2. Epub 2015 Apr 15.

Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, Los Angeles, California, USA. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2015.04.014DOI Listing
August 2015
4 Reads

The Expanded Endoscopic Endonasal Approach to Petroclival Lesions: A Useful Adjunct to Traditional Skull Base Approaches.

World Neurosurg 2015 Aug 11;84(2):224-5. Epub 2015 Apr 11.

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2015.04.010DOI Listing
August 2015
10 Reads

Excavating Meckel's cave: Cavum-trigeminale-cephaloceles (CTCs).

J Neuroradiol 2015 Jun 6;42(3):156-61. Epub 2015 Apr 6.

Department of Neuroradiology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; FMRIB Centre, Department of Clinical Neurology, University of Oxford, Oxford, UK.

Background And Purpose: Cavum-trigeminale-cephaloceles (CTCs) are rare lesions of Meckel's cave and the petrous apex. Despite distinctive imaging features, they are frequently mistaken for other petrous apex lesions. In contrast to many of these entities, CTCs do--when asymptomatic--not require any invasive work-up or even surgical excision. Read More

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http://dx.doi.org/10.1016/j.neurad.2015.02.004DOI Listing
June 2015
5 Reads

Quantitative analysis of the Kawase versus the modified Dolenc-Kawase approach for middle cranial fossa lesions with variable anteroposterior extension.

J Neurosurg 2015 Jul 3;123(1):14-22. Epub 2015 Apr 3.

Forensic Science and Toxicology, All India Institute of Medical Sciences; and.

Object: The surgical corridor to the upper third of the clivus and ventral brainstem is hindered by critical neurovascular structures, such as the cavernous sinus, petrous apex, and tentorium. The traditional Kawase approach provides a 10 × 5-mm fenestration at the petrous apex of the temporal bone between the 5th cranial nerve and internal auditory canal. Due to interindividual variability, sometimes this area proves to be insufficient as a corridor to the posterior cranial fossa. Read More

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http://dx.doi.org/10.3171/2015.2.JNS132876DOI Listing
July 2015
24 Reads
3.737 Impact Factor

Which Routes for Petroclival Tumors? A Comparison Between the Anterior Expanded Endoscopic Endonasal Approach and Lateral or Posterior Routes.

World Neurosurg 2015 Jun 17;83(6):929-36. Epub 2015 Feb 17.

Skull Base Multidisciplinary Unit, Department of Neurosurgery, Neurological Hospital Pierre Wertheimer, Lyon Cedex, France.

Objective: Petroclival tumors remain a surgical challenge. Classically, the retrosigmoid approach (RSA) has long been used to reach such tumors, whereas the anterior petrosectomy (AP) has been proposed to avoid crossing cranial nerves. More recently, the endoscopic endonasal approach has been "expanded" (i. Read More

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http://dx.doi.org/10.1016/j.wneu.2015.02.003DOI Listing
June 2015
13 Reads

Cochlear line: a novel landmark for hearing preservation using the anterior petrosal approach.

J Neurosurg 2015 Jul 6;123(1):9-13. Epub 2015 Feb 6.

Barrow Neurosurgical Associates, Phoenix, Arizona.

Object: The goal of this study was to develop a practical landmark for the safe and easy identification of the cochlea when performing anterior petrosectomy based on cadaver dissection results.

Methods: The cochlear line was defined as the line drawn from the crossing point between the greater superficial petrosal nerve (GSPN) and the petrous internal carotid artery to the line drawn over the apex of the superior circumference of the dura of the internal auditory canal at a right angle. The validity of the cochlear line marking the anteromedial perimeter of the cochlea at the angle of the GSPN and the internal acoustic canal as a practical landmark were evaluated using 5 cadaver heads. Read More

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http://dx.doi.org/10.3171/2014.12.JNS132840DOI Listing
July 2015
6 Reads

Endoscopic endonasal resection of skull base chondrosarcomas: technique and early results.

J Neurosurg 2015 Apr 16;122(4):735-42. Epub 2015 Jan 16.

Departments of 1 Neurological Surgery.

Object: The authors of this study sought to report the technique and early clinical outcomes of a purely endonasal endoscopic approach for resection of petroclival chondrosarcomas.

Methods: Between 2010 and 2014, 8 patients (4 men and 4 women) underwent endonasal endoscopic operations to resect petroclival chondrosarcomas at 2 institutions. The patients' mean age was 44. Read More

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http://dx.doi.org/10.3171/2014.11.JNS14827DOI Listing
April 2015
12 Reads

Endoscopic endonasal surgical management of chondrosarcomas with cerebellopontine angle extension.

