2,737 results match your criteria Skull Base Reconstruction


Assessment of intraoperative diffusion EPI distortion and its impact on estimation of supratentorial white matter tract positions in pediatric epilepsy surgery.

Neuroimage Clin 2022 Jun 23;35:103097. Epub 2022 Jun 23.

Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia; Peninsula Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia.

The effectiveness of correcting diffusion Echo Planar Imaging (EPI) distortion and its impact on tractography reconstruction have not been adequately investigated in the intraoperative MRI setting, particularly for High Angular Resolution Diffusion Imaging (HARDI) acquisition. In this study, we evaluated the effectiveness of EPI distortion correction using 27 legacy intraoperative HARDI datasets over two consecutive surgical time points, acquired without reverse phase-encoded data, from 17 children who underwent epilepsy surgery at our institution. The data was processed with EPI distortion correction using the Synb0-Disco technique (Schilling et al. Read More

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Endoscopic endonasal approaches for reconstruction of traumatic anterior skull base fractures and associated cerebrospinal fistulas: patient series.

J Neurosurg Case Lessons 2022 Jun 20;3(25):CASE2214. Epub 2022 Jun 20.

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Background: Post-traumatic cerebrospinal fluid (CSF) leaks of the anterior skull base may arise after traumatic brain injury (TBI). Onset of CSF rhinorrhea may be delayed after TBI and without prompt treatment may result in debilitating consequences. Operative repair of CSF leaks caused by anterior skull base fractures may be performed via open craniotomy or endoscopic endonasal approaches (EEAs). Read More

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Endoscopic Endonasal Reconstruction Using a Pedicled Middle Turbinate Flap for Spontaneous Cerebrospinal Fluid Rhinorrhea.

J Craniofac Surg 2022 May 30;33(3):e318-e320. Epub 2021 Sep 30.

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

Abstract: Although endoscopic skull-base reconstruction protocols to reduce cerebrospinal fluid (CSF) leakage are reported, the most effective management strategies have not been determined. We describe the successful repair of a spontaneous CSF leak using a vascularized middle turbinate flap (MTF) via an endonasal endoscopic approach and also discuss the effective reconstruction with other available pedicled flaps. An 11-year-old girl had a 5-month history of intermittent CSF rhinorrhea. Read More

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Postoperative protocols following endoscopic skull base surgery: An evidence-based review with recommendations.

Int Forum Allergy Rhinol 2022 Jun 9. Epub 2022 Jun 9.

Department of Otolaryngology, Head and Neck Surgery, University of California Irvine, Orange, California, USA.

Background: Postoperative management strategies for endoscopic skull base surgery (ESBS) vary widely because of limited evidence-based guidance.

Methods: The PubMed, EMBASE, and Cochrane databases were systematically reviewed from January 1990 through February 2022 to examine 18 postoperative considerations for ESBS. Nonhuman studies, articles written in a language other than English, and case reports were excluded. Read More

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Stem Cell Therapy in Limb Ischemia: State-of-Art, Perspective, and Possible Impacts of Endometrial-Derived Stem Cells.

Front Cell Dev Biol 2022 23;10:834754. Epub 2022 May 23.

Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Science, Tehran, Iran.

As an evidence-based performance, the rising incidence of various ischemic disorders has been observed across many nations. As a result, there is a growing need for the development of more effective regenerative approaches that could serve as main therapeutic strategies for the treatment of these diseases. From a cellular perspective, promoted complex inflammatory mechanisms, after inhibition of organ blood flow, can lead to cell death in all tissue types. Read More

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Minimally invasive nummular approach to a giant meningioma of the anterior fossa.

Surg Neurol Int 2022 6;13:187. Epub 2022 May 6.

Department of Neurosurgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Background: Several approaches are described for giant meningiomas of the anterior skull base. Recently, endonasal endoscopic approaches have been described as a minimally invasive (MI) alternative. However, the extension of dissection of the nose cavity and the risks of CSF leak do not fit in the MI prerogatives. Read More

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Application of the subdural evacuating port system for the drainage of postoperative tension pneumocephalus: A technical note.

Surg Neurol Int 2022 20;13:204. Epub 2022 May 20.

