Aerosolization in Endoscopic Sinus Surgery and Risk Mitigation in the COVID-19 Era: A Scoping Review
Conclusion Endoscopic sinus and skull base surgery impart a potential risk of aerosolization. Hence, surgical indications, protective measures for health care workers, and surgical instrumentation must be adapted accordingly in the COVID-19 context. [...] 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 - December 4, 2020 Category: Neurosurgery Authors: Roy, Catherine F. Kay-Rivest, Emily Nguyen, Lily H.P. Sirhan, Denis Tewfik, Marc A. Tags: Original Article Source Type: research

Adenoid Cystic Carcinoma of the Nasopharynx with Skull Base Involvement: Retrospective National Cohort Analysis of Treatment Paradigms, Outcomes, and Provider Density
This article examines a national cohort of patients with nasopharyngeal adenoid cystic carcinoma (ACC) for incidence, skull base invasion, overall survival, and treatment paradigms. Design, Setting, and Participants Retrospective national population-based study using Surveillance, Epidemiology, and End Results program data of patients with ACC of the nasopharynx (NACC) and skull base between 2004 and 2016. Main Outcomes and Measures Primary outcomes included 5-year overall survival and odds of radiation treatment. Statistical analysis was performed using STATA 15.0 (STATACorp). p-Values 
Source: Journal of Neurological Surgery Part B: Skull Base - December 4, 2020 Category: Neurosurgery Authors: Gadkaree, Shekhar K. Parikh, Anuraag S. Barbarite, Eric Feng, Allen L. McCarty, Justin Gray, Stacey T. Lin, Derrick T. Tags: Original Article Source Type: research

Endonasal Odontoidectomy in Basilar Invagination
Conclusion EEO may provide a significant anatomic and technical advantage over the trans-oral approach.The link to the video can be found at: https://youtu.be/Td6MDcjCNKk. [...] 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 - December 2, 2020 Category: Neurosurgery Authors: Simal-Juli án, Juan A. Miranda-Lloret, Pablo Sanchis-Mart ín, Maria R. Quiroz, Arnold Botella-Asunci ón, Carlos Kassam, Amin B. Tags: Skull Base: Operative Videos Source Type: research

Endoscopic Endonasal Transclival Odontoidectomy for Basilar Invagination: Operative Video and Technical Nuances
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1715522Basilar invagination is a congenital or acquired craniovertebral junction abnormality where the tip of the odontoid process projects through the foramen magnum which can cause severe symptomatic compression of the brainstem and spinal cord. If left untreated, patients can develop progressive quadriparesis. Traditionally, basilar invagination can be treated with cervical traction and posterior stabilization. However, in irreducible cases, anterior decompression via a transoral or endonasal approach may be necessary. In this operative video, we demonstrate an endoscopic e...
Source: Journal of Neurological Surgery Part B: Skull Base - December 2, 2020 Category: Neurosurgery Authors: Liu, James K. Dodson, Vincent N. Zhao, Kevin Eloy, Jean Anderson Tags: Skull Base: Operative Videos Source Type: research

Far Lateral Transcondylar Transtubercular Approach for Microsurgical Resection of Foramen Magnum Meningioma: Operative Video and Technical Nuances
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716533Surgical access to the ventral foramen magnum remains a technical challenge. With large lesions in this region compressing the brainstem and distorting the regional neurovascular relationships, formulating a surgical plan and its appropriate execution have crucial importance in achieving favorable outcomes. While the endoscopic endonasal approaches have gained increasing attention to access the clivus and the ventral brainstem, foramen magnum meningiomas are still preferred to be removed via an approach that obviates a trajectory through the nasopharyngeal mucosa. There...
Source: Journal of Neurological Surgery Part B: Skull Base - December 2, 2020 Category: Neurosurgery Authors: Liu, James K. Dodson, Vincent N. Meybodi, Ali T. Tags: Skull Base: Operative Videos Source Type: research