Neurosurg Focus 2014 ;37(4):E13

Department of Neurosurgery-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.

Object: Skull base chondrosarcomas are slow-growing, locally invasive tumors that arise from the petroclival synchondrosis. These characteristics allow them to erode the clivus and petrous bone and slowly compress the contents of the posterior fossa progressively until the patient becomes symptomatic, typically from cranial neuropathies. Given the site of their genesis, surrounded by the petrous apex and the clival recess, these tumors can project to the middle fossa, cervical area, and posteriorly, toward the cerebellopontine angle (CPA). Read More

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http://dx.doi.org/10.3171/2014.7.FOCUS14349DOI Listing
June 2015
18 Reads

Endoscope-assisted retrosigmoid intradural suprameatal approach for surgical treatment of trigeminal schwannomas.

Neurosurgery 2014 Dec;10 Suppl 4:565-75; discussion 575

*International Neuroscience Institute, Hannover, Germany; ‡Iranian International Neuroscience Institute, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Trigeminal schwannomas are the most common intracranial nonvestibular schwannomas, and the dumbbell-shaped subtype is the most challenging.

Objective: To evaluate the efficiency and safety of the endoscope-assisted retrosigmoid intradural suprameatal approach (EA-RISA) for dumbbell trigeminal schwannomas and to compare EA-RISA with classic RISA.

Methods: A retrospective study of all patients with trigeminal schwannomas was performed with a focus on dumbbell tumors. Read More

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http://dx.doi.org/10.1227/NEU.0000000000000478DOI Listing
December 2014
12 Reads

Gradenigo's syndrome as first presentation of solitary osseous plasmacytoma of the petrous apex.

Arch Iran Med 2014 Jul;17(7):526-8

Department of Neurosurgery, Arad Hospital, Tehran, Iran.

Plasma cell tumors of the skull base are rare in neurosurgical practice. True solitary osseous plasmacytoma of the skull base without development of multiple myeloma is extremely rare. We report a case of typical Gradenigo's syndrome, including left abducens nerve palsy, left facial pain and paresthesia in V1 and V2 distribution of trigeminal nerve caused by solitary osseous plasmacytoma of the left petrous apex. Read More

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http://dx.doi.org/0141707/AIM.0016DOI Listing
July 2014
5 Reads

Anatomy of the superior petrosal veins and their exposure and management during petrous apex meningioma surgery using the lateral suboccipital retrosigmoid approach.

Neurosurg Rev 2014 Oct 30;37(4):535-456. Epub 2014 Apr 30.

Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan,

During surgeries in the upper cerebellopontine angle (CPA), the superior petrosal veins (SPVs) often act as obstacles; and their sectioning sometimes causes serious complications. In this study, we introduced a classification system for the SPVs wherein their tributaries were classified into four groups on the basis of their courses and draining areas. We furthermore explained the detailed anatomy of the vein of the cerebellopontine fissure, which is the largest tributary. Read More

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http://dx.doi.org/10.1007/s10143-014-0548-4DOI Listing
October 2014
2 Reads

Combined lateral microscopic/endoscopic approaches to petrous apex lesions: pilot clinical experiences.

Ann Otol Rhinol Laryngol 2014 Aug;123(8):550-9

Background: Surgical treatment of lesions involving the temporal bone, petrous apex, or internal auditory canal is usually performed using the classical microscopic approach that necessitates wide external incisions and soft tissue dissection. At present, the main application of endoscopic surgery is in the surgical treatment of middle ear cholesteatoma, but with the natural evolution of the technique, there will be an increasing number of applications in lateral skull base surgery.

Objective: This study aimed to describe the pilot clinical experiences of our institution with combined microscopic/endoscopic-assisted approaches to the lateral skull base. Read More

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http://dx.doi.org/10.1177/0003489414525342DOI Listing
August 2014
3 Reads

Skull base chondrosarcomas: surgical treatment and results.

Ann Otol Rhinol Laryngol 2013 Dec;122(12):763-70

Gruppo Otologico Piacenza-Rome, Rome.

Objectives: We describe our experience in the management of patients with skull base chondrosarcoma, an uncommon neoplasm of the skull base.

