2,531 results match your criteria Skull Base Reconstruction


Simpson Grade I Removal of Tuberculum Sella Meningioma Through the Supraorbital Approach: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 May 14. Epub 2021 May 14.

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

As described by Cushing1 in the chiasmatic syndrome, tuberculum sellae meningiomas induce progressive asymmetrical, incongruous visual loss, which would lead to blindness. The surgical removal of these lesions has been rewarding in regard to visual preservation, or recovery, and has passed the test of time. Optic canal extension, in one or both canals, is a consistent feature of these tumors, and removing the tumor from the optic canals is paramount in the treatment of these lesions. Read More

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Reconstruction of Anterior Skull Base Fracture Using Autologous Fractured Fragments: A Simple Stitching-Up Technique.

Korean J Neurotrauma 2021 Apr 14;17(1):25-33. Epub 2021 Apr 14.

Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Objective: A displaced fracture in the anterior cranial base may be complicated by cerebrospinal fluid (CSF) rhinorrhea and enophthalmos. This study introduces a reconstruction technique with direct dural repair and reduction and fixation of the autologous fractured fragments.

Methods: Displaced fractures in the anterior cranial base were reconstructed using a stitching-up technique: A bicoronal scalp incision and frontal craniotomy was performed and the displaced bone was withdrawn. Read More

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The effect of prior radiation on the success of ventral skull base reconstruction: A systematic review and meta-analysis.

Head Neck 2021 May 11. Epub 2021 May 11.

Department of Otolaryngology - Head & Neck Surgery, M. D. Anderson Cancer Center, Houston, Texas, USA.

The incidence of cerebrospinal fluid leak after ventral skull base reconstruction is a primary outcome of interest to skull base surgeons. Exposure to pre-operative radiation may put patients at an increased risk of skull base reconstructive failure. A systematic search identified studies which included patients receiving ventral skull base reconstruction in the setting of pre-operative radiation. Read More

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Skull base repair following endonasal pituitary and skull base tumour resection: a systematic review.

Pituitary 2021 May 10. Epub 2021 May 10.

Division of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Purpose: Postoperative cerebrospinal fluid rhinorrhoea (CSFR) remains a frequent complication of endonasal approaches to pituitary and skull base tumours. Watertight skull base reconstruction is important in preventing CSFR. We sought to systematically review the current literature of available skull base repair techniques. Read More

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The Infratemporal Retro-Eustachian Transposition of the Temporoparietal Fascial Flap for Clival Reconstruction After Endoscopic Endonasal Approach: An Anatomic Conceptual Technique.

Oper Neurosurg (Hagerstown) 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Stanford Medical Center, Stanford, California, USA.

Background: Reconstruction after endoscopic endonasal approaches is a key element. Lower clivus reconstruction is difficult and most of the times a pedicled flap is not available. As the complexity and the dimensions of the exposure increase, a reliable reconstruction technique becomes more and more important. Read More

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Pyogenic Ventriculitis After Anterior Skull Base Surgery Treated With Endoscopic Ventricular Irrigation And Reconstruction Using a Vascularized Flap.

Acta Med Okayama 2021 Apr;75(2):243-248

Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.

Ventriculitis is a rare, serious complication of neurosurgery. A 59-year-old man who had undergone a craniotomy for a paranasal adenocarcinoma, developed a right frontal cystic lesion. We performed a bifrontal craniotomy to remove the lesion. Read More

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Failure of anterior skull base reconstruction for sinonasal carcinoma: consequence on the postoperative follow up. A multicentre evaluation of management.

Acta Otolaryngol 2021 May 4:1-5. Epub 2021 May 4.

Otolaryngology Head and Neck Surgery Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France.

Background: Numerous techniques for closure of the anterior skull base in cancer patients have a high success rate but management of failure is poorly documented.

Objectives: To standardize the post-operative follow-up after reconstruction surgery of the anterior skull base after removal for sinonasal carcinoma.

