2,343 results match your criteria Skull Base Reconstruction


Incidence and Predictive Factors for Additional Opioid Prescription after Endoscopic Skull Base Surgery.

J Neurol Surg B Skull Base 2020 Jun 12;81(3):301-307. Epub 2019 Jun 12.

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, United States.

 Postoperative pain management and opioid use following endoscopic skull base surgery (ESBS) is not well understood. A subset of patients requires additional opioid prescription (AOP) in the postoperative period. The objective of this study is to describe the incidence of AOP, as well as evaluate patient and surgical characteristics that may predict additional pain management requirements following ESBS. Read More

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http://dx.doi.org/10.1055/s-0039-1692473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253308PMC

Sellar Diaphragm Reconstruction with Tachosil During Endoscopic Endonasal Surgery: Technical Note.

J Neurol Surg B Skull Base 2020 Jun 28;81(3):275-279. Epub 2019 May 28.

Department of Rhinology, Hospital Universitario HM Puerta del Sur, Madrid, Spain.

This report introduces a new closure technique for the management of intraoperative cerebrospinal fluid (CSF) leakage during endoscopic endonasal surgery. The procedure is based on the combination of a traditional autologous tissue flap with a heterologous fibrin graft (TachoSil). We performed a retrospective analysis on 121 patients with pituitary adenomas treated in our center by the senior neurosurgeon (author V. Read More

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http://dx.doi.org/10.1055/s-0039-1688781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253299PMC

An Assessment of Globe Position Dynamics following Transcranial Lateral and Superior Orbital Wall Resections without Rigid Reconstruction: A Case Series of 55 Patients.

J Neurol Surg B Skull Base 2020 Jun 21;81(3):244-250. Epub 2019 May 21.

Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States.

 There is no consensus exists regarding which reconstructive approach, if any, should be used after performing transcranial lateral orbital wall resections. Rigid reconstruction is often done to prevent enophthalmos; however, it is not clear if this is a risk with extensive orbital wall resections for transcranial surgery.  To assess globe position dynamics in patients that underwent transcranial lateral and superior orbital wall resections without rigid reconstruction to determine if enophthalmos is a significant risk. Read More

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http://dx.doi.org/10.1055/s-0039-1688773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253305PMC

Traumatic non-missile penetrating transnasal anterior skull-base fracture and brain injury with cerebrospinal fluid leak: intraoperative leak detection and an effective reconstruction procedure for a localized skull base defect especially after COVID-19 outbreak.

World Neurosurg 2020 Jun 1. Epub 2020 Jun 1.

Departments of Neuorsurgery.

Background: Cerebrospinal fluid leakage in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture.

Case Description: We report a case of a 65-year-old beekeeping man who presented with epistaxis and serous rhinorrhea. When he fell down on the ground near his bee boxes, a garden pole poked into his right nostril. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.236DOI Listing

Cerebrospinal fluid leakage due to nasoseptal flap partial necrosis: A pitfall for skull base reconstruction of endoscopic endonasal surgery.

Surg Neurol Int 2020 23;11:121. Epub 2020 May 23.

Departments of Neurosurgery, Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, Japan.

Background: Vascularized nasoseptal flaps allow for the reconstruction of large dural defects and have remarkably reduced the incidence of postoperative complications during endoscopic endonasal skull base surgery. Nevertheless, some complications related to nasoseptal flap have been reported. Flap necrosis is a rare, but serious issue is associated with meningitis and cerebrospinal fluid (CSF) leak. Read More

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http://dx.doi.org/10.25259/SNI_117_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265470PMC

Sellar trough technique for endoscopic endonasal transclival repair.

Surg Neurol Int 2020 9;11:99. Epub 2020 May 9.

Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States.

Background: Endoscopic endonasal transclival approaches provide direct access to the ventral skull base allowing the treating of clival and paraclival pathology without the manipulation of the brain or neurovascular structures. Postoperative spinal fluid leak, however, remains a challenge and various techniques have been described to reconstruct the operative defect. The "gasket seal" has been well-described, but has anatomic challenges when applied to clival defects. Read More

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http://dx.doi.org/10.25259/SNI_6_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265379PMC

Diagnosis and treatment of congenital nasal dermoid and sinus cysts in 11 infants: A consort compliant study.

