2,102 results match your criteria Skull Base Reconstruction


Our Experience with a Novel CSF Leak Repair Material in 14 Patients Following Anterior Skull Base Surgery.

Clin Otolaryngol 2019 Jan 15. Epub 2019 Jan 15.

Department of Otolaryngology, Guy's and St Thomas' Hospital, London, SE1 9RT.

Hemopatch (HE) advanced hemostatic pad composed of collagen and a synthetic, protein-reactive monomer which polymerises on contact with protein containing body fluids such as blood and CSF to seal tissues. HE is readily available which shortens the operating time, and may be manipulated intra-nasally to reconstruct defects of the anterior skull base. Reconstruction using HE reduces the morbidity compared with traditional facia lata graft harvesting techniques. Read More

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http://doi.wiley.com/10.1111/coa.13287
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http://dx.doi.org/10.1111/coa.13287DOI Listing
January 2019
2 Reads

Endoscopic endonasal surgery for craniopharyngiomas: a series of 60 patients.

World Neurosurg 2019 Jan 2. Epub 2019 Jan 2.

Department of Neurosurgery, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, P.R. China. Electronic address:

Objective: To report our experience of the management of 60 craniopharyngioma patients with endoscopic endonasal surgery (EES) and evaluate the feasibility and safety of EES for craniopharyngiomas.

Method: The clinical data of 60 craniopharyngioma patients who underwent EES between November 2014 and December 2017 were analysed retrospectively. All patients had vascularized nasoseptal flaps, and the most recent 4 patients had "in situ bone flaps" for better skull base reconstruction. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750183293
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http://dx.doi.org/10.1016/j.wneu.2018.12.110DOI Listing
January 2019
2 Reads

Endoscopic Endonasal Approaches for Treatment of Craniovertebral Junction Tumours.

Acta Neurochir Suppl 2019 ;125:209-224

Head and Neck Surgery & Forensic Dissection Research Centre, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.

Tumours involving the craniovertebral junction (CVJ) are challenging because of their local invasiveness and high recurrence rates, as well as their proximity to critical neurovascular structures and the difficulty of reconstructing the resulting skull base defect at this site. Several surgical techniques are currently available to access these lesions, including the far lateral, extreme lateral, direct lateral, transcervical, transoral and transnasal approaches. In this paper, application of the endoscopic endonasal approach (EEA) in the treatment of CVJ tumours is analysed. Read More

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http://dx.doi.org/10.1007/978-3-319-62515-7_30DOI Listing
January 2019
1 Read

Predictors of Nasoseptal Flap (NSF) Use after Endoscopic Transsphenoidal Pituitary Mass Resection.

World Neurosurg 2018 Dec 29. Epub 2018 Dec 29.

Department of Neurosurgery, University of Alabama at Birmingham, Birmingham AL, USA.

Objective: The pedicled nasoseptal flap (NSF) is the widely accepted reconstructive technique of choice for repair of larger skull base defects after endoscopic endonasal approaches. There is a dearth of literature examining the decision-making process regarding flap harvest. The objective of this study is to evaluate preoperative characteristics that predict the use of NSF reconstruction following endoscopic transsphenoidal resection of pituitary tumors. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.12.097DOI Listing
December 2018

[The simple posterior operation for different types of malformations in the craniocervical junction with atlantoaxial dislocation].

Authors:
Y Y Li M H Li N Z Yu

Zhonghua Yi Xue Za Zhi 2018 Dec;98(47):3888-3891

Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.

To explore the therapeutic effect of simple posterior reduction and decompression technique for different types of malformations in the craniocervical junction with atlantoaxial dislocation. The clinical data of 34 cases of different malformations in the craniocervical junction who were treated by the simple posterior internal fixation and decompression surgery in the department of neurosurgery of the first affiliated hospital of Nanchang University from March 2014 to March 2017 were analyzed retrospectively.In 34 cases, including 26 cases of basilar invagination with atlantoaxial dislocation (19 cases with atlanto occipital fusion, 12 cases with Chiari malformation, 13 cases with syringomyelia), 8 cases of odontoid malformation with atlantoaxial dislocation (2 cases with Chiari malformation, 1 case with flat skull base, 1 case with malformation of atlas). Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.47.015DOI Listing
December 2018
2 Reads

Long-term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction.

Laryngoscope 2018 Dec 19. Epub 2018 Dec 19.

Department of Neurosurgery, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York, U.S.A.