Department of Neurosurgery, Lenox Hill Hospital, New York City, New York, United States.

Background: Tension pneumocephalus is a neurosurgical emergency requiring prompt intervention. A variety of either temporizing or definitive methods was previously described as part of its management. Here, we report on an off-label use of a bed-side device and the subdural evacuating port system (SEPS)™ for the treatment of tension pneumocephalus. Read More

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[Points and Pitfalls of Deep Dural Suture].

No Shinkei Geka 2022 May;50(3):663-670

Department of Neurosurgery, Nippon Medical School.

Infection, especially meningitis, has always been a problem in transsphenoidal surgery(TSS)for tumors of the sella turcica, and it would not be an exaggeration to say that the history of improvements in transsphenoidal sinus surgery is the history of the battle against meningitis. Furthermore, around 1990, endoscopy was introduced to TSS, and TSS has been applied to median skull base tumors extending beyond the sella turcica and is being performed as extended TSS. As a result, TSS has also been performed for surgeries with large dural defects, and the deep dural suture method(DDSM)has been advocated mainly in Japan while TSS has been improved to prevent cerebrospinal fluid leakage. Read More

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[Basic Concept of Skull Base Reconstructive Surgery].

No Shinkei Geka 2022 May;50(3):586-594

Department of Plastic and Reconstructive Surgery, Graduate School of Medical and Dental Sciences(Medicine), Tokyo Medical and Dental University.

In most cases of anterior cranial fossa defects, the cranial cavity and the nasal cavity are connected, and it is necessary to reconstruct the skull base in a narrow sense to separate both cavities. If the surgical purpose is only separation, reconstruction with a pedicled local flap is often possible. As other surgical purposes such as the reconstruction of surrounding tissues are added, the transplanted tissue volume becomes insufficient, and free tissue transfer is required. Read More

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[History of Skull Base Surgery].

Authors:
Akio Morita

No Shinkei Geka 2022 May;50(3):496-507

Department of Neurological Surgery, Nippon Medical School.

Skull base surgery is a surgical field that involves the cooperation of multiple surgical and medical specialties, including neurosurgery, head-neck surgery, plastic-reconstructive surgery, radiation oncology, as well as multiple medical supporting teams. This field has been developed with the collaborative efforts of these medical specialties, and its history can be divided into five phases: Beginning of surgery(Prior to 1940); Early skull base surgery driven by the ENT-HN surgery group(1940-70); Conventional skull base surgery development based on anatomical, physiological knowledge and microsurgical equipment and technique(1970-90); Reflection and consolidation of the surgical dimension(1995-2005); and Evolution of endoscopic and new skull base surgical techniques(2005-). Several topics and advancements have improved this surgical field, such as access to the cavernous sinus, petrosal-temporal bone, and foramen magnum; concepts of minimally invasive surgical techniques; advanced endoscopic instruments; knowledge of biological assessments; and development of surgical robotics. Read More

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Primary Intraosseous Cavernous Hemangioma of the Cranium: A Systematic Review of the Literature.

World Neurosurg 2022 May 30;164:323-329. Epub 2022 May 30.

Department of Neurosurgery, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Primary intraosseous cavernous hemangioma (PICH) is a rare, benign tumor of vascular origin, typically arising in the vertebral body. Its presence in the skull is exceedingly rare, with only a few cases being reported worldwide. We carried out the first systematic review of the literature, covering the epidemiology, clinical and imaging features, management, and prognosis of cranial PICH. Read More

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Surgical Effects of Resecting Skull Base Tumors Using Pre-operative Multimodal Image Fusion Technology: A Retrospective Study.

Front Neurol 2022 12;13:895638. Epub 2022 May 12.

Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated With Jinan University, China), Zhuhai, China.

Objectives: To analyze the surgical effects of resecting skull base tumors using multimodal three-dimensional (3D) image fusion technology in the neurosurgery department and present some typical cases.

Methods: From October 2019 to October 2021, we included 47 consecutive patients with skull base tumors in the Neurosurgery Department at Zhuhai People's Hospital in this study. Pre-operative head computed tomography and magnetic resonance imaging data acquisition was performed using the GE AW workstation software for registration fusion, image fusion, and 3D reconstruction. Read More

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Safety of restarting continuous positive airway pressure (CPAP) therapy following endoscopic endonasal skull base surgery.