Medicine (Baltimore) 2020 May;99(21):e19435

Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.

There have been few studies on congenital nasal dermoid and sinus cysts (NDSCs) in infants.This study was performed to obtain clinical data for the diagnosis and treatment of NDSCs in infants.We performed a retrospective analysis of 11 infants admitted with NDSCs between 2014 and 2019. Read More

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http://dx.doi.org/10.1097/MD.0000000000019435DOI Listing

Repair of the sellar floor using bioresorbable polydioxanone foils after endoscopic endonasal pituitary surgery.

Neurosurg Focus 2020 Jun;48(6):E16

Objective: Postoperative CSF leakage is the most common unwanted sequela of transnasal pituitary surgery. The individual anatomy, the extent of the sellar opening, and the occurrence of an intraoperative CSF leak add to the risk of postoperative rhinorrhea. Despite the current sophistication and recent developments in pituitary surgery, watertight closure of the sellar floor remains a matter of concern. Read More

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http://dx.doi.org/10.3171/2020.3.FOCUS2064DOI Listing

Giant nasofrontal meningioma: endoscopic and transcranial approach followed by microvascularized vastus laterallis flap reconstruction.

Childs Nerv Syst 2020 May 26. Epub 2020 May 26.

Department of Plastic Surgery, Hospital La Fe, Valencia, Spain.

A 12-year-old girl presented with headache, nasal voice, and anosmia. Magnetic resonance imaging demonstrated a 11 × 9 × 8-cm tumor extending from the nasal cavity to the frontal lobes. Histological analysis was consistent with transitional meningioma WHO grade I. Read More

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http://dx.doi.org/10.1007/s00381-020-04684-6DOI Listing

Cross-reinforcing suturing and intranasal knotting for dural defect reconstruction during endoscopic endonasal skull base surgery.

Acta Neurochir (Wien) 2020 May 16. Epub 2020 May 16.

Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.

Background: With technical improvement, accumulating lesions could be resected using endoscopic endonasal surgery. However, cerebrospinal fluid leakage is still a concern. Intraoperative dural defect reconstruction is critical. Read More

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http://dx.doi.org/10.1007/s00701-020-04367-wDOI Listing

Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap.

Braz J Otorhinolaryngol 2020 Apr 27. Epub 2020 Apr 27.

Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil; Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.

Introduction: Endoscopic transnasal access to the skull base, both for treatment and reconstruction, can cause olfactory morbidity. Knowing the main consequences of this intervention is essential to have objective criteria for decision-making regarding the appropriate surgical technique.

Objectives: The aim of this study is to determine the impact on olfactory function of the endonasal endoscopic access to the skull base with the creation of the nasoseptal flap. Read More

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http://dx.doi.org/10.1016/j.bjorl.2020.03.006DOI Listing

Experience With the Endoscopic Contralateral Transmaxillary Approach to the Petroclival Skull Base.

Laryngoscope 2020 May 15. Epub 2020 May 15.

Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Objectives/hypothesis: The contralateral transmaxillary (CTM) approach is a new surgical approach that improves the surgical trajectory relative to the petrous segment of the internal carotid artery (ICA). Here, we present our clinical experience with the CTM approach to the petroclival region of the skull base.

Study Design: Retrospective review. Read More

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http://dx.doi.org/10.1002/lary.28740DOI Listing

Comparison of a purely endoscopic three-layer technique versus pericranial flap for reconstruction of anterior skull base defects after sino-nasal tumor resection: assessment of postoperative frontal lobe sagging and frontal lobe falling.

Rhinology 2020 May 12. Epub 2020 May 12.

Otorhinolaryngology, Audiology and Phoniatrics Operative Unit, Azienda Ospedaliero Universitaria Pisana, Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, Pisa, Italy.