Objectives: The utilization of the nasoseptal flap (NSF) in endoscopic anterior skull base surgery (EASB) has resulted in reduced rates of postoperative cerebrospinal fluid leak (CSF). The long-term impact on sinonasal function after surgery remains incompletely defined.

Methods: A consecutive series of patients undergoing EASB with NSF and with at least 3 years follow-up was prospectively evaluated. Read More

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http://doi.wiley.com/10.1002/lary.27637
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http://dx.doi.org/10.1002/lary.27637DOI Listing
December 2018
7 Reads

Submental flap for reconstruction of anterior skull base, orbital, and high facial defects.

Am J Otolaryngol 2018 Nov 22. Epub 2018 Nov 22.

Purpose: Large anterior skull base, orbital, and high facial defects can present a challenging reconstructive problem. Limited data exists in the literature on the use of a submental flap for reconstructing such defects. We aimed to describe the feasibility, success, and advantages of using variations of the submental flap for reconstruction of anterior skull base, orbital, and high facial defects. Read More

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http://dx.doi.org/10.1016/j.amjoto.2018.11.008DOI Listing
November 2018

Titanium ossicular chain reconstruction in single stage canal wall down tympanoplasty for chronic otitis media with mucosa defect.

Am J Otolaryngol 2018 Nov 28. Epub 2018 Nov 28.

Department of Otology and Skull Base Surgery, Eye and ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, China; NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China. Electronic address:

Purpose: To evaluate surgical outcomes for chronic otitis media with mucosa defect underwent titanium ossicular chain reconstruction (OCR) in single stage canal wall down tympanoplasty (CWD).

Methods: A clinical retrospective study was performed on 83 cases of the chronic otitis media with mucosa defect and 123 ears with mucosa integrity according to intraoperative findings that underwent synchronous titanium OCR in single stage CWD form January 2012 to January 2018. Pre- and postoperative air conduction threshold (AC), air-bone gap (ABG) and ABG closure at 0. Read More

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http://dx.doi.org/10.1016/j.amjoto.2018.11.012DOI Listing
November 2018

Salvage or Solution: Alloplastic Reconstruction in Hemifacial Microsomia.

Cleft Palate Craniofac J 2018 Dec 13:1055665618817669. Epub 2018 Dec 13.

4 American Craniofacial Associates, Athens, Greece.

Introduction:: Skeletal reconstruction in severe grades of hemifacial microsomia (HFM) continues to be challenging. Traditional techniques of autografts and osseous distraction for reconstruction of the glenoid fossa, condyle, and ramus can fall short of expectations and can create new problems. This intercontinental study analyzes the role of alloplastic skeletal rehabilitation in severe HFM. Read More

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http://dx.doi.org/10.1177/1055665618817669DOI Listing
December 2018

Nasal Morbidity and Quality of Life After Endoscopic Transsphenoidal Surgery: A Single-Center Prospective Study.

World Neurosurg 2018 Dec 5. Epub 2018 Dec 5.

Unit of Neurosurgery, University of Brescia, Brescia, Italy.

Objective: The aim of this study was to assess nasal morbidity of endoscopic transsphenoidal approaches (ETAs) for treatment of sellar and parasellar diseases through evaluation of quality of life (QoL) and nasal function. The impact of different ETAs, according to extent and reconstruction technique, was also studied.

Methods: Patients undergoing ETA for treatment of sellar or parasellar lesions were prospectively recruited and examined preoperatively and at 6 months after surgery according to the following workup: nasal endoscopy, rhinomanometry, acoustic rhinometry, University of Pennsylvania Smell Identification Test, Anterior Skull Base Nasal Inventory-12, Sino-nasal Outcome Test-22, and Short-Form Health Survey-36 (SF-36). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750183277
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http://dx.doi.org/10.1016/j.wneu.2018.11.212DOI Listing
December 2018
3 Reads

Skull base reconstruction with pedicled nasoseptal flap: Technique, indications, and limitations.

J Craniomaxillofac Surg 2019 Jan 16;47(1):29-32. Epub 2018 Nov 16.

Neurosurgery, Centre Hospitalier Universitaire de Liège, University of Liège, Liège, Belgium.

Endoscopic skull base surgery allows extensive tumor resection but results in large defects requiring robust dural repair. The vascularized nasal septal flap pedicled on the posterior nasal septal artery is known to have an excellent success rate for dural defect coverage. Detailed step-by-step descriptions of the harvest and placement of this flap are scarce. Read More

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http://dx.doi.org/10.1016/j.jcms.2018.11.012DOI Listing
January 2019

Nasal Functions in Three-Dimensional Endoscopic Skull Base Surgery.