Managing the Anomalous Vertebral Artery in C1 –C2 Stabilization for Congenital Atlantoaxial Instability
This study aimed to demonstrate the technique of handling the anomalous vertebral artery in congenital atlantoaxial instability. The vertebral artery course can be variable in congenital atlantoaxial instability, especially if there is assimilation of atlas. The surgical technique to stabilize the atlantoaxial joint should ensure the patency and safety of the vertebral artery and prevents devastating stroke. Computed tomography (CT) angiography of the vertebral artery is mandatory in planning the surgical strategies. The vertebral artery can be injured during dissection of soft tissues between atlas and axis and can be com...
Source: Journal of Neurological Surgery Part B: Skull Base - November 26, 2020 Category: Neurosurgery Authors: Rathakrishnan, Roopesh Kumar Vadivel Raghavendra, Sunil Kapilavayi Tags: Skull Base: Operative Videos Source Type: research

Extended Anterolateral Infralabyrinthine Transjugular Approach for Microsurgical Resection of Giant Glomus Vagale Tumor: Operative Video and Technical Nuances
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716532Glomus vagale tumor is a paraganglioma of the vagus nerve. It is a rare type of benign tumor that occupies the head and neck and skull base regions. Patients often present with lower cranial nerve dysfunctions such as difficulty swallowing, tongue weakness, and hoarseness. Surgical treatment can be complex and difficult due to its high vascularity, frequent involvement of lower cranial nerves, and surrounding critical vascular structures. In this operative video, we demonstrate an extended anterolateral infralabyrinthine transjugular approach for microsurgical resection...
Source: Journal of Neurological Surgery Part B: Skull Base - November 26, 2020 Category: Neurosurgery Authors: Liu, James K. Zhao, Kevin Baredes, Soly Jyung, Robert W. Tags: Skull Base: Operative Videos Source Type: research

Midline Suboccipital Subtonsillar Approach in Semisitting Position for Resection of Jugular Tubercle Meningioma: 2-Dimensional Operative Video
We present a case of a large jugular tubercle meningioma that was removed through a midline suboccipital subtonsillar approach in semisitting position. The patient is a 49-year-old woman with chronic, medication-resistant cephalgias but devoid of any subjective focal neurological deficit. On magnetic resonance imaging (MRI), an extra-axial lesion, originating from the left jugular tubercle was discovered. There was significant obliteration of the peripontine cisternal space, and compression of the adjacent pontomedullary junction; the lesion also extended into the left jugular foramen.On physical exam, an absent gag reflex...
Source: Journal of Neurological Surgery Part B: Skull Base - November 26, 2020 Category: Neurosurgery Authors: Lieber, Stefan Nunez, Maximiliano Tatagiba, Marcos Tags: Skull Base: Operative Videos Source Type: research

Far Lateral Approach for Disconnection of Craniocervical Junction Dural Arteriovenous Fistula Presented with Myelopathy and Hydrocephalus
We report a case of craniocervical junction dural arteriovenous fistula (dAVF) presented with myelopathy and normal pressure hydrocephalus, and was treated with hybrid approach of embolization and surgical disconnection. A 68-year-old gentleman presented with 1 year history of unsteady gait and sphincter disturbance. Magnetic resonance imaging (MRI) showed abnormally enlarged and tortuous vessels over right cerebellomedullary cistern. Digital subtraction angiogram (DSA) showed Cognard's type-V dAVF at craniocervical junction. Catheter embolization was performed via external carotid artery and finally surgical disconnection...
Source: Journal of Neurological Surgery Part B: Skull Base - November 26, 2020 Category: Neurosurgery Authors: Lam, Siu Kei Samuel Chu, Sai Lok Yuen, Shing Chau Yam, Kwong Yui Tags: Skull Base: Operative Videos Source Type: research