Background: The evolution of endoscopic skull base approaches has enabled surgeons to manage selected skull base tumors through a transnasal endoscope-assisted approach. On the other side, more extensive lesions may require a combined cranioendoscopic approach. In this paper, we analysed and compared the incidence of frontal lobe sagging after endoscopic multilayer (EM) reconstruction versus pericranial flap (PF) reconstruction. Read More

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http://dx.doi.org/10.4193/Rhin19.431DOI Listing

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity.

Semin Plast Surg 2020 May 6;34(2):99-105. Epub 2020 May 6.

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

Multiple anterior surgical approaches are available to obtain access to the nasopharynx, clivus, and craniocervical junction. These include the direct and transoral robotic surgery transpalatal, maxillary swing, and endoscopic endonasal approaches. In this article, we describe the indications for these techniques, surgical steps, and associated morbidities. Read More

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http://dx.doi.org/10.1055/s-0040-1709432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202914PMC

Management and Outcomes of Spontaneous Cerebrospinal Fluid Otorrhoea.

Front Surg 2020 21;7:21. Epub 2020 Apr 21.

Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.

A cohort of patients with spontaneous cerebrospinal fluid (sCSF) otorrhoea. To report surgical outcome and discuss a treatment protocol. Between 2012 and 2018 all patients presenting with sCSF were collected and data assessment was performed including clinical symptoms (hearing loss, aural fullness, meningitis, recurrent otitis media), preoperative audiometry, CT and MRI scanning. Read More

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http://dx.doi.org/10.3389/fsurg.2020.00021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186757PMC

Contributing factors for delayed postoperative cerebrospinal fluid leaks and suggested treatment algorithm.

Int Forum Allergy Rhinol 2020 Jun 3;10(6):779-784. Epub 2020 May 3.

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

Background: Delayed postoperative cerebrospinal fluid (CSF) leaks are uncommon and largely unstudied complications. In this study we aim to identify their etiology and understand the efficacy of various reconstruction strategies.

Methods: A retrospective chart analysis of 1017 endonasal skull base surgeries performed by a single neurosurgeon was completed identifying delayed CSF leaks (occurring >1 week after surgery). Read More

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http://dx.doi.org/10.1002/alr.22544DOI Listing

The expanded endonasal approach in pediatric skull base surgery: A review.

Laryngoscope Investig Otolaryngol 2020 Apr 4;5(2):313-325. Epub 2020 Mar 4.

Otolaryngology-Head and Neck Surgery The Ohio State University Columbus Ohio USA.

Objective: Surgery of the pediatric skull base has multiple unique challenges and has seen recent rapid advances. The objective of this review is to assess key issues in pediatric skull base surgery (SBS), including anatomic limitations, surgical approaches, reconstruction techniques, postoperative care, complications, and outcomes.

Data Sources: PubMed literature review. Read More

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http://dx.doi.org/10.1002/lio2.369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178460PMC

Endoscopic Anterior Skull Base Reconstruction: A Meta-Analysis and Systematic Review of Graft Type.

World Neurosurg 2020 Apr 21. Epub 2020 Apr 21.

UC Irvine Department of Otolaryngology - Head and Neck Surgery, Irvine, CA, USA; UC Irvine Department of Neurological Surgery, Irvine, CA, USA. Electronic address:

Objective: The influence of graft type (non-autologous versus autologous) on surgical outcomes in endoscopic anterior skull base (EASB) reconstruction is not well-understood. This review systematically evaluated rates of post-operative complications of EASB repairs that utilized autologous or non-autologous grafts.

Methods: Original studies reporting EASB reconstruction outcomes were extracted from PubMed, Ovid, and Cochrane Library from database inception to 2019. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.089DOI Listing

Morbidity in the postoperative follow-up of endoscopic anterior skull base surgery.

Braz J Otorhinolaryngol 2020 Apr 11. Epub 2020 Apr 11.

Departamento de Morfologia da Faculdade de Medicina da Universidade de Brasília, Brasília, DF, Brazil.