Ann Otol Rhinol Laryngol 2018 Dec 10:3489418816723. Epub 2018 Dec 10.

2 Neurosurgery Division, Department of Neurosciences, University of Turin, Turin, Italy.

Objectives:: Endoscopic transnasal transsphenoidal surgery has become the standard procedure for the majority of skull base diseases, including sellar, parasellar, and clival pathologies. The aim of this study was the objective evaluation of nasal airflow resistances and olfactory function in 3-dimensional (3D) endoscopic transnasal transsphenoidal surgery.

Methods:: One hundred patients who underwent 3D transnasal endoscopic surgery for sellar, parasellar, and clival diseases were enrolled. Read More

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http://dx.doi.org/10.1177/0003489418816723DOI Listing
December 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

Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial.

J Neurosurg 2018 Oct 1:1-7. Epub 2018 Oct 1.

Departments of1Neurological Surgery and.

OBJECTIVEBased on a null hypothesis that the use of short-term lumbar drainage (LD) after endoscopic endonasal surgery (EES) for intradural pathology does not prevent postoperative CSF leaks, a trial was conducted to assess the effect of postoperative LD on postoperative CSF leak following standard reconstruction.METHODSA prospective, randomized controlled trial of lumbar drain placement after endoscopic endonasal skull base surgery was performed from February 2011 to March 2015. All patients had 3-month follow-up data. Read More

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http://dx.doi.org/10.3171/2018.4.JNS172447DOI Listing
October 2018
1 Read

Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery.

J Neurosurg 2018 Oct 1:1-7. Epub 2018 Oct 1.

OBJECTIVETranssphenoidal surgery (TSS) is commonly used for anterior skull base surgery, especially in the sella turcica (sellar) region. However, because of its anatomical position, CSF leakage is a major complication of this approach. The authors introduced a new grading reconstruction strategy for anterior skull base surgery with continuous dural suturing in 2013. Read More

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http://dx.doi.org/10.3171/2018.4.JNS18366DOI Listing
October 2018
2 Reads

Probabilistic Tractography to Predict the Position of Cranial Nerves Displaced by Skull Base Tumors: Value for Surgical Strategy Through a Case Series of 62 Patients.

Neurosurgery 2018 Nov 26. Epub 2018 Nov 26.

CREATIS Laboratory CNRS UMR5220, Inserm U1206, INSA-Lyon, University of Lyon 1, Lyon, France.

Background: Predicting the displacement of cranial nerves by tumors could make surgery safer and the outcome better. Recent advances in imaging and processing have overcome some of the limits associated with cranial nerve tractography, such as spatial resolution and fiber crossing. Among others, probabilistic algorithms yield to a more accurate depiction of cranial nerve trajectories. Read More

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https://academic.oup.com/neurosurgery/advance-article/doi/10
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http://dx.doi.org/10.1093/neuros/nyy538DOI Listing
November 2018
10 Reads

Recurrent Pott's Puffy Tumor Treated With Anterior Skull Base Resection With Reconstruction of the Anterolateral Thigh Flap.

J Craniofac Surg 2019 Jan;30(1):e94-e96

Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center.

Pott's puffy tumor (PPT) is a rare, life-threatening complication of frontal sinusitis that is treated with a combination of appropriate antibiotics and surgery for the removal of infected tissue. A 56-year-old man with recurrent forehead swelling was admitted and diagnosed with recurrent PPT. He had undergone endoscopic sinus surgery and pericranial abscess drainage. Read More

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http://dx.doi.org/10.1097/SCS.0000000000005100DOI Listing
January 2019
1 Read

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
5 Reads

Moulded Osteomyofascial Pedicled Split (MOPS) Craniotomy Flap in Reconstruction of Anterior Cranial Fossa Defects: Pilot Study of a Novel Technique.

Asian J Neurosurg 2018 Oct-Dec;13(4):1011-1017

Department of Neurosurgery, Government Medical College, Kottayam, Kerala, India.

Introduction: Anterior cranial fossa (ACF) defects still remains a reconstructive challenge to neurosurgeons due to the difficult location, inaccessibility, and unfavorable vascular anatomy. Usual reconstructive methods reported complications such as recurrent cerebrospinal fluid leak due to bone resorption and tissue breakdown. This is mainly due to the avascularity of the bone graft and inability to provide bony structural support for the skull base. Read More

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http://dx.doi.org/10.4103/ajns.AJNS_23_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208263PMC
November 2018
10 Reads

Trochlear Nerve Repair during Retrosigmoid Suprameatal Approach for Petrotentorial Meningioma: Operative Video.

