Residual Tumor Volume and Tumor Progression after Subtotal Resection and Observation of WHO Grade I Skull Base Meningiomas
This study investigated the impact of residual tumor volume (RTV) on tumor progression after subtotal resection and observation of WHO grade I skull base meningiomas. Study Design This study is a retrospective volumetric analysis. Setting This study was conducted at a single institution. Participants Patients who underwent subtotal resection of a WHO grade I skull base meningioma and postsurgical observation (July 1, 2007–July 1, 2017). Main Outcome Measure The main outcome was radiographic tumor progression. Results Sixty patients with residual skull base meningiomas were anal...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2021 Category: Neurosurgery Authors: Przybylowski, Colin J. Hendricks, Benjamin K. Furey, Charuta G. DiDomenico, Joseph D. Porter, Randall W. Sanai, Nader Almefty, Kaith K. Little, Andrew S. Tags: Original Article Source Type: research

Cerebrospinal Fluid Leak after Transsphenoidal Surgery: A Systematic Review and Meta-analysis
Conclusion The overall recent prevalence of CSF leak after TSS in adults is 3.4%. Intraoperative CSF leak and cavernous sinus invasion appear to be significant risk factors for postoperative CSF leak. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - August 20, 2021 Category: Neurosurgery Authors: Slot, Emma M.H. Sabaoglu, Rengin Voormolen, Eduard H.J. Hoving, Eelco W. van Doormaal, Tristan P.C. Tags: Original Article Source Type: research

Treatment Outcomes for Osteoradionecrosis of the Central Skull Base: A Systematic Review
This study is a systematic review. Materials and Methods Two researchers extracted information including patient population, surgical technique, outcomes of interest, and study design. A computerized search of Medline, Embase, and the Cochrane library (January 1990–June 2020) looked for several papers on the subject of skull base ORN. Results A total of 29 studies had met inclusion criteria, including data from 333 patients. Nasopharyngeal carcinoma was the most common primary tumor (85%). Average age at diagnosis of ORN was 55.9 years (range = 15–80 years) and 72.3% of patients we...
Source: Journal of Neurological Surgery Part B: Skull Base - August 18, 2021 Category: Neurosurgery Authors: Shaikh, Noah Makary, Chadi A. Ryan, Lindsey Reyes, Camilo Tags: Original Article Source Type: research

Endoscopic Paramaxillary Approach to the Infratemporal Fossa and Pterygomaxillary Space: Computer Modeling Analysis and Clinical Series
Conclusion The endoscopic paramaxillary approach is a transoral minimally disruptive approach to the ITF and PS that provides excellent surgical exposure for resection of lesions involving these areas. Compared with previously described endoscopic approaches, there are no external incisions; tumor manipulation is straightforward without angled endoscopy, and all areas of the infratemporal fossa and pterygomaxillary space can be accessed. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  | &nb...
Source: Journal of Neurological Surgery Part B: Skull Base - August 18, 2021 Category: Neurosurgery Authors: Konuthula, Neeraja Abuzeid, Waleed M. Humphreys, Ian M. Bly, Randall A. Moe, Kris Tags: Original Article Source Type: research

Intraoperative Indocyanine Green Angiography for Assessing Flap Perfusion in Skull Base Reconstruction: A Systematic Review
Conclusion The available literature suggests intraoperative ICG enhancement is associated with postoperative MRI enhancement. Given the small sample sizes in the literature and the rarity of complications associated with skull base reconstruction, intraoperative ICG enhancement has not been predictive of flap necrosis or postoperative complications such as CSF leak or meningitis. Level of Evidence This study presents level 3 evidence as a systematic review of case studies, case reports, and retrospective and prospective trials with no blinding, controls, and inconsistently applied reference standards. [...] Ge...
Source: Journal of Neurological Surgery Part B: Skull Base - July 19, 2021 Category: Neurosurgery Authors: Shaikh, Noah O'Brien, Daniel Makary, Chadi Turner, Meghan Tags: Original Article Source Type: research

Optimal Diagnostic Criteria and a Staging System for Otogenic Skull Base Osteomyelitis
Conclusion We proposed here the clinically useful diagnostic criteria and staging systems that can predict infection control and prognosis of otogenic SBO. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - July 16, 2021 Category: Neurosurgery Authors: Takahashi, Kuniyuki Morita, Yuka Ogi, Manabu Nonomura, Yoriko Kitazawa, Meiko Yagi, Chihiro Yamagishi, Tatsuya Ohshima, Shinsuke Izumi, Shuji Horii, Arata Tags: Original Article Source Type: research