World J Otorhinolaryngol Head Neck Surg 2022 Mar 31;8(1):61-65. Epub 2022 Mar 31.

Department of Otolaryngology, Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia USA.

Objectives: Patients with obstructive sleep apnea (OSA) are at increased risk of perioperative and postoperative morbidity. The use of continuous positive airway pressure (CPAP) in the perioperative period may be of potential benefit. However, among patients who have undergone endonasal skull base surgery, many surgeons avoid prompt re-initiation of CPAP therapy due to the theoretical increased risk of epistaxis, excessive dryness, pneumocephalus, repair migration, intracranial introduction of bacteria, and cerebrospinal fluid (CSF) leak. Read More

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Does reconstruction affect outcomes following exclusively endoscopic endonasal resection of benign orbital tumors: A systematic review with meta-analysis.

World J Otorhinolaryngol Head Neck Surg 2022 Mar 31;8(1):25-35. Epub 2022 Mar 31.

Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery University of Washington Seattle Washington USA.

Objective: As exclusively endoscopic endonasal resection of benign orbital tumors has become more widespread, high-quality outcomes data are lacking regarding the decision of when and how to reconstruct the medial orbital wall following resection. The goal of this study was to systematically review pertinent literature to assess clinical outcomes relative to orbital reconstruction practices.

Methods: Data Sources: PubMed, EMBASE, Web of Science. Read More

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Nasoseptal flap and rigid reconstruction in endoscopic endonasal skull base surgeries: The longitudinal experience of a single center.

Ear Nose Throat J 2022 May 21:1455613221099483. Epub 2022 May 21.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, 191082King Saud University, Riyadh, Saudi Arabia.

Background: Recently, endoscopic endonasal approaches (EEA) have been used for skull base defect reconstruction surgeries. The nasoseptal flap (NSF), a vascular pedicled flap, was introduced to decrease postoperative cerebrospinal fluid (CSF) leakage.

Purposes: This study aimed to outline the authors' institutional experience using NSF and rigid implants in anterior skull base defect reconstruction surgeries following EEA. Read More

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Clinical Impact of Hydroxyapatite on the Outcome of Skull Base Reconstruction for Intraoperative High-Flow CSF Leak: A Propensity Score Matching Analysis.

Front Oncol 2022 4;12:906162. Epub 2022 May 4.

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Background: Despite recent advances in skull base reconstructive techniques, including the multilayer technique during the last decade, complete reconstruction of grade 3 intraoperative high-flow cerebrospinal fluid (CSF) leak remains challenging. This study was designed to investigate the role of injectable hydroxyapatite (HXA) used in the multilayer technique on the clinical outcome of skull base reconstruction for intraoperative high-flow CSF leak.

Materials And Methods: This study enrolled 187 patients who experienced intraoperative high-flow CSF leak after endoscopic endonasal surgery for anterior skull base or suprasellar pathologies between January 2014 and July 2021. Read More

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A computed tomography study on the olfactory fossa in dried skulls.

Surg Radiol Anat 2022 May 11. Epub 2022 May 11.

Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.

Purpose: The computed tomography (CT) study investigates the olfactory fossa (OF) morphometry and morphology.

Methods: Fifty Greek adult dried skulls were macroscopically investigated for the detection of the OF morphological patterns and after a multiplanar CT reconstruction, the OF morphometry was accurately calculated using a digital ruler.

Results: Types I and II surface contour patterns were the most frequently identified (36 and 32%), followed by types III, IV, and V (16, 12, and 4%). Read More

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Patterns of Opioid Usage and Predictors of Utilization Following Endoscopic Skull Base Surgery.

Laryngoscope 2022 May 11. Epub 2022 May 11.

Department of Neurological Surgery, University of California, Irvine, Orange, California, U.S.A.

Objective: Pain control is an important topic that has not been extensively studied in patients undergoing endoscopic skull base surgery (ESBS). The purpose of this study is to identify opioid requirements after ESBS and the risk factors predictive of increased use.