J Neurol Surg B Skull Base 2018 Dec 1;79(Suppl 5):S404-S406. Epub 2018 Oct 1.

Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.

When operating on difficult skull base lesions, it is essential to be able to handle unexpected intraoperative findings or troubles, while achieving maximal lesion removal and minimal functional deficit. This video demonstrates a case of trochlear nerve repair that was performed during the retrosigmoid suprameatal approach for treatment of a petrotentorial meningioma, extending into the Meckel's cave. The patient is a 47-year-old woman with a right petrotentorial meningioma, extending into the Meckel's cave. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1669967
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http://dx.doi.org/10.1055/s-0038-1669967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240355PMC
December 2018
5 Reads

[The current trends and the tactical-technical approaches to the management of the neoplastic processes in the base of the skull].

Vestn Otorinolaringol 2018 ;83(5):7-10

Department of Otorhinolaryngology, Ural State Medical University, Ministry of Health of the Russian Federation, Ekaterinburg, Russia.

The neoplastic processes localized in the base of the skull and the surrounding region have until recently been considered as the inoperable condition. Juvenile angiofibroma of the base of the skull or angiofibroma of the base of the skull (ABS) is most frequently encountered in the otorhinolaryngological practice. In terms of the histological picture, ABS is a benign tumour having a very complicated structure. Read More

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http://dx.doi.org/10.17116/otorino2018830517DOI Listing
January 2018
1 Read

Random nasoseptal flap for revision skull base reconstruction.

J Clin Neurosci 2019 Feb 29;60:167-169. Epub 2018 Oct 29.

Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address:

The nasoseptal flap (NSF) has become the workhorse of endoscopic skull base reconstruction (ESBR). With the increase in endoscopic skull base procedures, there has also been the need for staged and revision procedures where the use of the NSF is no longer an option. These cases have posed new and interesting challenges to skull base surgeons especially with regards to reconstructive options. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09675868183139
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http://dx.doi.org/10.1016/j.jocn.2018.10.038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326883PMC
February 2019
6 Reads

[Hybrid prosthesis for vascular reconstruction of the internal carotid artery near the skull base after radical excision of a very rare malignant glomus caroticum paraganglioma].

HNO 2018 Oct 30. Epub 2018 Oct 30.

Fachbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.

Background: Neck tumors are challenging regarding the diagnostic and therapeutic management particularly in cases of malignant growth near relevant vessels to achieve R0 resection status and the best prognosis.

Aim: The aim of this case report on a patient with a rare malignant tumor of the glomus caroticum (paraganglioma) is to present the successful outcome of a demanding interdisciplinary surgical approach (otorhinolaryngology and vascular surgery). Surgical re-intervention was necessary due to malignant tumor growth (detected in the histopathological investigation of the first specimen) including vascular resection using a hybrid graft for vascular reconstruction of the internal carotid artery near the skull base. Read More

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http://link.springer.com/10.1007/s00106-018-0588-0
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http://dx.doi.org/10.1007/s00106-018-0588-0DOI Listing
October 2018
7 Reads

Association of Smoking Tobacco With Complications in Head and Neck Microvascular Reconstructive Surgery.

JAMA Facial Plast Surg 2018 Oct 18. Epub 2018 Oct 18.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark.

Importance: Smoking is a highly prevalent risk factor among patients with head and neck cancer. However, few studies have examined the association of this modifiable risk factor on postoperative outcomes following microvascular reconstruction of the head and neck.

Objective: To analyze the risk associated with smoking in patients undergoing free flap surgery of the head and neck. Read More

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http://archfaci.jamanetwork.com/article.aspx?doi=10.1001/jam
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http://dx.doi.org/10.1001/jamafacial.2018.1176DOI Listing
October 2018
18 Reads

Multiple Surgical Treatments for Repeated Recurrence of Skull Base Mesenchymal Chondrosarcoma.

NMC Case Rep J 2018 Oct 13;5(4):99-103. Epub 2018 Sep 13.

Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima, Japan.