Comparison of Endoscopic Endonasal Approach and Lateral Microsurgical Infratemporal Fossa Approach to the Jugular Foramen: An Anatomical Study
Conclusion The EEA to the jugular foramen is anatomically feasible but requires mobilization of the ICA to provide access to the anterior and medial aspects of the jugular foramen. The lateral infratemporal approach requires facial nerve transposition to provide access to the lateral and posterior parts of the jugular foramen. A deep understanding of the complex anatomy of this region is paramount for safe and effective surgery of the jugular foramen. Both techniques may be complementary considering the different regions of the jugular foramen accessed with each approach. [...] Georg Thieme Verlag KG Rüdigerstra&...
Source: Journal of Neurological Surgery Part B: Skull Base - July 5, 2021 Category: Neurosurgery Authors: Liu, Jianfeng Pinheiro-Neto, Carlos D. Yang, Dazhang Wang, Eric Gardner, Paul A. Hirsch, Barry E. Snyderman, Carl H. Fernandez-Miranda, Juan C. Tags: Original Article Source Type: research

The Asterion-to-Transverse Process of the Atlas Line as a Surgical Landmark
Conclusion The A-TPC1 line is a helpful landmark reliably found posterior to the sigmoid sinus in cadaveric specimens and radiographic CT scans. It can corroborate the accuracy of neuronavigation, assist in minimizing the risk of sigmoid sinus injury, and is a useful tool in planning surgical approaches to the posterolateral skull base, both preoperatively and intraoperatively. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - July 5, 2021 Category: Neurosurgery Authors: Basma, Jaafar Mahoney, Dom E. Anagnostopoulos, Christos Michael, L. Madison Sorenson, Jeffrey M. Porter, David G. Pichierri, Angelo Tags: Original Article Source Type: research

History, Variations, and Extensions of the Retrosigmoid Approach: Anatomical and Literature Review
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729177The retrosigmoid approach is the workhorse for posterior fossa surgery. It gives a versatile corridor to tackle different types of lesions in and around the cerebellopontine angle. The term “extended” has been used interchangeably in the literature, sometimes creating confusion. Our aim was to present a thorough analysis of the approach, its history, and its potential extensions. Releasing cerebrospinal fluid from the subarachnoid spaces and meticulous microsurgical techniques allowed for the emergence of the retrosigmoid approach as a unilateral variation o...
Source: Journal of Neurological Surgery Part B: Skull Base - July 5, 2021 Category: Neurosurgery Authors: Basma, Jaafar Anagnostopoulos, Christos Tudose, Andrei Harty, Mikhail Michael, L. Madison Teo, Mario Porter, David G. Tags: Original Article Source Type: research

A Volumetric Study of the Corpus Callosum in the Turkish Population
Conclusion The results suggest that compared with females/males, females have a faster decline in the volume of all volumes of the CC. We think that quantitative structural magnetic resonance data of the brain is vital in understanding human brain function and development. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 30, 2021 Category: Neurosurgery Authors: Soysal, Handan Acer, Niyazi Özdemir, Meltem Eraslan, Önder Tags: Original Article Source Type: research

Extended Middle Fossa Approach for Trigeminal Schwannoma Resection
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1727108Trigeminal schwannomas are rare benign tumors, it is second most common intracranial schwannomas after vestibular schwannomas. The management includes not limited to observation, stereotactic radiosurgery/radiotherapy, and/or surgical resection. Tumor size and patient clinical status are the most important factors in management.In this video, we describe the technical nuances of an extended middle fossa approach for large trigeminal schwannoma with cavernous sinus extension resection. A 44-year-old right-handed female with several months' history of progressive right fa...
Source: Journal of Neurological Surgery Part B: Skull Base - June 22, 2021 Category: Neurosurgery Authors: Muhsen, Baha'eddin A. Najera, Edinson Borghei-Razavi, Hamid Adada, Badih Tags: Skull Base: Operative Videos Source Type: research

An Integrated Management Paradigm for Skull Base Chordoma Based on Clinical and Molecular Characteristics
Conclusion Genotypic grouping by 1p36 and homozygous 9p21(p16) deletions can predict prognosis in SBC and guide management. GTR remains the cornerstone of SBC treatment and can be sufficient without AdjXRT in low and intermediate risk tumors. Low-risk tumors are associated with a less invasive phenotype, which makes them more amenable to GTR. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 22, 2021 Category: Neurosurgery Authors: Abdallah, Hussein M. Gersey, Zachary C. Muthiah, Nallammai McDowell, Michael M. Pearce, Thomas Costacou, Tina Snyderman, Carl H. Wang, Eric W. Gardner, Paul A. Zenonos, Georgios A. Tags: Original Article Source Type: research

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies
Conclusion Tumor histology, metastatic sites, and several disease factors affected prognosis in anterior skull base malignancies with DM. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 10, 2021 Category: Neurosurgery Authors: Kraft, Daniel O. Carey, Ryan M. Prasad, Aman Rajasekaran, Karthik Kohanski, Michael A. Kennedy, David W. Palmer, James N. Adappa, Nithin D. Newman, Jason G. Brant, Jason A. Tags: Original Article Source Type: research