Introduction: Endoscopic access to the sellar region by videoendoscopy shows a low rate of surgical complications, with findings that indicate risk factors for reducing morbidities during and after the postoperative period.

Objective: To evaluate, over a nine-year period, the acquisition of skills by the anterior skull base surgical team, according to the time of elimination of nasal crusts and/or the presence of morbidities in the postoperative follow-up of individuals treated in a tertiary public hospital.

Methods: After confirming the diagnosis of skull base pathologies, the individuals in this study underwent endoscopic surgery according to the rostrocaudal or coronal axis. Read More

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http://dx.doi.org/10.1016/j.bjorl.2020.02.006DOI Listing

Surgical Management of Skull Base Osteoradionecrosis in the Cancer Population - Treatment Outcomes and Predictors of Recurrence: A Case Series.

Oper Neurosurg (Hagerstown) 2020 Apr 23. Epub 2020 Apr 23.

Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: Skull base osteoradionecrosis (ORN) is a challenging treatment-related complication sometimes seen in patients with cancer. Although ORN management strategies for other anatomic sites have been reported, there is a paucity of data guiding the management of skull base ORN.

Objective: To report a single-center tertiary care series of skull base ORN and to better understand the factors affecting ORN recurrence after surgical management. Read More

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http://dx.doi.org/10.1093/ons/opaa082DOI Listing

"Parachute" Technique for Reconstruction of Small Skull Base Defects of the Ventral Skull Base.

Laryngoscope 2020 Apr 21. Epub 2020 Apr 21.

Otorhinolaryngology Department-Skull Base Center, Lariboisière Hospital, Paris, France.

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http://dx.doi.org/10.1002/lary.28660DOI Listing

Finite element analysis to determine the cause of ring fractures in a motorcyclist's head.

Leg Med (Tokyo) 2020 Apr 7;45:101697. Epub 2020 Apr 7.

Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science, Ministry of Justice, 1347 West Guangfu Road, Shanghai, China. Electronic address:

The finite element (FE) method can potentially help in reconstructing skull fracture biomechanisms, enabling differentiation of the injury patterns caused by traffic accidents. This study aims to (1) reconstruct a motorcycle driver-car accident case using the total human model for safety and FE simulations; and (2) analyze the biomechanisms of fatal ring fractures in the motorcyclist's skull base to determine if the fatal craniocerebral injuries were caused by a fall onto the highway after hitting a pedestrian or by the subsequent impact of a car. We simulated a series of loading scenarios of falls onto the road and impacts by a car, with and without a helmet being used. Read More

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http://dx.doi.org/10.1016/j.legalmed.2020.101697DOI Listing
April 2020
1.441 Impact Factor

A case report of Gorham-Stout disease diagnosed during the course of recurrent meningitis and cholesteatoma.

J Otolaryngol Head Neck Surg 2020 Apr 16;49(1):18. Epub 2020 Apr 16.

Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Background: Gorham-Stout disease is a rare bone disorder. Here, we present a case of Gorham-Stout disease diagnosed during follow-up of a patient with cholesteatoma; the disease affected the temporal bone and other sites of the skull. To the best of our knowledge, this is the first report of Gorham-Stout disease diagnosed with recurrent cerebrospinal leakage after surgery to treat cholesteatoma. Read More

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http://dx.doi.org/10.1186/s40463-020-00412-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161102PMC

Traumatic prolapse of the globe into the anterior cranial fossa: a case report.

BMC Ophthalmol 2020 Apr 3;20(1):128. Epub 2020 Apr 3.

Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing, China.

Background: Orbital fracture associated with traumatic intracranial prolapse of the eyeball is rare. In all previously reported cases, vision was severely impaired with no light perception. Herein, we report a case of traumatic prolapse of the globe into the anterior cranial fossa, in which the patient's vision was preserved by early repositioning. Read More

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http://dx.doi.org/10.1186/s12886-020-01403-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119161PMC

Clinical features of newly developed NF2 intracranial meningiomas through comparative analysis of pediatric and adult patients.

Clin Neurol Neurosurg 2020 Mar 19;194:105799. Epub 2020 Mar 19.

Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address:

Objective: NF2 patients can develop new meningiomas throughout their lifetime. Little is known about the clinical features of newly developed NF2 meningiomas. In this study, we analyzed newly developed NF2 meningiomas in a large patient population. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105799DOI Listing
March 2020
1.248 Impact Factor

Salvage Free Tissue Transfer for Clival Osteoradionecrosis After Repeat Proton Beam Therapy.

World Neurosurg 2020 Mar 27;138:485-490. Epub 2020 Mar 27.

Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.

Background: Craniocervical junction chordoma treated with surgery and Proton Beam Therapy evolved with Osteonecrosis and CSF leak. As the vascularization of the head was compromised, we harvested an Anterolateral thigh musculofascial flap to seal the leak.

Case Description: A 56-year-old man presented with a history of chronic headaches and dysarthria with tongue deviation to the right. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.108DOI Listing

Reconstruction after endoscopic surgery for skull base malignancies.

J Neurooncol 2020 Mar 27. Epub 2020 Mar 27.

Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Introduction: The ability to resect malignancies of the ventral skull base using endoscopic endonasal approaches has created a need for effective endoscopic reconstructive techniques. The purpose of this review is to summarize current techniques for reconstruction of large skull base defects during endoscopic endonasal surgery.

Methods: Recent medical literature was reviewed to identify techniques and best practices for repair of skull base defects during endoscopic endonasal surgery. Read More

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http://dx.doi.org/10.1007/s11060-020-03465-0DOI Listing

Erratum: Increased Defect Size is Associated with Increased Complication Rate after Free Tissue Transfer for Midanterior Skull-Base Reconstruction.

J Neurol Surg B Skull Base 2020 Apr 10;81(2):e1. Epub 2019 Jun 10.

Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

[This corrects the article DOI: 10.1055/s-0038-1676777.]. Read More

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http://dx.doi.org/10.1055/s-0039-1692394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082163PMC

Scalp Reconstruction after Malignant Tumor Resection: An Analysis and Algorithm.

J Neurol Surg B Skull Base 2020 Apr 1;81(2):149-157. Epub 2019 Mar 1.

Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany.

 An oncologic tumor resection of the scalp can result in complex wounds that result in challenging scalp reconstructions. This study aimed to evaluate the outcomes of microvascular-based scalp reconstructions (MSR) in oncologic patients and to propose an algorithmic treatment approach.  Within a 5-year period, 38 patients having undergone 41 MSR (15 anterolateral thigh (ALT), 15 gracilis muscle (GM), and 11 latissimus dorsi muscle (LDM) flaps) after extensive scalp tumor resections fulfilled inclusion criteria for this study. Read More

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http://dx.doi.org/10.1055/s-0039-1683371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082164PMC

Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants.

J Neurol Surg B Skull Base 2020 Apr 1;81(2):142-148. Epub 2019 Mar 1.

Center for Neurosurgery, University Hospital of Cologne, Cologne, Germany.

 Computer-aided design and manufacturing (CAD/CAM) implants are fabricated based on volumetric analysis of computed tomography (CT) scans and are routinely used for the reconstruction of orbital fractures. We present three cases of patients with sphenoorbital meningiomas that underwent tumor resection, orbital decompression, and orbital reconstruction with patient specific porous titanium or acrylic implants in a single procedure.  The extent of bone resection of the sphenoorbital meningiomas was planned in a virtual three-dimensional (3D) environment using preoperative thin-layer CT data. Read More

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http://dx.doi.org/10.1055/s-0039-1681044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082166PMC

Impact of Multilayer Vascularized Reconstruction after Skull Base Endoscopic Endonasal Approaches.

J Neurol Surg B Skull Base 2020 Apr 28;81(2):128-135. Epub 2019 Feb 28.

Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, United States.