We report a case of a young male who received multiple surgical treatments for repeated recurrence of skull base mesenchymal chondrosarcoma (MC). When the patient was 18 years old, we subtotally removed the skull base MC and he was treated with stereotactic radiosurgery for remnant tumors in the left cavernous sinus. After 30 months, we removed residual tumors that had regrown partially, via combined endonasal endoscopic and orbitozygomatic approaches. Read More

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http://dx.doi.org/10.2176/nmccrj.cr.2018-0016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187253PMC
October 2018
1 Read

Extension of the Clinical Significance of the "Cog".

ORL J Otorhinolaryngol Relat Spec 2018 10;80(5-6):317-325. Epub 2018 Oct 10.

Department of Otology, Microsurgery, and Skull Base Surgery, Institute of Otorhinolaryngology, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai,

Objective: To study the clinical anatomy of the epitympanum, the attic, and its medial wall, to try to discover a new clinical operation-related anatomical landmark, and to investigate the adjacent anatomical relationship with this landmark.

Materials And Methods: Eight donor temporal bone specimens were dissected endoscopically. For 29 healthy persons (17 males and 12 females), CT images of the temporal bone (57 ears) were taken, 3-dimensional (3-D) reconstruction and multidimensional plane reconstruction were performed, and identification and assessment of 3-D spatial relationships between any 2 of these complex structures were done. Read More

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https://www.karger.com/Article/FullText/493012
Publisher Site
http://dx.doi.org/10.1159/000493012DOI Listing
October 2018
3 Reads

Lateral frontoethmoidal cell obstructing frontal sinus drainage pathway - report of six cases.

Wideochir Inne Tech Maloinwazyjne 2018 Sep 22;13(3):420-428. Epub 2018 May 22.

Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland.

The European Anatomical Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses distinguishes anterior, posterior, medial and lateral frontoethmoidal cells. The lateral cells have not been characterized yet. Other classifications (Lee and Kuhn, International Frontal Sinus Anatomy Classification) neglect them. Read More

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https://www.termedia.pl/doi/10.5114/wiitm.2018.75885
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http://dx.doi.org/10.5114/wiitm.2018.75885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174175PMC
September 2018
3 Reads

Three-Dimensional Volume Imaging to Increase the Accuracy of Surgical Management in a Case of Recurrent Chordoma of the Clivus.

Am J Case Rep 2018 Oct 2;19:1168-1174. Epub 2018 Oct 2.

Department of Orthodontics and Radiology, School of Dentistry, University City of São Paulo (UNICID), São Paulo, SP, Brazil.

BACKGROUND The clivus is a depression in the anterior occipital bone of the skull base, posterior to the dorsum sellae, at the junction with the sphenoid bone. Chordoma is a rare tumor arising from embryonic remnants of the notochord and can be locally aggressive with a tendency to recur. The optimal management of this rare tumor remains controversial. Read More

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http://dx.doi.org/10.12659/AJCR.911592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180943PMC
October 2018
2 Reads

The re-anastomosis end-to-end bypass technique: a comprehensive review of the technical characteristics and surgical experience.

Neurosurg Rev 2018 Sep 25. Epub 2018 Sep 25.

Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, No. 50, Yikesong Rd, Haidian District, Beijing, 100093, China.

Re-anastomosis end-to-end bypass is a straightforward subtype of intracranial-intracranial reconstruction technique that has been utilized to treat complex aneurysms and skull base tumors. This simple technique involves connecting the cut ends of an afferent and efferent artery under added tension after excising the lesion. The current study aims to provide a detailed description of the technical pitfalls, ideal anatomical sites and indications, and clinical outcomes for intracranial complex disorders. Read More

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http://dx.doi.org/10.1007/s10143-018-1036-zDOI Listing
September 2018
7 Reads

Cholesteatoma of the External Auditory Canal: Review of Staging and Surgical Strategy.

Otol Neurotol 2018 Dec;39(10):e1026-e1033

Department of Otology, Neurotology and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy.

Introduction: External auditory canal cholesteatomas (EACC) is insidious in nature and rare entity. There are only few case series on EACCs and surgical strategy is not standardized.

Objectives: 1) To elucidate etiology of EACC and cardinal features. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001972DOI Listing
December 2018
2 Reads

Real-Time Navigation-Guided Drilling Technique for Skull Base Surgery in the Middle and Posterior Fossae.

J Neurol Surg B Skull Base 2018 Oct 17;79(Suppl 4):S334-S339. Epub 2018 Jul 17.

Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.