Recurrent Sphenocavernous Meningioma
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725941A case of a recurrent sphenocavernous meningioma is presented. The patient is a 42-year-old male who presented with an episode of transient right-sided numbness. A magnetic resonance imaging (MRI) revealed a large left sphenocavernous meningioma. The patient underwent a frontotemporal craniotomy for tumor resection. Near total resection was achieved with minimal residual in the left cavernous sinus (CS) and orbital apex. The pathology was consistent with meningioma, World Health Organization (WHO) grade I. A follow-up MRI was done 9 months after surgery and showed a gro...
Source: Journal of Neurological Surgery Part B: Skull Base - June 8, 2021 Category: Neurosurgery Authors: Inoue, Mizuho Labib, Mohamed Yang, Alexander Youssef, A. Samy Tags: Skull Base: Operative Videos Source Type: research

Cochlear Implantation in Vestibular Schwannoma: A Systematic Literature Review
Conclusions Categorization of hearing outcome into superior performance and inferior performance based on sentence recognition revealed a generally good hearing outcome regardless of treatment or patient population. Select patients with sporadic and NF2 VS may benefit from CI. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 8, 2021 Category: Neurosurgery Authors: Tadokoro, Kent Bartindale, Matthew Robert El-Kouri, Nadeem Moore, Dennis Britt, Christopher Kircher, Matthew Tags: Original Article Source Type: research

Direct Clipping of Paraclinoid Aneurysm in Conjunction with Extradural Anterior Clinoidectomy: Technical Nuance and Functional Outcome
Conclusion We can conclude that our surgical method is safe and can be considered an acceptable treatment. Although surgical stress can cause temporary executive dysfunction shortly after surgery, this decline is temporary. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 3, 2021 Category: Neurosurgery Authors: Tsunoda, Sho Inoue, Tomohiro Takeuchi, Naoko Akabane, Atsuya Saito, Nobuhito Tags: Original Article Source Type: research

Primary Dural Repair Using Titanium Microclips Following Lateral Skull Base Surgery
Conclusion To our knowledge, this is the first report on the use of microclips in repairing dural defects following lateral skull base surgery. Surgical outcomes for this small case series suggest that dural repair of the later skull base with nonpenetrating titanium microclips is a useful adjunct in dural repair following lateral skull base surgery. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 3, 2021 Category: Neurosurgery Authors: Milton, Camille K. Bien, Alexander G. Krempl, Greg A. Sanclement, Jose A. Mhawej, Rachad Glenn, Chad A. Tags: Original Article Source Type: research

Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas
Conclusion The skull base atlas provides an effective way to study essential surgical anatomy and to teach operative strategies in this complex region. Interactive 3D computer graphical environments are highly suitable for conveying complex anatomy and to train and review surgical concepts. They remain underutilized in clinical practice. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - June 3, 2021 Category: Neurosurgery Authors: Kockro, Ralf A. Schwandt, Eike Ringel, Florian Eisenring, Christian Valentin Nowinski, Wieslaw Lucjan Tags: Original Article Source Type: research

Clinical Efficacy of the Multilayered Skull Base Reconstruction Using In Situ Bone Flap in Endoscopic Endonasal Approach for Craniopharyngioma
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1726128 Objective The aim of the study is to summarize and analyze the efficacy of the multilayered skull base reconstruction using in situ bone flap in endoscopic endonasal approach (EEA) for craniopharyngiomas. Methods A retrospective review of 65 patients who underwent resection of their histopathology confirmed craniopharyngiomas performed at a single institution. Based on the team's understanding and mastery of skull base reconstruction techniques, patients were divided into two groups according to the methods of reconstruction in two periods. First (March...
Source: Journal of Neurological Surgery Part B: Skull Base - May 31, 2021 Category: Neurosurgery Authors: Zhou, Yuefei Hei, Yue Soto, Jose M. Jin, Tao Jiang, Xiaofan Feng, Dongxia Liu, Weiping Gao, Dakuan Tags: Original Article Source Type: research

Cost-Effectiveness of Routine Type and Screens in Select Endonasal Skull Base Surgeries
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1730896 Objective The study aimed to evaluate the cost-effectiveness of obtaining preoperative type and screens (T/S) for common endonasal skull base procedures, and determine patient and hospital factors associated with receiving blood transfusions. Study Design Retrospective database analysis of the 2006 to 2015 National (nationwide) Inpatient Sample and cost-effectiveness analysis. Main Outcome Measures Multivariate regression analysis was used to identify factors associated with transfusions. A cost-effectiveness analysis was then performed to deter...
Source: Journal of Neurological Surgery Part B: Skull Base - May 31, 2021 Category: Neurosurgery Authors: Spillinger, Aviv Allen, Meredith Karabon, Patrick Hojjat, Houmehr Shenouda, Kerolos Hussein, Inaya Hajj Jacob, Jeffrey T. Svider, Peter F. Folbe, Adam J. Tags: Original Article Source Type: research