 The use of vascularized flap to reconstruct the skull base defects has dramatically changed the postoperative cerebrospinal fluid (CSF) leak rates allowing the expansion of endoscopic skull base procedures. At present, there is insufficient scientific evidence to permit identification of the optimal reconstruction technique after the endoscopic endonasal approach (EEA).  The main purpose of this article is to establish the risk factors for failure in the reconstruction after EEA and whether the use of a surgical reconstruction protocol can improve the surgical results. Read More

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http://dx.doi.org/10.1055/s-0039-1677705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082169PMC

Increased Defect Size is Associated with Increased Complication Rate after Free Tissue Transfer for Midanterior Skull-Base Reconstruction.

J Neurol Surg B Skull Base 2020 Apr 26;81(2):121-127. Epub 2019 Feb 26.

Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

 Complications after skull-base reconstruction are often problematic. We consider that local factors, for example, localization of defect areas are possible risk factors. This study aimed to investigate our case series of skull-base reconstructions in our institution and to identify local risk factors that predispose to wound complications. Read More

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http://dx.doi.org/10.1055/s-0038-1676777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082168PMC

Three-Dimensional Surface Reconstruction of the Human Cochlear Nucleus: Implications for Auditory Brain Stem Implant Design.

J Neurol Surg B Skull Base 2020 Apr 22;81(2):114-120. Epub 2019 Feb 22.

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

 The auditory brain stem implant (ABI) is a neuroprosthesis placed on the surface of the cochlear nucleus (CN) to provide hearing sensations in children and adults who are not candidates for cochlear implantation. Contemporary ABI arrays are stiff and do not conform to the curved brain stem surface. Recent advancements in microfabrication techniques have enabled the development of flexible surface arrays, but these have only been applied in animal models. Read More

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http://dx.doi.org/10.1055/s-0039-1677863DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082162PMC

Audiometric Outcomes and Middle Ear Disease following Cerebrospinal Fluid Leak Repair.

Otolaryngol Head Neck Surg 2020 Jun 24;162(6):942-949. Epub 2020 Mar 24.

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.

Objective: To investigate audiometric outcomes and incidence of chronic ear disease following lateral skull base repair (LSBR) of cerebrospinal fluid (CSF) leaks.

Study Design: Retrospective review.

Setting: Tertiary skull base center. Read More

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http://dx.doi.org/10.1177/0194599820911720DOI Listing

Reconstruction of skull base bone defects using an in situ bone flap after endoscopic endonasal transplanum-transtuberculum approaches.

Eur Arch Otorhinolaryngol 2020 Mar 16. Epub 2020 Mar 16.

Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China.

Purpose: The creation of bone flaps which can be later repositioned and fixed in situ for repairing the bone defects during the endoscopic endonasal approaches (EEAs)-similar to transcranial craniotomies-is still a challenge. We present an in situ bone flap (ISBF) closure for the repair of bone defects after endoscopic endonasal transplanum-transtuberculum approaches (EETAs).

Methods: A retrospective analysis of consecutive patients who underwent the EETAs between January 2016 and February 2019 was performed. Read More

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http://dx.doi.org/10.1007/s00405-020-05911-1DOI Listing

Rational design of secondary operation for penetrating head injury: A case report.

Chin J Traumatol 2020 Apr 11;23(2):84-88. Epub 2020 Mar 11.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041 China. Electronic address:

Penetrating head injury is rare, and thus management of such injuries is non-standard. Early diagnosis and intraoperative comprehensive exploration are necessary considering the complexity and severity of the trauma. However, because of the lack of microsurgical techniques in local hospitals, the possible retained foreign bodies and other postoperative complications such as cerebrospinal fluid (CSF) leak usually require a rational design for a secondary operation to deal with. Read More

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http://dx.doi.org/10.1016/j.cjtee.2019.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156957PMC

Extended Middle Cranial Fossa Approach for Lesions Invading Infratemporal Fossa: Anatomic Study and Clinical Application.

World Neurosurg 2020 Mar 4;138:83. Epub 2020 Mar 4.

Department of Neurosurgery, Carolina Neuroscience Institute, Raleigh, North Carolina, USA.