 The usefulness of the bony surface registration method for navigation system image-guided surgery in the lateral or prone position has been reported. This study was performed to evaluate the efficacy of our new real-time navigation-guided drilling technique with bony surface registration for skull base surgery in the middle and posterior fossae.  The study included 29 surgeries for skull base tumors that required drilling of the petrous bone between January 2015 and December 2017 in Shinshu University Hospital. Read More

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http://dx.doi.org/10.1055/s-0038-1667044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133694PMC
October 2018

Complications of Nasoseptal Flap Reconstruction: A Systematic Review.

J Neurol Surg B Skull Base 2018 Oct 20;79(Suppl 4):S291-S299. Epub 2018 Aug 20.

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

 The nasoseptal flap (NSF) is considered the primary vascularized flap for reconstruction of dural defects with endoscopic endonasal surgery (EES) of the skull base. However, the complications and morbidities associated with this reconstructive flap are poorly understood. This article presents a systematic review of the complications and morbidities related to the use of the NSF in skull base surgery. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1668158
Publisher Site
http://dx.doi.org/10.1055/s-0038-1668158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133677PMC
October 2018
15 Reads

EC-IC bypass for cerebral revascularization following skull base tumor resection: Current practices and innovations.

J Surg Oncol 2018 Oct 9;118(5):815-825. Epub 2018 Sep 9.

Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Complex skull base tumors can involve critical vessels of the head and neck. To achieve a gross total resection, vessel sacrifice may be necessary. In cases where vessel sacrifice will cause symptomatic cerebral ischemia, surgical revascularization is required. Read More

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http://dx.doi.org/10.1002/jso.25178DOI Listing
October 2018

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

Oper Neurosurg (Hagerstown) 2018 Sep 4. Epub 2018 Sep 4.

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
September 2018
1 Read

Combined endoscopic and transcervical approach for free flap reconstruction of nasopharyngeal and clival defects: A case report.

Microsurgery 2018 Sep 3. Epub 2018 Sep 3.

Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.

We report a case during which a new method of reconstruction for a nasopharyngeal and skull base defect was successfully performed. A 45-year-old female with granulomatosis with polyangiitis presented with computed tomography (CT) findings demonstrative of chronic clival and cervical spine osteomyelitis secondary to nasopharyngeal destruction. The posterior nasopharyngeal defect, evident as a wide area of mucosal erosion exposing the clivus centrally, was successfully reconstructed with an anterior serratus muscle-free tissue transfer via both transcervical and endoscopic transnasal approaches utilizing a laparoscopic fixation device, a previously unreported method for free flap inset, to secure the free flap. Read More

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http://doi.wiley.com/10.1002/micr.30363
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http://dx.doi.org/10.1002/micr.30363DOI Listing
September 2018
5 Reads

Outcomes of reconstruction after temporal bone resection for malignancy.

J Craniomaxillofac Surg 2018 Oct 11;46(10):1856-1861. Epub 2018 Aug 11.

Tina and Rick Caruso Department of Otolaryngology and Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address:

Reconstruction after temporal bone resection (TBR) is challenging due to the lack of consensus on an optimal approach. Records of the Keck Hospital of USC were searched to identify, collect and group data on patients who underwent TBR for malignancy. Chi-square analysis was used for categorical variables, and ANOVA was used for continuous variables. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10105182183015
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http://dx.doi.org/10.1016/j.jcms.2018.08.002DOI Listing
October 2018
9 Reads

Application of computer-assisted navigation systems in oral and maxillofacial surgery.

Jpn Dent Sci Rev 2018 Aug 7;54(3):139-149. Epub 2018 May 7.

Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan.

The oral and maxillofacial region has a complicated anatomy with critical contiguous organs, including the brain, eyes, vital teeth, and complex networks of nerves and blood vessels. Therefore, advances in basic scientific research within the field of intraoperative oral and maxillofacial surgery have enabled the introduction of the features of these techniques into routine clinical practice to ensure safe and reliable surgery. A navigation system provides a useful guide for safer and more accurate complex in oral and maxillofacial surgery. Read More

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http://dx.doi.org/10.1016/j.jdsr.2018.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094868PMC

Abdominal Fat Graft for Sellar Reconstruction: Retrospective Outcomes Review and Technical Note.

Oper Neurosurg (Hagerstown) 2018 Aug 16. Epub 2018 Aug 16.

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

Background: The transsphenoidal approach is the standard of care for the treatment of pituitary adenomas and is increasingly employed for many anterior skull base tumors. Persistent postoperative cerebrospinal fluid (CSF) leaks can result in significant complications.