Primary Repair of Posteriorly Located Anterior Skull Base Dural Defects Using Nonpenetrating Titanium Clips in Cranial Trauma
Conclusion Primary repair of posteriorly located ASB dural defects is challenging due to narrow working angles and thin dura mater. Use of nonpenetrating titanium microclips for primary repair of posteriorly located dural defects is a reasonable adjunctive repair technique and was associated with no postoperative CSF leaks in this 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 - November 26, 2020 Category: Neurosurgery Authors: Milton, Camille K. Andrews, Bethany J. Baker, Cordell M. O'Connor, Kyle P. Conner, Andrew K. Sughrue, Michael E. McKinney, Kibwei A. El Rassi, Edward T. Sanclement, Jose A. Glenn, Chad A. Tags: Original Article Source Type: research

Revising the Indications of Transtemporal Surgical Approaches in the Modern Endoscopic Era of Skull Base Surgery: A Dying Art
Conclusion Surgical approach should be tailored based on the individual basis, to obtain adequate exposure and complete excision. Selection of appropriate surgical approach should also be based on the training and preference of the operating surgeon. Whenever necessary, combined surgical approaches facilitating full tumor exposure are recommended so that complete tumor excision is feasible. This requires a multidisciplinary team comprising neurosurgeons, neuro-otologist, neuroanesthetist, and plastic surgeons. The surgeon must know precise microsurgical anatomy to preserve the adjacent nerves and vessels, which is nec...
Source: Journal of Neurological Surgery Part B: Skull Base - November 26, 2020 Category: Neurosurgery Authors: Manogaran, Ravi Sankar Kumar, Raj Mathialagan, Arulalan Mehrotra, Anant Keshri, Amit Singh, Neha Bhuskute, Govind S. Singh, Suyash Tags: Original Article Source Type: research

Endoscopic Transnasal Odontoidectomy
Conclusion Endoscopic transnasal odontoidectomy provides a direct access to the dens and adjacent structures of the anterior upper cervical spine with a less invasive burden on the oropharingeal structures.The link to the video can be found at: https://youtu.be/Ofrk1sFTV9I. [...] 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 - November 23, 2020 Category: Neurosurgery Authors: Zoia, Cesare Bongetta, Daniele Luzzi, Sabino Tags: Skull Base: Operative Videos Source Type: research

Resection of Foramen Magnum Meningioma through Modified Far Lateral Approach: Surgical Principles and Technical Nuances
Conclusion The surgery of FMM is challenging due to the deep surgical corridor, critical location, close proximity with various neurovascular structures, firm consistency, and high vascularity of the tumor. The modified far lateral approach by preserving the occipital condyle may prevent the postoperative incidence of craniovertebral junction instability. The key operative principles to achieve the best surgical outcome include careful dissection along the arachnoid plane, gentle handling of cranial nerves, veins, and perforator vessels, avoidance of traction on brainstem and spinal cord, intraoperative neurophysiolog...
Source: Journal of Neurological Surgery Part B: Skull Base - November 23, 2020 Category: Neurosurgery Authors: Narayan, Vinayak Jumah, Fareed Nanda, Anil Tags: Skull Base: Operative Videos Source Type: research

Endoscopic Endonasal Odontoidectomy with Nasopharyngeal Flap Reconstruction
Conclusions This operative video demonstrates nuances in endoscopic endonasal odontoidectomy. This case also demonstrates that ventral decompression after long-term cervical fusion can improve myelopathy and that fusion in the setting of bony ventral compression, rather than rheumatoid panus, may not reduce over time with fusion only.The link to the video can be found at: https://youtu.be/370FFuBA89Y. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source...
Source: Journal of Neurological Surgery Part B: Skull Base - November 23, 2020 Category: Neurosurgery Authors: London, Nyall R. Mohyeldin, Ahmed Carrau, Ricardo L. Prevedello, Daniel M. Tags: Skull Base: Operative Videos Source Type: research