Materials And Methods: Retrospective review of failure of anterior skull base reconstruction between 2005 and 2018 in a multicenter setting. Read More

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Free flap transfer, a safe and efficient method for reconstruction of composite skull base defects after salvage resection of advanced intra- and extracranial communicating tumors: Short title Free flap transfer for reconstruction of composite skull base defects.

World Neurosurg 2021 Apr 30. Epub 2021 Apr 30.

Department of Neurosurgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China. Electronic address:

Object: Surgical treatment of advanced intra- and extracranial communicating skull base tumors is challenging, especially for the reconstruction of the large composite defect left by tumor resection. The aim of the study is to evaluate the utility of the free flap reconstruction of the defects resulting from radical resection of these tumors in a single institution.

Methods: The clinical data of 17 consecutive patients who underwent free flap reconstruction for defect left by salvage resection of advanced intra- and extracranial communicating tumors from 2013 to 2019 were retrospectively collected and analyzed. Read More

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Integrated multi-modality image-guided navigation for neurosurgery: open-source software platform using state-of-the-art clinical hardware.

Int J Comput Assist Radiol Surg 2021 May 3. Epub 2021 May 3.

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Purpose: Image-guided surgery (IGS) is an integral part of modern neuro-oncology surgery. Navigated ultrasound provides the surgeon with reconstructed views of ultrasound data, but no commercial system presently permits its integration with other essential non-imaging-based intraoperative monitoring modalities such as intraoperative neuromonitoring. Such a system would be particularly useful in skull base neurosurgery. Read More

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

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

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

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

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Symptomatic ecchordosis physaliphora of the upper clivus: an exceedingly rare entity.

Acta Neurochir (Wien) 2021 Apr 26. Epub 2021 Apr 26.

Division of Neurosurgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.

Objective: This paper highlights the management of 5 patients affected by symptomatic ecchordosis physaliphora (EP), treated via endoscopic endonasal transsphenoidal-transclival approach and contextual multilayer skull base reconstruction. A detailed analysis of each case is provided, along with the review of the current body of literature.

Methods: A retrospective review of patients treated by means of endoscopic endonasal approach for EP from 2010 to 2020 in the Otolaryngology and Neurosurgery Departments of a tertiary-care referral center for endoscopic skull base surgery was analyzed. Read More

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Endoscopic Reconstruction of Skull Base Defects Using Tutoplast.

Allergy Rhinol (Providence) 2021 Jan-Dec;12:21526567211009200. Epub 2021 Apr 9.

Department of Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

Background: Various graft materials that are classified as autografts, xenografts, and allografts based on their origin have been used to endoscopically repair skull base defects. Tutoplast® (Tutogen Medical GmbH), an allogeneic natural collagen matrix, is processed through chemical sterilization that preserves tissue biocompatibility and structural integrity.

Objective: To study the safety and efficacy of Tutoplast Fascia Lata and Tutoplast Temporalis Fascia® as primary graft materials in the endoscopic reconstruction of skull base defects of different sizes and etiologies and to compare the outcomes with those of other traditional graft materials based on our experience. Read More

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Outcomes and Utility of Intracranial Free Tissue Transfer.

Ann Otol Rhinol Laryngol 2021 Apr 21:34894211008699. Epub 2021 Apr 21.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.

Objective: Complications associated with intracranial vault compromise can be neurologically and systemically devastating. Primary and secondary repair of these deficits require an air and watertight barrier between the intracranial and extracranial environments. This study evaluated the outcomes and utility of using intracranial free tissue transfer as both primary and salvage surgical repair of reconstruction. Read More

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Deployment of a bioabsorbable plate as the rigid buttress for skull base repair after endoscopic pituitary surgery.

Gland Surg 2021 Mar;10(3):1010-1017

Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China.

Background: Bioresorbable alloplastic implants have become desirable as a rigid buttress for reconstructing skull base defects. This study aimed to describe the use of a biodegradable plate (PolyMax RAPID) in skull base repair of endoscopic endonasal pituitary surgery and to investigate the clinical outcome and safety of this novel method.