Cerebrovascular Complications of Vestibular Schwannoma Surgery
Conclusion Although radiographic findings suggestive of CVC were unexpectedly common in this cohort, intraoperative vascular injury and postoperative clinical CVC were exceedingly rare. The association between unfavorable facial nerve outcome and clinical CVC is likely a marker for more difficult operations, predisposing to higher risk of complications. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 31, 2021 Category: Neurosurgery Authors: Rayan, Tarek Helal, Ahmed Graffeo, Christopher S. Perry, Avital Carlstrom, Lucas P. Driscoll, Colin L. W. Link, Michael J. Tags: Original Article Source Type: research

A Laboratory Investigation on a Tailored Skin and Muscle Flap Variant for the Retrosigmoid Approach
Conclusion This modified approach provides a wide surgical corridor to access the CPC while ensuring the minimal invasiveness of the standard S-shaped incision. Compared with the latter, it preserves better the integrity of the surrounding soft tissues and appears less likely to cause any iatrogenic injury to occipital muscles and cutaneous nerves. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 31, 2021 Category: Neurosurgery Authors: Chibbaro, Salvatore Cebula, Helene Zaed, Ismail Gubian, Arthur Todeschi, Julien Scibilia, Antonino Nannavecchia, Beniamino Scheer, Louise Bozzi, Maria Teresa Mahoudeau, Pierre Coca, Andres Signorelli, Francesco Djennaoui, Idir Debry, Christian Ganau, Mari Tags: Original Article Source Type: research

Treatment Outcomes of Sinonasal Malignancies Involving the Orbit
This study aimed to analyze the oncological outcomes of sinonasal malignancies involving the orbit. Patients and Methods We reviewed the medical records of 116 patients with a sinonasal malignancy who had orbital invasion at initial diagnosis and followed up at least 6 months between June 1991 and October 2017 at a single institute. The overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) rates according to the clinicopathological factors, extent to orbit, and treatment modality were compared. Results Patients were mainly treated with surgery and postoperative radiatio...
Source: Journal of Neurological Surgery Part B: Skull Base - May 29, 2021 Category: Neurosurgery Authors: Shin, Chul Ho Lee, Ho Jun Chung, Yoo-Sam Kim, Ji Heui Tags: Original Article Source Type: research

Comparative Outcomes by Surgical Approach in Patients with Malignant Sinonasal Disease
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729978 Objective There is a paucity of data on comparative outcomes for open versus endoscopic surgery for patients with malignant sinonasal pathology. Most of the available studies are limited by a sample size
Source: Journal of Neurological Surgery Part B: Skull Base - May 29, 2021 Category: Neurosurgery Authors: Lenze, Nicholas R. Quinsey, Carolyn Sasaki-Adams, Deanna Ewend, Matthew G. Thorp, Brian D. Ebert, Charles S. Zanation, Adam M. Tags: Original Article Source Type: research

Endoscopic Endonasal versus Transcranial Optic Canal Decompression: A Morphometric, Cadaveric Study
Conclusion The endoscopic endonasal and the transcranial approaches provide a similar length of optic canal decompression, but the transcranial approach leads to greater circumferential decompression. The endoscopic endonasal approach has the benefit of being minimally invasive, though. Ultimately, the surgical approach decision should be based on the location of the pathology and the surgeon's comfort. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Ne...
Source: Journal of Neurological Surgery Part B: Skull Base - May 29, 2021 Category: Neurosurgery Authors: Kim, Jun Plitt, Aaron R Vance, Awais Connors, Scott Caruso, James Welch, Babu Garzon-Muvdi, Tomas Tags: Original Article Source Type: research

A Prospective Evaluation of Quality of Life in Patients Undergoing Extended Endoscopic Endonasal Surgery for Benign Pituitary Gland Lesion
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1730322 Introduction Endoscopic endonasal surgery (EES) has become the preferred approach for pituitary tumor resection. Nevertheless, research on quality of life related to pituitary adenoma surgery is scarce. Objective The aim of the study is to evaluate short-term quality of life in patients after endoscopic endonasal resection of pituitary tumors and to find predictors for poor quality of life (QOL) outcome. Materials and Methods A prospective cohort study was conducted, including all patients who underwent EES for pituitary tumors in a tertiary med...
Source: Journal of Neurological Surgery Part B: Skull Base - May 29, 2021 Category: Neurosurgery Authors: Carmel Neiderman, Narin Nard Wengier, Anat Dominsky, Omri Ringel, Barak Warshavsky, Anton Horowitz, Gilad Baran, Tomer Ziv Ram, Zvi Grossman, Rachel Fliss, Dan Marian Avraham, Abergel Tags: Original Article Source Type: research