Impact of the Extent of Microsurgical Resection in Sphenopetro-clival Meningiomas Trough a Multistaged Approach: A Volumetric Analysis
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1714112 Objective Sphenopetroclival meningiomas (SPCMs) represent a challenge for surgical treatment. The authors used an objective volumetric analysis to assess the effect of the grade of resection and different surgical strategies that may affect the outcome of this tumors. Methods Over a period of 4 years, patients with SPCMs were treated using a middle versus posterior fossa approach, or a two-stage surgery combining both approaches, based on the tumor location in relation to the petrous ridge and tumor volume. Retrospectively, all cases were analyzed with ...
Source: Journal of Neurological Surgery Part B: Skull Base - November 19, 2020 Category: Neurosurgery Authors: Mart ínez-Pérez, Rafael Tsimpas, Asterios Ganau, Mario Mura, Jorge M. Tags: Original Article Source Type: research

Far Lateral Approach for Malignant, Severely Calcified Cerebellopontine Angle Tumor
Conclusion The far-lateral approach is an effective approach for maximal safe resection of a malignant brainstem, cerebellar, and CPA tumor.The link to the video can be found at: https://youtu.be/AIGebJPJEnw. [...] 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 - November 17, 2020 Category: Neurosurgery Authors: Kiyofuji, Satoshi Graffeo, Christopher S. Perry, Avital Link, Michael J. Tags: Skull Base: Operative Videos Source Type: research

Clival Meningioma Removal through a Suboccipital Retrosigmoid Approach: Operative Video and Technical Nuances
Conclusion: In this case, the regular retrosigmoid approach, extended into the foramen magnum was enough for the removal of this pure clival meningioma.The link to the video can be found at: https://youtu.be/3d6Uj4gjmDU. [...] 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 - November 17, 2020 Category: Neurosurgery Authors: Candanedo, Carlos Moscovici, Samuel Spektor, Sergey Tags: Skull Base: Operative Video Source Type: research

Far-Lateral Transcondylar Approach to a Right Cervicomedullary Dural Arteriovenous Fistula of the Posterior Fossa
Conclusion A deep understanding of the microsurgical vascular anatomy is necessary for successful occlusion of a cervicomedullary DAVF.The link to the video can be found at: https://youtu.be/-LfOcNB05BY. [...] 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 - November 5, 2020 Category: Neurosurgery Authors: Rubio, Roberto R. Chae, Ricky Dubnicoff, Todd Winkler, Ethan Abla, Adib A. Tags: Skull Base: Operative Videos Source Type: research

Microsurgical Resection of a Large Dumbbell-Shaped Jugular Foramen Schwannoma via Infralabyrinthine, Retrofacial, and Transjugular Approach
We present a surgical video in a patient with a dumbbell-shaped glossopharyngeal schwannoma. The combination of posterior fossa craniotomy, mastoidectomy, and unroofing of the jugular foramen with high cervical exposure was selected. Although transposition of the mastoid segment of the facial nerve provides an excellent surgical corridor, it may affect normal facial nerve function. Sufficient drilling of the infralabyrinthine, retrofacial area of the mastoid without facial nerve transposition is important for the safe gross total removal of the tumor. Subcapsular removal behind the jugular vein is also important for preser...
Source: Journal of Neurological Surgery Part B: Skull Base - November 3, 2020 Category: Neurosurgery Authors: Abe, Daisu Aoyagi, Masaru Tags: Skull Base: Operative Videos Source Type: research

Decreased Incidence of CSF Leaks after Skull Base Fractures in the 21st Century: An Institutional Report
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716689 Objectives Cerebrospinal fluid (CSF) leaks are a possible complication in patients with skull base fractures (SBFs). The widely cited incidence of CSF leaks is 10 to 30% in SBF patients; however, this estimate is based only on a few outdated studies. A recent report found CSF leaks in
Source: Journal of Neurological Surgery Part B: Skull Base - October 16, 2020 Category: Neurosurgery Authors: Stopa, Brittany M. Leyva, Oscar A. Harper, Cierra N. Truman, Kyla A. Corrales, C. Eduardo Smith, Timothy R. Gormley, William B. Tags: Original Article Source Type: research

A Morphometric Study of Stylomastoid Foramen with Its Clinical Applications
Conclusion These measurements will aid neurosurgeons in doing surgeries near the stylomastoid foramen or anesthetics to give facial nerve block near the foramen. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 12, 2020 Category: Neurosurgery Authors: Tewari, Siddharth Gupta, Chandni Palimar, Vikram Tags: Original Article Source Type: research