Methods: This study was a retrospective review of all patients undergoing ESBS at a tertiary academic skull base surgery program between July 2018 and August 2020. Read More

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Minimally invasive pericranial flap harvest through a supraorbital eyebrow craniotomy: Technical note in salvage skull base reconstruction.

Clin Neurol Neurosurg 2022 06 26;217:107266. Epub 2022 Apr 26.

Pacific Neuroscience Institute, Santa Monica, CA, USA; Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA. Electronic address:

Background And Importance: The supraorbital eyebrow craniotomy is a minimally invasive approach that provides access to pathologies of the anterior and middle cranial fossae. Vascularized flaps are preferred when considering reconstructive options, however, small incisions may not provide adequate access to vascularized tissue. We present two cases demonstrating a modified technique for harvesting pericranium through an eyebrow supraorbital craniotomy for reconstruction of large skull base defects. Read More

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Current trends in craniofacial reconstruction.

Surgeon 2022 May 4. Epub 2022 May 4.

Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland.

Reconstruction of the head and neck continues to pose a variety of difficult functional and aesthetic challenges to the plastic surgeon. While the surgical treatment for midfacial and skull base tumours continues to advance, the three-dimensional reconstruction predicaments continue to increase in complexity. Reconstructive strategies of the head and neck require the restoration of intricate skeletal architecture and large volumes of both internal and external soft tissue envelopes that can withstand adjuvant therapies. Read More

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Endoscopic Extended Transclival Approach for Lower Clival Meningioma.

World Neurosurg 2022 May 2;164:117. Epub 2022 May 2.

Department of Otorhinolaryngology, University of Tokyo Hospital, Tokyo, Japan.

We present a case of lower clival meningioma treated with the endoscopic transnasal extended transclival approach. A 52-year-old woman with a large clival meningioma had undergone transcondylar approach and posterolateral approach in the previous hospital and presented with mild swallowing difficulty and hypoglossal nerve palsy in the right side. The tumor compressed the medulla oblongata, involving the lower cranial nerves bilaterally and facial nerve on the right side. Read More

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Quick and simple dural threading technique for transsphenoidal surgery - dural tenting, haemostasis and skull base reconstruction.

Acta Neurochir (Wien) 2022 06 2;164(6):1619-1622. Epub 2022 May 2.

Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Turumai-cho, Nagoya City, , Aichi, 466-8550, Japan.

Background: Dural suturing is one of the most robust reconstruction methods in transsphenoidal surgery; however, the technique is considered difficult, primarily due to the restricted range of needle movement.

Method: We performed dural threading during transsphenoidal surgery by holding the needle with forceps as a hook and moving the needle in a distal to proximal direction.

Conclusion: Our dural suturing technique is simple and quick. Read More

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Endoscopic Endonasal Dural Reconstruction for a Cerebrospinal Fluid Leak in the Middle Cranial Fossa of a Patient with Gorham-stout Disease with Skull Base Defect.

NMC Case Rep J 2022 1;9:55-61. Epub 2022 Apr 1.

Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

We report the use of endoscopic endonasal surgery for dural reconstruction following a cerebrospinal fluid leak in a 33-year-old patient with recurrent meningitis since at age of 2 years. Magnetic resonance imaging showed osteolytic changes in the left temporal and sphenoid bones, including the left pterygoid plate, a few left temporal encephaloceles, and cerebrospinal fluid-like fluid in the expanded Meckel's cave and the parapharyngeal space. After endoscopic endonasal surgery, Gorham-Stout disease was diagnosed. Read More

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Pedicled frontal periosteal rescue flap via eyebrow incision for skull base reconstruction (SevEN-002).

BMC Surg 2022 Apr 29;22(1):151. Epub 2022 Apr 29.

Department of Neurosurgery, Yonsei University College of Medicine, 50 Yonsei-ro, 120-752, Seodaemun-gu, Seoul, South Korea.

Purpose: Cerebrospinal fluid (CSF) leakage is one of the major complications after endoscopic endonasal surgery. The reconstructive nasoseptal flap is widely used to repair CSF leakage. However, it could not be utilized in all cases; thus, there was a need for an alternative. Read More

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Augmented reality-assisted craniofacial reconstruction in skull base lesions - an innovative technique for single-step resection and cranioplasty in neurosurgery.