Headache Before and After Endoscopic Transsphenoidal Pituitary Tumor Surgery: A Prospective Study
This study was conducted at university tertiary referral hospital. Participants A total of 110 adult patients underwent endoscopic TSS for pituitary tumors. Main Outcome Measures The Migraine Disability Assessment (MIDAS) questionnaire was used before and 6 months after surgery for the assessment of headache. Clinical variables with potential influence on headache were analyzed. Results Sixty-eight (62%) patients experienced headaches at least once during the 3 months before surgery. Thirty (27%) patients reported disabling headache before surgery, with younger age being an independent associated factor (p 
Source: Journal of Neurological Surgery Part B: Skull Base - May 29, 2021 Category: Neurosurgery Authors: Andersson, Agnes Hall én, Tobias Olsson, Daniel S. Farahmand, Dan Olofsson, Ann-Charlotte Jakobsson Ung, Eva Jakobsson, Sofie Bergquist, Henrik Johannsson, Gudmundur Ragnarsson, Oskar Skoglund, Thomas Tags: Original Article Source Type: research

Endoscopic Endonasal Approaches to the Clivus with No Violation of the Nasopharynx: Surgical Anatomy and Clinical Illustration
Conclusion This study shows the anatomical feasibility of total clivectomy and exposure of the craniovertebral junction with preservation of the nasopharynx. A more favorable anatomical posterior fossa defect for the reconstruction is achieved with this technique. Further clinical studies are needed to assess if this change would impact the postoperative CSF leak rate. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 27, 2021 Category: Neurosurgery Authors: Pinheiro-Neto, Carlos D. Salgado-Lopez, Laura Leonel, Luciano C.P.C. Aydin, Serdar O. Peris-Celda, Maria Tags: Original Article Source Type: research

Safety of Endoscopic Transsphenoidal Pituitary Surgery during the COVID-19 Pandemic and Comparison to the Pre-Pandemic Era
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1730352 Objective The COVID-19 pandemic has caused significant disruption to the surgical care of patients with pituitary tumors. Guidance issued early during the pandemic suggested avoiding transnasal approaches to minimize risks of transmitting COVID-19 to health care professionals involved in these procedures. Methods This observational, single-center study compares results of endoscopic transsphenoidal approach (TSA) for pituitary tumors since the start of the pandemic to a pre-pandemic period. Anesthetic time, surgical time, and complication rates were com...
Source: Journal of Neurological Surgery Part B: Skull Base - May 27, 2021 Category: Neurosurgery Authors: Amarouche, Meriem Rashid, Samin Eraifej, John Borg, Anouk Halliday, Jane Warner, Orlando J. Cudlip, Simon A. Tags: Original Article Source Type: research

30-Day Readmissions and Coordination of Care Following Endoscopic Transsphenoidal Pituitary Surgery: Experience with 409 Patients
Conclusion Delayed hyponatremia is one of the most common causes of 30-day readmission following ETPS. Postoperative follow-up with an endocrinologist may reduce risk of 30-day readmission following ETPS. Implications for Clinical Practice A multidisciplinary team incorporating otolaryngologist, neurosurgeons, and endocrinologist may identify patients at risk of 30-day readmissions. Protocols checking serum sodium within 1 week of surgery in conjunction with endocrinologist to tailor fluid restriction may reduce readmissions from delayed hyponatremia. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 7...
Source: Journal of Neurological Surgery Part B: Skull Base - May 25, 2021 Category: Neurosurgery Authors: Ghiam, Michael K. Chyou, Darius E. Dable, Cortney L. Katz, Andrew P. Eichberg, Daniel G. Zhang, Hang Ayala, Alejandro R. Kargi, Atil Y. Komotar, Ricardo J. Sargi, Zoukaa Tags: Original Article Source Type: research

Gamma Knife Radiosurgery for Large Vestibular Schwannoma More Than 10  cm3: A Single-Center Indian Study
Conclusion Microsurgery should remain the first-choice treatment option for large VSs. GKRS is a viable alternative with good tumor control and improved or stabilized cranial neuropathies with a low complication rate. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 23, 2021 Category: Neurosurgery Authors: Yeole, Ujwal Prabhuraj, A. R. Arivazhagan, Arimappamagan Narasingarao, K. V. L. Vazhayil, Vikas Bhat, Dhananjaya Srinivas, Dwarakanath Govindswamy, Bhanumathi Sampath, Somanna Tags: Original Article Source Type: research