The Longissimus Capitis Insertion as a Superficial Landmark for the Sigmoid Sinus: An Anatomical Study
Conclusion To our knowledge, use of the attachment site of the LC on the mastoid process as an external landmark for the underlying sigmoid sinus has not previously been reported. Based on our cadaveric findings, the sigmoid sinus is centered under the attachment of the LC regardless of the width of its tendon. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 12, 2020 Category: Neurosurgery Authors: Iwanaga, Joe Watanabe, Koichi Khan, Pervez A. Nerva, John D. Amenta, Peter S. Dumont, Aaron S. Tubbs, R. Shane Tags: Original Article Source Type: research

Advancement of PI3 Kinase Inhibitor Combination Therapies for PI3K-Aberrant Chordoma
Conclusion High throughput with in vitro combination screening is feasible with chordoma cells and allows for rapid identification of synergistic dual-therapies. Potential combination therapies and targetable pathways were identified. T (brachyury) knockdown produced significant reduction in cell viability, but did not show additional benefit with PI3K pathway inhibition in this model. Further in vitro and in vivo validation of these therapeutic combinations is warranted. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |...
Source: Journal of Neurological Surgery Part B: Skull Base - October 12, 2020 Category: Neurosurgery Authors: Heft Neal, Molly E. Michmerhuizen, Nicole L. Kovatch, Kevin J. Owen, John Henry J. Zhai, Jingyi Jiang, Hui McKean, Erin L. Prince, Mark E.P. Brenner, J. Chad Tags: Original Article Source Type: research

Effects of Preoperative Embolization on Juvenile Nasopharyngeal Angiofibroma Surgical Outcomes: A Study of the Kids' Inpatient Database
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716676 Objectives The aim of the study is to evaluate the effect of preoperative vascular embolization (PVE) on juvenile nasopharyngeal angiofibroma (JNA) surgical outcomes using a national pediatric hospitalization database. Methods The health care cost and utilization project Kids' Inpatient Database was queried for all cases of operative management of JNA between the years of 1997 and 2016. Cases were stratified based on whether the patient received PVE. A multiple linear regression was used to predict the effect of PVE on hospital length of stay (LOS) and ...
Source: Journal of Neurological Surgery Part B: Skull Base - October 12, 2020 Category: Neurosurgery Authors: Choi, Jonathan S. Yu, Justin Lovin, Benjamin D. Chapel, Alyssa C. Patel, Akash J. Gallagher, K. Kelly Tags: Original Article Source Type: research

The Influence of Household Income on Survival following Posterior Fossa Tumor Resection at a Large Academic Medical Center
Conclusion This study suggests that lower household income is associated with increased mortality in both the 90-day window and total follow-up period. It is possible that there is an opportunity for health care providers to use socioeconomic status to proactively identify high-risk patients and provide additional resources in the postoperative setting. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 12, 2020 Category: Neurosurgery Authors: Blue, Rachel Detchou, Donald K. Dimentberg, Ryan Shultz, Kaitlyn Spadola, Michael McClintock, Scott D. Malhotra, Neil R. Tags: Original Article Source Type: research

Management of Cutaneously Exposed Carotid Stents in Recurrent and Unresectable Head and Neck Cancer
Conclusion In this small series, durable coverage of an exposed carotid artery with PMMF was successful in two of three patients with extensive disease burden and complex prior treatment history. No mortalities occurred within 30 days postoperatively. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 12, 2020 Category: Neurosurgery Authors: Beer-Furlan, Andr é Heilingoetter, Ashley Rayle, Christopher O'Toole, Thomas Nielsen, Thomas J. Crowley, Richard Webster Al-Khudari, Samer Tags: Original Article Source Type: research