Methods: Between January 2019 and January 2020, 22 patients with pituitary adenomas who underwent endoscopic skull base repair with a Polymax RAPID plate were included. Read More

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Surgical management of intraoperatively diagnosed facial nerve schwannoma located at internal auditory canal and cerebellopontine angle - our experiences of 14 cases.

Acta Otolaryngol 2021 Apr 7:1-5. Epub 2021 Apr 7.

Department of Otology and Skull Base Surgery, Eye & ENT Hospital, Fudan University, Shanghai, PR China.

Background: Facial nerve schwannomas located at internal auditory canal and cerebellopontine angle (IAC/CPA FNS) were diagnosed intraoperatively, it poses a therapeutic dilemma to the surgeon.

Objective: To report our experience in managing IAC/CPA FNS and to propose a treatment strategy.

Methods: A total of 14 patients with IAC/CPA FNS who were diagnosed intraoperatively and treated by operation between 2015 and 2019 were retrospectively studied. Read More

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Post-operative outcomes of different surgical approaches to oropharyngeal squamous cell cancer: a case-matched study.

J Laryngol Otol 2021 Apr 5;135(4):348-354. Epub 2021 Apr 5.

ENT Clinic, Head and Neck Department, University of Trieste, Italy.

Objective: To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management.

Methods: Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared. Read More

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

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

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

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

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Surgical Approaches to the Orbit: Transpalpebral.

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

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

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

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February 2021

Osteocutaneous radial forearm free flap for anterior cranial base reconstruction: Technical note.

Neurochirurgie 2021 Mar 23. Epub 2021 Mar 23.

Département de neurochirurgie, Hôpital Gui-de-Chauliac, Centre hospitalier universitaire de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.

The reconstruction of anterior skull base defects after carcinologic surgery is challenging. Large defects can require the use of autologous free tissue transfer. Currently, most reconstructions use soft-tissue flaps. Read More

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Endoscopic transsphenoidal surgery reconstruction using the fibrin sealant patch Tachosil.

Br J Neurosurg 2021 Mar 26:1-10. Epub 2021 Mar 26.

Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Introduction: The incidence of CSF leak following endoscopic transsphenoidal surgery remains the most important measure in the success of any repair. The nasoseptal flap (NSF) has played a pivotal role in reconstructing defects. However, morbidity associated with the NSF includes bleeding, septal injury, altered smell and crusting. Read More

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Simplifying Access to the Lateral Sphenoid Recess: A Modification of the Transpterygoid Approach.

Am J Rhinol Allergy 2021 Mar 24:19458924211003813. Epub 2021 Mar 24.

Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Meningoencephaloceles originating in the lateral recess of the sphenoid sinus can be difficult to access. Historically, the endoscopic transpterygoid approach was advocated, which carries additional morbidity given the dissection of the pterygopalatine fossa (PPF) contents to provide a direct line approach to the defect. Given our increased facility with angled endoscopes and instrumentation, we now approach this region in a less invasive manner. Read More

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Dislocation of the mandibular condyle into the middle cranial fossa. A case of temporomandibular joint arthroplasty with resorbable fixation system and temporalis myofascial flap: systematic review and meta-analysis.

Br J Oral Maxillofac Surg 2021 05 19;59(4):389-397. Epub 2020 Aug 19.

General Hospital of Mexico "Eduardo Liceaga".

The aims of the present study were to comprehensively assess all the published cases on dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) in the literature in English and describe the clinical, imaging, and therapeutic variables for this condition. An electronic search was undertaken in March 2020 using PubMed/MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases. Eligibility criteria included publications with sufficient information to confirm the diagnosis. Read More

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"Single-step" resection and cranio-orbital reconstruction for spheno-orbital metastasis with custom made implant. A case report and review of the literature.

Int J Surg Case Rep 2021 Apr 11;81:105755. Epub 2021 Mar 11.

Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy.

Introduction And Importance: Brain metastasis involving the skull base is a rare complication of malignant tumors. Besides radiotherapy, surgical treatment is a therapeutical option even though it may apply complex technical procedures that may delay complementary therapies. However, in recent days, the innovation of custom-made implants allows treating selected patients with fewer complications and better results. Read More

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Surgical Management of Skull Base and Spine Chordomas.