Effect of Microvascular Decompression of the Vagus Root Entry/Exit Zone on Blood Pressure in Patients with Hemifacial Spasm Associated with Essential Hypertension: A Retrospective Clinical Analysis
This study aimed to evaluate blood pressure alterations after microvascular decompression (MVD) surgery in patients with hemifacial spasm (HFS) with coexisting hypertension (HTN). Methods A total of 56 patients with HFS with concurrent HTN who underwent MVD surgery in our center between 2015 and 2019 were retrospectively analyzed. Patients were divided into control and experimental groups: patients who received MVD treatment for only the facial nerve and those who received MVD for the affected facial nerve, ipsilateral vagus nerve, and adjacent ventrolateral medulla, respectively. Preoperative (3 days) and postoper...
Source: Journal of Neurological Surgery Part B: Skull Base - May 23, 2021 Category: Neurosurgery Authors: Wei, Xuefeng Wang, Jiao Kong, Xuerui Gao, Caibin Wang, Feng Tags: Original Article Source Type: research

Olfactory Preservation in Craniofacial Resection of Tumor Invading Hemianterior Skull Base: Operative Video
We present the case of a 32-year-old woman with osteosarcoma in the right ethmoid sinus. The tumor invaded the ipsilateral cribriform plate, dura menta, and orbital periosteum; however, the nasal septum and crista galli were intact (Fig. 1A, B). Because the tumor was a high-grade malignancy and the orbita had been invaded, we performed craniofacial resection instead of endoscopic resection (Fig. C2A). We drilled into the right side of the crista galli, midline of the cribriform plate, and perpendicular plate of the ethmoid bone via craniotomy. As a result, we accessed the nasal cavity directly (Fig. 2B). To preserve the na...
Source: Journal of Neurological Surgery Part B: Skull Base - May 23, 2021 Category: Neurosurgery Authors: Kobayashi, Kenya Miyakita, Yasuji Matsumoto, Fumihiko Omura, Go Matsumura, Satoko Ikeda, Atsuo Eguchi, Kohtaro Ito, Akiko Narita, Yoshitaka Akazawa, Satoshi Yoshimoto, Seiichi Tags: Skull Base: Operative Videos Source Type: research

Systematic and Other Reviews: Criteria and Complexities
J Neurol Surg B Skull Base 2021; 82: 273-276 DOI: 10.1055/s-0041-1729564 Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 19, 2021 Category: Neurosurgery Authors: Sataloff, Robert T. Bush, Matthew L. Chandra, Rakesh Chepeha, Douglas Rotenberg, Brian Fisher, Edward W. Goldenberg, David Hanna, Ehab Y. Kerschner, Joseph E. Kraus, Dennis H. Krouse, John H. Li, Daqing Link, Michael Lustig, Lawrence R. Selesnick, Samuel Tags: Editorial Source Type: research

Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729996Anterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it m...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Sayyahmelli, Sima Sun, Zhaoliang Avci, Emel Ba şkaya, Mustafa K. Tags: Skull Base: Operative Videos Source Type: research

Transcavernous Approach for Gross Total Resection of a Dumbbell-Shaped Giant Trigeminal Schwannoma
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729995Trigeminal schwannomas are rare nerve sheet tumors that represent the second most common intracranial site of occurrence after vestibular nerve origins. Microsurgical resection of giant dumbbell-shaped trigeminal schwannomas often requires complex skull base approaches. The extradural transcavernous approach is effective for the resection of these giant tumors involving the cavernous sinus.The patient is a 72-year-old man with headache, dizziness, imbalance, and cognitive decline. Neurological examination revealed left-sided sixth nerve palsy, a diminished corneal refle...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Sayyahmelli, Sima Avci, Emel Ozaydin, Burak Ba şkaya, Mustafa K. Tags: Skull Base: Operative Videos Source Type: research

Endoscopic-Assisted Resection of Anterior Foramen Magnum Meningiomas through a Midline Suboccipital Subtonsillar Approach
Conclusion Anterior foramen magnum meningiomas can be safely removed through this relatively faster midline suboccipital approach with bilateral exposure of lower cranial nerves (CNs) and vertebral arteries and lower approach-related morbidity (no condyle drilling). The surgical corridor is created by the tumor during debulking reducing need for brain retraction and the removal of the anterior dural attachment coagulated under the microscope is verified and completed endoscopically with pituitary curettes (Simpson's grade II) (Fig. 1C and D).The link to the video can be found at: https://youtu.be/9eACAJVwQBs. [...] Ge...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Roser, Florian Rigante, Luigi Tags: Skull Base: Operative Videos Source Type: research

Clinoidal Meningioma with Cavernous Sinus Invasion
We present a-49-year old female presenting headache and progressive right eye visual loss in the last 6 months. Magnetic resonance imaging showed a large clinoidal meningioma on the right side, invading the superior, lateral and medial aspects of the cavernous sinus, the optic canal, and the clinoidal segment of the internal carotid artery (ICA).A cranio-orbital approach was performed. The anterior clinoid process was removed extradurally to achieve devascularization of the anterior clinoidal meningioma, followed by the peeling of the middle fossa to decompress V2 and open the superior orbital fissure. We open the dura in ...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Abrao, Adriana Azeredo Coutinho da Silva, Carlos Eduardo Tags: Skull Base: Operative Videos Source Type: research