Regional Recurrences and Hyams Grade in Esthesioneuroblastoma
Conclusion ENBs are associated with a risk of regional failure. The current analysis suggests that Hyams low-grade and high-grade malignancies have comparable rates of early and delayed regional recurrences, although small sample size may limit our conclusions. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Ziai, Hedyeh Yu, Eugene Weinreb, Ilan Perez-Ordonez, Bayardo Yao, Christopher M. K. L. Xu, Wei Yang, Dongyang Witterick, Ian J. Monteiro, Eric Gilbert, Ralph W. Irish, Jonathan C. Gullane, Patrick J. Goldstein, David P. Ringash, Jolie Bayley, Andrew de Al Tags: Original Article Source Type: research

Anatomical Variations and Relationships of the Infratemporal Fossa: Foundation of a Novel Endonasal Approach to the Foramen Ovale
Conclusion Displacement of the LPP and LPTM provided direct exposure of foramen ovale and V3 avoiding dissection of the muscle and pterygoid plexus; thus, this maneuver may prevent intraoperative bleeding and postoperative trismus. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Li, Lifeng London, Nyall R. Prevedello, Daniel M. Carrau, Ricardo L. Tags: Original Article Source Type: research

Ovoid Foramen Magnum Shape is Associated with Increased Complications and Decreased Extent of Resection for Anterolateral Foramen Magnum Meningiomas
Conclusion This is the first study demonstrating that ovoid FMs may pose surgical challenges, poorer operative outcomes, and lower rates of extent of resection. Preoperative radiological investigation including morphometric FM measurement to determine if FMs are ovoid or nonovoid can improve surgical planning and complication avoidance. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Kina, Hakan Erginoglu, Ufuk Hanalioglu, Sahin Ozaydin, Burak Baskaya, Mustafa K. Tags: Original Article Source Type: research

Vestibular Schwannoma Tumor Size and Growth Rate Predict Response with Gamma Knife Stereotactic Radiosurgery
Conclusion Smaller pretreatment tumor volume and greater linear tumor growth rates were associated with postradiosurgery tumor enlargement when controlling for age, gender, and radiation dose. Level of Evidence :This study indicates that the level of evidence is V. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Killeen, Daniel E. Tolisano, Anthony M. Isaacson, Brandon Kutz, J Walter Barnett, Samuel Wardak, Zabi Hunter, Jacob B. Tags: Original Article Source Type: research

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach
Conclusion The present study is the first to utilize machine learning algorithms in approaching OCVST. Our findings support the therapeutic use of AC in the management of OCVST when complicated by thrombophilia, intracranial abscess, and cholesteatoma. Patients with intracranial abscess and cholesteatoma may benefit from AC and surgery. Patients with cholesteatoma can be managed with NAC and surgery. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Kaufmann, Matthew R. Camilon, Philip Ryan Levi, Jessica R. Devaiah, Anand K. Tags: Original Article Source Type: research

The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development
Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Bayar Muluk, Nuray Arikan, Osman K ürşat Atasoy, P ınar Kili ç, Rahmi Tuna Yal çinozan, Eda Tags: Original Article Source Type: research

Acute Sigmoid Sinus Compromise Following Skull Base Procedures: Is a “Laissez-Faire” Approach Best?
Conclusion Acute iatrogenic sigmoid sinus compromise can be managed expectantly. We believe that the treatment for each instance of VSC must be individualized, considering the symptoms of the patient, rather than applying a universal algorithm. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Arnone, Gregory D. Kunigelis, Katherine E. Gurau, Andrei Coulter, Ian Thompson, John Youssef, A. Samy Tags: Original Article Source Type: research

Temporal Bone Adenoma: A Comprehensive Analysis of Clinical Aspects and Surgical Outcome on a Very Rare Entity
Conclusion Total surgical resection is the treatment of choice in MEAs to minimize the risk for recurrence; this can come with morbidity, mostly sensorineural deafness. Given the very limited literature, long-term follow-up is recommended. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - October 4, 2020 Category: Neurosurgery Authors: Alsalman, Hussain Crowther, John A. McLellan, Douglas Kontorinis, Georgios Tags: Original Article Source Type: research