Methods: Thirteen cases of surgically treated skull base chondrosarcomas were identified. The patients' follow-ups ranged from 7 to 86 months (mean, 47 months). Read More

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http://dx.doi.org/10.1177/000348941312201206DOI Listing
December 2013
9 Reads

Recurrence of a nasopharyngeal carcinoma manifesting as a cerebellopontine angle mass.

Ear Nose Throat J 2013 Dec;92(12):E11-3

Department of Otorhinolaryngology-Head and Neck Surgery, Pantai Cheras Medical Centre, 1 Jalan 1/96a, 56100 Cheras, Kuala Lumpur, Malaysia.

As many as 31% of patients with nasopharyngeal carcinoma present with intracranial extension. Despite this high percentage, extension to the cerebellopontine angle is rare. The mechanism of tumor spread to the cerebellopontine angle is not completely understood. Read More

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December 2013
6 Reads

Neuroimaging: intrinsic lesions of the central skull base region.

Semin Ultrasound CT MR 2013 Oct;34(5):412-35

Department of Radiology, Section of Neuroradiology, University of Alabama at Birmingham, Birmingham, AL.

The sphenoid bone is the osseous foundation of the central skull base. The body of the sphenoid is cuboid in shape and its posterior margin is joined to the basilar occipital bone (basiocciput) via a synchondrosis to form the complete clivus. Traditionally, radiologic discussions of intrinsic disease of the central skull base emphasize marrow space-occupying lesions including metastatic disease, myeloma, and chordoma. Read More

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http://dx.doi.org/10.1053/j.sult.2013.08.004DOI Listing
October 2013
5 Reads

[Anterior petrosal approach - analysis of the surgical technique in cadavers simulation].

Neurol Neurochir Pol 2013 Jul-Aug;47(4):363-74

Katedra i Oddział Kliniczny Neurochirurgii, Śląski Uniwersytet Medyczny w Katowicach, Sosnowiec.

The aim of the study was to present consecutive stages of the anterior petrosal approach (APA). Eight simulations of APA were performed on non-fixed human cadavers without any known pathologies of the head and neck. The consecutive stages of the procedure were documented with photographs and schemes. Read More

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December 2013
2 Reads

Surgical resection of large and giant petroclival meningiomas via a modified anterior transpetrous approach.

Neurosurg Rev 2013 Oct 18;36(4):587-93; discussion 593-4. Epub 2013 Jun 18.

Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University, No.6, Tiantan Xili, Dongcheng District, Beijing, 100050, China,

The authors describe a modified anterior transpetrous approach (ATPA) for the surgical resection of 21 cases of petroclival meningiomas (PCMs). Briefly, a curved periauricular skin incision was used. The cerebellar tentorium and the dura on the petrous apex were coagulated and incised to expose the petrous apex bone fully. Read More

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http://dx.doi.org/10.1007/s10143-013-0484-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771372PMC
October 2013
1 Read

Transzygomatic approach with intraoperative neuromonitoring for resection of middle cranial fossa tumors.

J Neurol Surg B Skull Base 2012 Feb;73(1):28-35

Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.

The authors reviewed the surgical experience and operative technique in a series of 11 patients with middle fossa tumors who underwent surgery using the transzygomatic approach and intraoperative neuromonitoring (IOM) at a single institution. This approach was applied to trigeminal schwannomas (n = 3), cavernous angiomas (n = 3), sphenoid wing meningiomas (n = 3), a petroclival meningioma (n = 1), and a hemangiopericytoma (n = 1). An osteotomy of the zygoma, a low-positioned frontotemporal craniotomy, removal of the remaining squamous temporal bone, and extradural drilling of the sphenoid wing made a flat trajectory to the skull base. Read More

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http://dx.doi.org/10.1055/s-0032-1304561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424022PMC
February 2012
29 Reads

Retrosigmoid intradural inframeatal approach: indications and technique.

Neurosurgery 2013 Sep;73(1 Suppl Operative):ons53-9; discussion ons60

International Neuroscience Institute, Hanover, Germany.

Background: Surgery of lesions of the petrous apex involving the inframeatal/infralabyrinthine area is challenging and related to a high risk of complications. Various extensive skull-base approaches have been used.

Objective: To present and evaluate our experience with a new hearing-preserving extension of the retrosigmoid approach to the inframeatal/infralabyrinthine area. Read More

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http://dx.doi.org/10.1227/NEU.0b013e3182889e59DOI Listing
September 2013
2 Reads