Risk Factors and Reconstruction Techniques for Persistent Cerebrospinal Fluid Leak in Patients Undergoing Endoscopic Endonasal Approach to the Posterior Fossa
Conclusion Multiple recurrent CSF leak after EES primarily occurs following resection of recurrent/residual posterior fossa chordoma. Obesity is a major risk factor and meningitis is universal with persistent leak. Flap necrosis may play a role in the development of persistent CSF leaks, and the use of secondary vascularized flaps, specifically extracranial–pericranial flaps, should be considered as an early rescue option in obese patients. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Torres-Bayona, Sergio Velasquez, Nathalia Nakassa, Ana Eguiluz-Melendez, Aldo Hernandez, Vanessa Vega, Belen Borghei-Razavi, Hamid Miranda-Acosta, Yeiris Wang, Eric W. Snyderman, Carl H. Gardner, Paul A. Tags: Original Article Source Type: research

Fresh Cadaver Simulation Model with Continuous Extracorporeal Circulation as a Training Platform for Intracranial High-Flow Bypass: Technical Note and Rheologic Feasibility Evaluation
Conclusion This study confirmed the feasibility of a totally intracranial high-flow bypass in a fresh cadaver model that achieved hemodynamic features aligned with those of normal middle cerebral artery flow in the clinical setting. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Santori, Alejandro Mercado Arancibia, Mar ía Sol Andaluz, Norberto Tags: Original Article Source Type: research

Ergonomics in Endoscopic Transsphenoidal Surgery: A Survey of the North American Skull Base Society
Conclusion Most respondents value ergonomics in ETS. The variability in surgical set-ups and the relatively high report of complaints underline the need for further studies to optimize ergonomics in ETS. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Mattogno, Pier Paolo Marciano, Filippo Catalino, Michael P. Mattavelli, Davide Cocca, Paola Lopomo, Nicola Francesco Nicolai, Piero Laws, Edward R. Witterick, Ian Raza, Shaan M. Devaiah, Anand K. Lauretti, Liverana Olivi, Alessandro Fontanella, Marco M. G Tags: Original Article Source Type: research

Health Literacy and Web-Based Audiovisual Multimedia in Pituitary and Endoscopic Skull Base Surgery
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729979 Introduction The internet presents a rich milieu of multimedia options relating to pituitary and endoscopic skull base surgery (ESBS). Misinformation can create discordance between patient and provider expectations. The purpose of this study is to analyze the understandability and actionability of available ESBS and pituitary surgery audiovisual information on YouTube and Google. Methods The top 50 videos generated by searching “pituitary surgery/transsphenoidal surgery” and “endoscopic skull base surgery” in both YouTube and Goo...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Gill, Amarbir S. Biggs, Philip C. Hagwood, Garrett Beliveau, Angela M. Shahlaie, Kiarash Strong, E. B. Steele, Toby O. Tags: Original Article Source Type: research

Peripheral and Central Smell Regions in Migraine Patients using Mara ş Powder (Smokeless Tobacco): A Magnetic Resonance Imaging Evaluation
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729907 Objective In the present study, we investigated the efficacy of Maraş powder (smokeless tobacco) use on smell regions in migraine patients. Methods The cranial magnetic resonance imaging images of 58 adult patients were included in this retrospective study. Thirty-eight of them were migraine patients (18 of them using Maraş powder and 20 of them not using Maraş powder) and 20 of them were healthy controls. Bilateral peripheral (olfactory bulb [OB] volume and olfactory sulcus depth) and central smell regions (insular gyrus area and corpus amygdala are...
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Do ğan, Adil Bayar Muluk, Nuray Inan ç, Yılmaz Tags: Original Article Source Type: research

Sinonasal Symptom Outcomes following Endoscopic Anterior Cranial Base Surgery in the Pediatric Population
Conclusion Endoscopic ACB surgery in the pediatric population results in increased sinonasal symptom morbidity in the early postoperative period; however, symptoms return to near baseline by ∼3 months, and quality-of-life scores progressively improve in the postoperative period. These trends were similar to those seen in our historic adult cohort. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 17, 2021 Category: Neurosurgery Authors: Carle, Taylor R. Wung, Vivian Heaney, Anthony P. Chiu, Harvey K. Suh, Jeffrey D. Bergsneider, Marvin Wang, Marilene B. Tags: Original Article Source Type: research