Objective: To analyze our series of patients undergoing abdominal fat graft repair of the sellar floor defect following transsphenoidal surgery, describe and investigate our current, routine technique, and review contemporary and past methods of skull base repair. Read More

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http://dx.doi.org/10.1093/ons/opy219DOI Listing

Using Three-Dimensional Printing to Create Individualized Cranial Nerve Models for Skull Base Tumor Surgery.

World Neurosurg 2018 Dec 16;120:e142-e152. Epub 2018 Aug 16.

Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing, China. Electronic address:

Objective: Using three-dimensional (3D) printing to create individualized patient models of the skull base, the optic chiasm and facial nerve can be previsualized to help identify and protect these structures during tumor removal surgery.

Methods: Preoperative imaging data for 2 cases of sellar tumor and 1 case of acoustic neuroma were obtained. Based on these data, the cranial nerves were visualized using 3D T1-weighted turbo field echo sequence and diffusion tensor imaging-based fiber tracking. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.236DOI Listing
December 2018
16 Reads

A Simple and Reliable Submental Intubation Technique for Maxillofacial Fractures.

J Craniofac Surg 2018 Oct;29(7):1952-1955

Department of Plastic Surgery, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan.

In 1986, Altemir first reported the use of submental intubation to avoid tracheotomy in patients with panfacial and midfacial fractures for whom intermaxillary fixation is necessary, but orotracheal and nasotracheal intubations are not recommended. This novel technique allowed intraoperative access to perform dental occlusion and reconstruction of the nasal pyramid in patients with skull base fractures. Herein, we describe a refined technique based on Altemir's original procedure. Read More

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http://dx.doi.org/10.1097/SCS.0000000000004628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200376PMC
October 2018
10 Reads

Complete Cavernous Sinus Resection: An Analysis of Complications.

World Neurosurg 2018 Nov 1;119:89-96. Epub 2018 Aug 1.

Neurorestoration Center, Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, USA. Electronic address:

Background: Complete cavernous sinus resection has been described for patients with malignant or recurrent cavernous sinus tumors without other therapeutic options but has been associated with high morbidity and mortality rates. We reviewed the complications associated with complete cavernous sinus resection to gain insights for future complication avoidance.

Methods: A retrospective analysis of a prospective, single-institution database was performed to identify patients who had undergone complete cavernous sinus resection from July 2014 to October 2017. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.206DOI Listing
November 2018
3 Reads

Pediatric free flap reconstruction for head and neck defects.

Curr Opin Otolaryngol Head Neck Surg 2018 Oct;26(5):334-339

Department of Otorhinolaryngology-Head and Neck Surgery, Jose R. Reyes Memorial Medical Center, San Lazaro Compound, Rizal Avenue Sta. Cruz, Manila, Philippines.

Purpose Of Review: The aim of this study was to review recent literature on the use of pediatric free flap reconstruction for head and neck defects with focus on skull base, congenital deformities, mandibular reconstruction and operative considerations.

Recent Findings: Reconstruction of the skull base depends on the defect size, location, bony involvement, and pedicle length with a variety of flaps to choose from. Free flaps may be used to correct congenital anomalies due to facial clefts and syndromic causes requiring bony and tissue bulk. Read More

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http://dx.doi.org/10.1097/MOO.0000000000000473DOI Listing
October 2018

Technique for reconstruction of large clival defects through an endoscopic-assisted tunneled retropharyngeal approach.

Int Forum Allergy Rhinol 2018 Dec 2;8(12):1454-1458. Epub 2018 Aug 2.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Background: Reconstruction of the clivus and posterior cranial base defects following endoscopic skull-base surgery can be particularly challenging. Commonly, defects in this region are repaired with pedicled mucoperichondrial flaps from the sinonasal cavity. Complex and large defects often require regional or free flaps, particularly when intranasal flaps have been exhausted. Read More

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http://doi.wiley.com/10.1002/alr.22187
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http://dx.doi.org/10.1002/alr.22187DOI Listing
December 2018
16 Reads

Left orbital roof giant cell tumor of bone: A case report.

Surg Neurol Int 2018 26;9:127. Epub 2018 Jun 26.

Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Background: Giant cell tumor of bone originating from the connective tissue within the bone marrow is benign but locally aggressive lesion. In all, 90% of the cases involve the epiphysis of long bones and less than 2% involve the skull. Giant cell tumors of the skull occur most frequently in the sphenoid and temporal bones, and very rarely in the ethmoid, frontal, parietal, and occipital bones. Read More

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http://dx.doi.org/10.4103/sni.sni_467_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034354PMC
June 2018
10 Reads

Modified nasal floor and inferior meatus flap for septal perforation repair. Extension and limits.