Skull base tumors arising from the middle cranial fossa and invading of the infratemporal fossa (ITF) and middle cranial fossa are challenging for neurosurgeons, because of complex anatomy and critical neurovascular structure involvement. The first pioneering ITF approaches resulted in invasive procedures and carried a high rate of surgical morbidity. However, the acquisition of deep anatomical knowledge, and the development operative skills and reconstruction techniques allowed surgeons to achieve total or near total resection of many ITF lesions with a low morbidity rate. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.02.141DOI Listing

Surgical management of craniopharyngiomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section.

Acta Neurochir (Wien) 2020 May 28;162(5):1159-1177. Epub 2020 Feb 28.

Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland.

Background And Objective: Craniopharyngiomas are locally aggressive neuroepithelial tumors infiltrating nearby critical neurovascular structures. The majority of published surgical series deal with childhood-onset craniopharyngiomas, while the optimal surgical management for adult-onset tumors remains unclear. The aim of this paper is to summarize the main principles defining the surgical strategy for the management of craniopharyngiomas in adult patients through an extensive systematic literature review in order to formulate a series of recommendations. Read More

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http://dx.doi.org/10.1007/s00701-020-04265-1DOI Listing
May 2020
1.788 Impact Factor

Reconstruction of pediatric skull base defects: A retrospective analysis emphasizing the very young.

Int J Pediatr Otorhinolaryngol 2020 Jun 19;133:109962. Epub 2020 Feb 19.

Department of Otolaryngology Head and Neck Surgery, The Ohio State University, Columbus, OH, USA; Pediatric Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address:

Introduction: Pathology of the pediatric skull base is rare and ranges from congenital defects to malignancy and traumatic defects. Pediatric patients, particularly those ≤6 years of age, present a unique set of anatomic challenges for the skull base surgeon. The goal of this study was to retrospectively review our experience with reconstruction of pediatric skull base defects with particular emphasis on those ≤6 years of age. Read More

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http://dx.doi.org/10.1016/j.ijporl.2020.109962DOI Listing

Lateral nasal wall flap for endoscopic reconstruction of the skull base: anatomical study and clinical series.

Int Forum Allergy Rhinol 2020 May 27;10(5):673-678. Epub 2020 Feb 27.

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Background: The lateral nasal wall (LNW) flap provides vascularized endonasal reconstruction primarily in revision surgery. Although the harvesting technique and reconstructive surface have been reported, the arterial supply to the LNW flap and its clinical implications is not well defined. This study presents anatomical dissections to clarify the vascular supply to this flap, and the associated clinical outcomes from this reconstructive technique. Read More

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http://dx.doi.org/10.1002/alr.22534DOI Listing
May 2020
2.371 Impact Factor

Securing the position of the nasoseptal flap in endoscopic transsphenoidal surgery: No need for a Foley catheter (technical report).

Am J Otolaryngol 2020 Feb 8:102417. Epub 2020 Feb 8.

Division of Neurosurgery, Department of Surgery, Dalhousie University, QEII Health Science Centre, Halifax, NS B3H 3A7, Canada; Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, QEII Health Science Centre, Halifax, NS B3H 2Y9, Canada. Electronic address:

Background: The pedicled nasoseptal mucoperiosteal flap is currently widely used for the reconstruction of a skull base defect following transsphenoidal surgery. The flap is generally secured in position by a Foley catheter balloon. We describe an alternative technique using cylinders of Gelfoam™ (Pfizer Incorporated) to buttress the flap in place, obviating the need for a balloon catheter. Read More

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http://dx.doi.org/10.1016/j.amjoto.2020.102417DOI Listing
February 2020

Angular Vessels for Free-Tissue Transfer in Head and Neck Reconstruction: Clinical Outcomes.

Laryngoscope 2020 Feb 19. Epub 2020 Feb 19.

Section Head Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.

Objectives/hypothesis: To evaluate the efficacy and reconstructive applications of angular vessel microvascular anastomosis in free-tissue transfer.

Study Design: Retrospective cohort study.

Methods: A study of patients treated from January 2010 to July 2017 was performed. Read More

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http://dx.doi.org/10.1002/lary.28540DOI Listing
February 2020

The sellar barrier and intraoperative CSF leak in elderly patients.