Endoscopic Endonasal Resection of Rathke Cleft Cyst with Xanthogranulomatous Change: Two-Dimensional Operative Video
Conclusion Pathology confirmed dense fibrous tissue with features of chronic inflammation, cholesterol clefts, hemosiderin pigment, multinucleate giant cells, and foamy macrophages. Additional cyst wall sampling identified squamous and ciliated epithelial lining, collectively consistent with Rathke's cleft cyst and xanthogranulomatous reaction. These lesions can undergo surgical cure with resection, most commonly by transsphenoidal approach.The link to the video can be found at: https://youtu.be/S2n5iQ3aFgc. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: ...
Source: Journal of Neurological Surgery Part B: Skull Base - May 12, 2021 Category: Neurosurgery Authors: Zhang, Michael Mahavadi, Anil K. Deftos, Michael L. Ali, Arshad Singh, Harminder Tags: Skull Base: Operative Videos Source Type: research

Transcavernous Approach to the Anteromedial Triangle for Residual Functional Pituitary Adenoma
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1727119Surgical treatment of functional pituitary adenomas is as rule performed by transsphenoidal approach. However, when then lesion invades the parasellar structures and the cavernous sinus, the transsphenoidal removal of these adenomas is usually incomplete. In this video, we present the technical nuances of a transcavernous approach to the anterio-medial triangle for the resection of a residual functional pituitary adenoma. The patient is a 40-year-old male who was diagnosed with growth hormone secreting pituitary macroadenoma. He underwent two transsphenoidal resections ...
Source: Journal of Neurological Surgery Part B: Skull Base - May 11, 2021 Category: Neurosurgery Authors: Starnoni, Daniele Cossu, Giulia Messerer, Mahmoud Daniel, Roy Thomas Tags: Skull Base: Operative Videos Source Type: research

Transcavernous Approach for Microsurgical Clipping of Ruptured Right Superior Cerebellar Artery Aneurysm with Cadaveric Stepwise Video Illustration
We present the case of a 67-year-old RHF who presented with ruptured right-sided SCA aneurysm. She complained of Headache, confusion, and double vision. On physical examination, she had no focal deficits and was Hunt and Hess grade 3. A brain computed tomography (CT) scan revealed a subarachnoid hemorrhage Fisher's grade 4. A brain CT angiography (CTA) demonstrated an aneurysm at the origin of right SCA. The patient had failed attempt of endovascular coiling and she underwent microsurgical clipping.Stepwise demonstration of the approach with cadaveric anatomical dissection is illustrated. The technique presented here allow...
Source: Journal of Neurological Surgery Part B: Skull Base - May 11, 2021 Category: Neurosurgery Authors: Najera, Edinson Muhsen, Baha'eddin A. Borghei-Razavi, Hamid obrzut, Michal Adada, Badih Tags: Skull Base: Operative Videos Source Type: research

Endoscopic-Assisted Microsurgical Resection of Right Recurrent Meckel's Cave Meningioma Extended to Cavernous Sinus
Conclusion This surgical case shows how the anatomical knowledge is mandatory in skull base surgery and how the integration of microsurgical and endoscopic-assisted techniques allows to obtain optimal results.The link to the video can be found at: https://youtu.be/qxt_389AdWU. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: Journal of Neurological Surgery Part B: Skull Base)
Source: Journal of Neurological Surgery Part B: Skull Base - May 11, 2021 Category: Neurosurgery Authors: Fava, Arianna di Russo, Paolo Giammattei, Lorenzo Froelich, S ébastien Tags: Skull Base: Operative Videos Source Type: research

Transcavernous Resection of a Giant Extensive Chondrosarcoma with Endoscopic Assistance
J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1727124Chondrosarcomas are one of the major malignant neoplasms which occur at the skull base. These tumors are locally invasive. Gross total resection of chondrosarcomas is associated with longer progression-free survival rates. The patient is a 55-year-old man with a history of dysphagia, left eye dryness, hearing loss, and left-sided facial pain. Magnetic resonance imaging (MRI) showed a giant heterogeneously enhancing left-sided skull base mass within the cavernous sinus and the petrous apex with extension into the sphenoid bone, clivus, and the cerebellopontine angle, wit...
Source: Journal of Neurological Surgery Part B: Skull Base - May 11, 2021 Category: Neurosurgery Authors: Elshamy, Walid Soylemez, Burcak Sayyahmelli, Sima Keser, Nese Baskaya, Mustafa K. Tags: Skull Base: Operative Videos Source Type: research

The Efficacy of Adjuvant Chloroquine for Glioblastoma: A Meta-Analysis of Randomized Controlled Studies
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1718766 Introduction The efficacy of adjuvant chloroquine for glioblastoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of adjuvant chloroquine on treatment efficacy for recurrent glioblastoma. Methods We search PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through January 2020 for randomized controlled trials (RCTs) assessing the efficacy of adjuvant chloroquine for glioblastoma. This meta-analysis is performed using the random-effect model. Results Three RCTs are included in t...
Source: Journal of Neurological Surgery Part B: Skull Base - May 11, 2021 Category: Neurosurgery Authors: Wei, Hong Jiang, Zhenfu Tags: Original Article Source Type: research