Curr Treat Options Oncol 2021 Mar 20;22(5):40. Epub 2021 Mar 20.

Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 442, Houston, TX, 77030-4009, USA.

Opinion Statement: Management of chordoma along the cranial-spinal axis is a major challenge for both skull base and spinal surgeons. Although chordoma remains a rare tumor, occurring in approximately 1 per 1 million individuals, its treatment poses several challenges. These tumors are generally poorly responsive to radiation and chemotherapy, leading to surgical resection as the mainstay of treatment. Read More

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The importance of flaps in reconstruction of locoregionally advanced lateral skull-base cancer defects: a tertiary otorhinolaryngology referral centre experience.

Radiol Oncol 2021 Mar 19. Epub 2021 Mar 19.

Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Background: The aim of the study was to identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer.

Patients And Methods: The retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre was made.

Results: Twelve patients with locoregionally advanced cancer were analysed. Read More

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Risk factor for cerebrospinal fluid leak after endoscopic endonasal skull base surgery: a single-center experience.

Acta Otolaryngol 2021 Mar 18:1-5. Epub 2021 Mar 18.

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Background: One of the major complications in endoscopic endonasal skull base surgery (EESBS) is postoperative cerebrospinal fluid (CSF) leaks. Recently, EESBS has been applied to various skull base diseases as well as more complicated cases influenced by previous treatment with or without various comorbidities.

Aims/objectives: This study aimed to assess the factors that influence the results of postoperative CSF leak after EESBS with mixed patient backgrounds. Read More

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Spontaneous Cerebrospinal Fluid Rhinorrhea from a Prolactin-Secreting Pituitary Macroadenoma.

Cureus 2021 Feb 3;13(2):e13111. Epub 2021 Feb 3.

Neurosurgery, University of Utah, Salt Lake City, USA.

Cerebrospinal fluid (CSF) rhinorrhea is a rare complication of macroprolactinomas that, in the vast majority of cases, is subsequent to either medical or surgical intervention. Here, we present the successful management of a rare case of spontaneous, noniatrogenic CSF rhinorrhea in a patient with an untreated macroprolactinoma. A 27-year-old man with no significant medical history presented with six months of persistent CSF rhinorrhea, which was confirmed by testing for beta-2-transferrin. Read More

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February 2021

Skull base reconstruction: A question of flow? A critical analysis of 521 endoscopic endonasal surgeries.

PLoS One 2021 15;16(3):e0245119. Epub 2021 Mar 15.

Department of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy.

Introduction: Post-operative CSF leak still represents the main drawback of Endoscopic Endonasal Approach (EEA), and different reconstructive strategies have been proposed in order to decrease its rate.

Objective: To critically analyze the effectiveness of different adopted reconstruction strategies in patients that underwent EEA.

Materials And Methods: Adult patients with skull base tumor surgically treated with EEA were retrospectively analyzed. Read More

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Combined Endoscopic and Transoral Approach for Total Maxillectomy.

J Vis Exp 2021 02 26(168). Epub 2021 Feb 26.

Department of Otolaryngology, Eye & ENT Hospital, Fudan University; Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor, Chinese Academy of Medical Sciences;

The technique of maxillectomy has been revised since it was first described in the 1820s. During the past decade, the endoscopic approach has been widely practiced for resecting maxilla. Compared with the traditional approaches, the combined endoscopic and transoral approach has many advantages such as avoiding facial incisions and postoperative scars and better visualization of the surgical margin. Read More

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February 2021

Endoscopic Endonasal Odontoidectomy with Nasopharyngeal Flap Reconstruction.

J Neurol Surg B Skull Base 2021 Feb 23;82(Suppl 1):S12-S13. Epub 2020 Nov 23.

Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States.

 This study aimed to demonstrate the nuances in preoperative management, surgical technique, and reconstruction for an endoscopic endonasal odontoidectomy.  Assembly of an operative video demonstrating technique for endoscopic endonasal odontoidectomy.  this study is a comprehensive skull base team at a tertiary care center. Read More

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February 2021