J Clin Neurosci 2020 Mar 15;73:48-50. Epub 2020 Feb 15.

Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina; Departamento de Neurocirugía, Hospital Padilla, Tucumán, Argentina.

Cerebral spinal fluid (CSF) leak is a significant complication in pituitary surgery, increasing both patient morbidity and mortality. In a recent publication, Campero et al. observed worse postoperative prognosis and increased risk of intraoperative CSF leak in patients with reduced sellar barrier thickness. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.01.078DOI Listing

Transclival approaches for intradural pathologies: historical overview and present scenario.

Neurosurg Rev 2020 Feb 14. Epub 2020 Feb 14.

Division of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Recently, endoscopic transsphenoidal transclival approaches have been developed and their role is widely accepted for extradural pathologies. Their application to intradural pathologies is still debated, but is undoubtedly increasing. In the past five decades, different authors have reported various extracranial, anterior transclival approaches for intradural pathologies. Read More

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http://dx.doi.org/10.1007/s10143-020-01263-wDOI Listing
February 2020

Reconstruction after open surgery for skull-base malignancies.

J Neurooncol 2020 Feb 13. Epub 2020 Feb 13.

The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 443, Houston, TX, 77030, USA.

Purpose: Resection of skull base malignancies that would have been associated with unacceptable morbidity and mortality in the past are now performed with reliable results due in large part to advancements in reconstructive surgery. The goal of this review is to describe the best evidence-based methods of reconstruction following open surgery for skull base tumors in order to attain improved outcomes for patients.

Methods: A review of recent studies involving reconstruction following open skull base surgeries was performed. Read More

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http://dx.doi.org/10.1007/s11060-019-03370-1DOI Listing
February 2020

Huge Anterior Skull Base Defect Reconstruction on Communicating Between Cranium and Nasal Cavity: Combination Flap of Galeal Flap and Reverse Temporalis Flap.

J Craniofac Surg 2020 Mar/Apr;31(2):436-439

Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Introduction: Traditionally, galeal flap or cranialization was often used to reconstruct the skull base defect caused by trauma or tumor removal. However, in the case of huge skull base defect, galeal flap is not enough to block the communication between nasal cavity and intracranial space. In this study, authors suggest combination flap of galea and reverse temporalis muscle as a method for reconstruction of huge skull base defect. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006221DOI Listing
February 2020
0.676 Impact Factor

[OTOLARYNGOLOGY, HEAD AND NECK SURGERY - VARIETY OF PATHOLOGIES AND MANAGEMENT OPTIONS].

Harefuah 2020 Feb;159(1):74-76

Department of Otolaryngology, Head and Neck Surgery, Lady Davies Carmel Medical Center.

Introduction: The field of otolaryngology, head and neck surgery faces a wide range of medical conditions, starting with upper airway morbidity, head and neck tumors, hearing loss and deafness, ear diseases, nose, sinuses, and anterior skull base conditions, pediatric otolaryngology, laryngology and facial and reconstructive plastic surgery. The current issue of this journal presents a variety of manuscripts that are in the forefront of our specialty in Israel and around the world. The management of laryngeal tumors is undergoing thorough modification aiming to preserve the organ while early tumors are treated endoscopically using laser technology. Read More

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February 2020

Acellular dermal matrix as an alternative to autologous fascia lata for skull base repair following extended endoscopic endonasal approaches.

Acta Neurochir (Wien) 2020 Apr 11;162(4):863-873. Epub 2020 Feb 11.

Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital, 525 East 68th St., Box #99, New York, NY, 10065, USA.

Background: Skull base reconstruction after extended endoscopic endonasal approaches (EEAs) can be challenging. In addition to the nasoseptal flap, which has been adopted by most centers, autologous fascia lata is also often utilized. Harvesting of fascia lata requires a separate thigh incision, may prolong recovery, and results in a visible scar. Read More

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http://dx.doi.org/10.1007/s00701-019-04200-zDOI Listing