Rhinology 2018 Dec;56(4):386-392

Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.

Background: The nasal floor and inferior meatus (NFIM) flap represents an available option for the reconstruction of a septal perforation (SP). This study explores the feasibility of repairing SPs using a modified simple and extended (including inferior turbinate) NFIM flap.

Methods: An anatomic study was achieved in fresh frozen cadaveric specimens to measure the area and lengths of NFIM flap. Read More

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http://dx.doi.org/10.4193/Rhin18.036DOI Listing
December 2018

Lateral Supraorbital Versus Pterional Approach: Analysis of Surgical, Functional, and Patient-Oriented Outcomes.

World Neurosurg 2018 Nov 18;119:e192-e199. Epub 2018 Jul 18.

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

Background: Recently, the lateral supraorbital (LSO) keyhole variant of the standard pterional (PT) approach has been popularized for anterior skull base surgery, because it provides good anatomic exposition, reduced complications, and better aesthetic and functional results. However, these aspects have been formally compared only by a limited number of studies. We reviewed our experience with 50 consecutive anterior communicating artery (AComA) and A1/A2 aneurysms. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.091DOI Listing
November 2018

Pitfalls of skull base reconstruction in endoscopic endonasal approach.

Neurosurg Rev 2018 Jul 7. Epub 2018 Jul 7.

Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

Various skull base reconstruction techniques have been developed in endoscopic endonasal approach (EEA) for skull base lesions to prevent postoperative cerebrospinal fluid (CSF) leakage. This study was performed to evaluate the efficacy and pitfalls of our method of skull base reconstruction after EEA. A total of 123 patients who underwent EEA (127 surgeries) between October 2014 and May 2017 were reviewed. Read More

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http://dx.doi.org/10.1007/s10143-018-1006-5DOI Listing
July 2018
2 Reads

Surgical Management of Sphenoid Sinus Lateral Recess Cerebrospinal Fluid Leaks: A Single Neurosurgical Center Analysis of Endoscopic Endonasal Minimal Transpterygoid Approach.

World Neurosurg 2018 Oct 6;118:e473-e482. Epub 2018 Jul 6.

Department of Neurosurgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. Electronic address:

Objective: To review the results of sphenoid sinus lateral recess (SSLR) cerebrospinal fluid (CSF) leaks treated with the endoscopic endonasal minimal transpterygoid approach (EEMTPA) and to discuss the surgical technique and outcomes.

Methods: We performed a retrospective analysis of 13 cases who underwent SSLR CSF leak repair through the EEMTPA in our clinic between September 2008 and December 2017. Demographic and etiological features with reconstruction and surgical outcomes were examined. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.06.219DOI Listing
October 2018
5 Reads

Accuracy of two midsagittal planes in three-dimensional analysis and their measurement in patients with skeletal mandibular deviation: a comparative study.

Br J Oral Maxillofac Surg 2018 Sep 4;56(7):600-606. Epub 2018 Jul 4.

The Second Orthodontic Department, China Medical University School & Hospital of Stomatology, Shenyang 110002, Liaoning, China; Key Laboratory of oral diseases of Liaoning Province, the Second Orthodontic Department, China Medical University School & Hospital of Stomatology, Shenyang 110002, Liaoning, China. Electronic address:

Our aim was to evaluate the accuracy of two midsagittal planes (MSP) to provide a better reference plane for studying the 3-dimensional structural symmetry in patients with skeletal mandibular deviation. Thirty adult patients with facial asymmetry were admitted to the Department of Orthodontics, Hospital of Stomatology, between January 2015 and 2017. The DICOM data were collected and reconstructed using ProPlan CMF 2. Read More

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http://dx.doi.org/10.1016/j.bjoms.2018.06.009DOI Listing
September 2018
2 Reads

Recurrent fibrosarcoma of maxillary sinus involving the cranial base: A rare case.

J Cancer Res Ther 2018 Jun;14(Supplement):S542-S543

Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518001, China.

Adult fibrosarcoma (FS) of the maxillary sinus and the cranial base is a rare soft tissue sarcoma which is clinically characterized by a high frequency of local repeated recurrence if not excised widely. At present, the standard treatment option for FS is surgical resection. Here, we report a case of a 46-year-old male with a 5 months history recurrent FS of the maxillary sinus. Read More

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http://dx.doi.org/10.4103/0973-1482.176180DOI Listing