Neurosurg Rev 2022 Apr 20. Epub 2022 Apr 20.

Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Defects of the cranial vault often require cosmetic reconstruction with patient-specific implants, particularly in cases of craniofacial involvement. However, fabrication takes time and is expensive; therefore, efforts must be made to develop more rapidly available and more cost-effective alternatives. The current study investigated the feasibility of an augmented reality (AR)-assisted single-step procedure for repairing bony defects involving the facial skeleton and the skull base. Read More

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Transinfratemporal Fossa Transposition of the Temporalis Muscle Flap for Skull Base Reconstruction after Endoscopic Expanded Nasopharyngectomy: Anatomical Study and Clinical Application.

J Neurol Surg B Skull Base 2022 Apr 11;83(2):159-166. Epub 2021 May 11.

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States.

 Temporalis muscle flap (TMF) is widely used in traditional skull base surgery, but its application in endoscopic skull base surgery remains rarely reported. We aimed to investigate the surgical anatomy and clinical application of TMF for reconstruction of skull base defects after expanded endoscopic nasopharyngectomy.  Nine fresh cadaver heads (18 sides) were used for endoscopic dissection at the University of Pittsburgh School of Medicine in the United States. Read More

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Therapeutic Potential of Microvesicles in Cell Therapy and Regenerative Medicine of Ocular Diseases With an Especial Focus on Mesenchymal Stem Cells-Derived Microvesicles.

Front Genet 2022 29;13:847679. Epub 2022 Mar 29.

Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

These days, mesenchymal stem cells (MSCs), because of immunomodulatory and pro-angiogenic abilities, are known as inevitable factors in regenerative medicine and cell therapy in different diseases such as ocular disorder. Moreover, researchers have indicated that exosome possess an essential potential in the therapeutic application of ocular disease. MSC-derived exosome (MSC-DE) have been identified as efficient as MSCs for treatment of eye injuries due to their small size and rapid diffusion all over the eye. Read More

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Dorsal Approach in the Surgical Treatment of Complex Dorsal Dislocation of Index Metacarpophalangeal Joint; a Case Report.

Arch Acad Emerg Med 2022 9;10(1):e13. Epub 2022 Feb 9.

Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Complex metacarpophalangeal (MCP) joint dislocation is an uncommon entity, which occurs following a hyperextension injury. Closed reduction is not feasible due to entrapped volar plate and/or coexisting fractures. Various approaches and techniques have been proposed for treatment of complex MCP dislocation; however, controversies exist over which one is superior. Read More

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February 2022

Radioanatomical Study of the Skull Base and Septum in Chinese: Implications for Using the HBF for Endoscopic Skull Base Reconstruction.

Authors:
Dongsheng Gu

Oxid Med Cell Longev 2022 29;2022:9940239. Epub 2022 Mar 29.

Department of Otolaryngology-Head and Neck Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an City, Jiangsu Province, China.

Objective: Radioanatomy provides surgeons with different choices to prevent the failure of reconstruction caused by improper flap selection and the occurrence of CSF leakage or other severe complications. To establish a radioanatomical model, this study radioanatomically investigated the use of the Hadad-Bassagasteguy nasoseptal flap (HBF) in skull base reconstruction performed via the transethmoidal, transsphenoidal, and transclival approaches to provide preoperative guidance for the selection of approaches for skull base reconstruction and preparation of the HBF.

Methods: The computed tomography images of 40 Chinese adults were selected for the radioanatomical measurement of data related to the HBF and skull base reconstruction via the transethmoidal, transsphenoidal, and transclival approaches. Read More

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Reconstruction of Skull Base Defects in Pituitary Surgery.

Otolaryngol Clin North Am 2022 Apr;55(2):449-458

Department of Otolaryngology, Albert Einstein College of Medicine, 3400 Bainbridge Avenue, Bronx, NY 10467, USA. Electronic address:

Advancements in sellar floor defect reconstruction have expanded the capacity of skull base surgery complexity. Several investigators have developed grading scales for the intraoperative appearance of the sella following pituitary tumor resection. Certain repairs are unnecessary for lower-grade defects that typically involve low-flow cerebrospinal fluid (CSF) leaks and do not require complex repair techniques. Read More

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