Surgery around the Orbit: How to Select an Approach
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1713893Orbital region pathologies may be safely and effectively treated through a various number of approaches. As the concept of “outcome” and minimally invasive surgery keeps gaining popularity in neurosurgery, these approaches—each with specific indications and limitations—together provide the best surgical options. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 20, 2020 Category: Neurosurgery Authors: Locatelli, Davide Dallan, Iacopo Castelnuovo, Paolo Tags: Review Article Source Type: research

Retrosigmoid Approach for Resecting a Giant Lateral Pontine Ependymoma: Two-Dimensional Operative Video
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1705158Ependymoma is one of the most common pediatric tumors in central nervous system, for which gross total resection has been the most favorable prognostic factor.1 2 However, surgery of ependymomas located in brain stem is significantly challenging. This video demonstrates the microsurgical removal of an ependymoma originating from ependymal cells of the lateral recess of fourth ventricle via retrosigmoid approach in an 11-year-old female. The patient presented with a 6-month history of continues headache and vomiting. On examination, she had a walking instability and a...
Source: Journal of Neurological Surgery Part B: Skull Base - September 16, 2020 Category: Neurosurgery Authors: Wang, Hongxiang Yan, Yong Xu, Tao Chen, Juxiang Tags: Skull Base: Operative Videos Source Type: research

Lateral Suboccipital Approach in Semisitting Position for Resection of Vagal Schwannoma: 2-Dimensional Operative Video
We present a case of a sizeable vagal schwannoma that was resected through a lateral suboccipital approach in semisitting position. An extra-axial lesion, occupying the left cerebellomedullary cistern and extending from the pontomedullary junction to the jugular foramen was incidentally discovered in a 40-year-old woman afflicted with secondary progressive multiple sclerosis during repeated magnetic resonance imaging (Fig. 1). On physical examination, a mild deviation of the uvula to the right and a diminished gag reflex were observed. The patient was referred to our department after considerable growth of the lesion was n...
Source: Journal of Neurological Surgery Part B: Skull Base - September 16, 2020 Category: Neurosurgery Authors: Lieber, Stefan Nunez, Maximiliano Tatagiba, Marcos Tags: Skull Base: Operative Videos Source Type: research

Endoscopic Transnasal Odontoidectomy
Conclusions The endoscopic transnasal approach to the resection of odontoid is a safe and effective treatment to address basilar invasion and ventral compression of the brainstem.The link to the video can be found at: https://youtu.be/m_c3-Vn-l80. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 16, 2020 Category: Neurosurgery Authors: Falco, Jeffrey J. Solares, C. Arturo Reyes, Camilo Tags: Skull Base: Operative Videos Source Type: research

Cavernous Sinus Meningioma with Orbital Involvement: Algorithmic Decision-Making and Treatment Strategy
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1715471Cavernous sinus meningioma (CSM) with orbital involvement presents a unique challenge to modern-day neurosurgeons. In the modern era of preventive medicine with enhanced screening tools, physicians encounter CSM more frequently. An indolent natural history, late clinical presentation, close proximity to vital neurovascular structures, poor tumor-to-normal tissue interface, and high risk of iatrogenic morbidity and mortality with aggressive resection add to the complexity of decision-making and optimal management of these lesions. The clinical dilemma of deciding whether...
Source: Journal of Neurological Surgery Part B: Skull Base - September 16, 2020 Category: Neurosurgery Authors: Raheja, Amol Couldwell, William T. Tags: Review Article Source Type: research

Anatomy of the Orbit
This article provides a detailed illustration and description of the microsurgical anatomy of the orbit, with a focus on the intrinsically complex spatial relationships around the annular tendon and the superior orbital fissure, the transition from cavernous sinus to the orbital apex. Sparse reference will be made to surgical approaches, their indications or limitations, since they are addressed elsewhere in this special issue. Instead, an attempt has been made to highlight anatomical structures and elucidate concepts most relevant to safe and effective transcranial, transfacial, transorbital, or transnasal surgery of orbi...
Source: Journal of Neurological Surgery Part B: Skull Base - September 16, 2020 Category: Neurosurgery Authors: Lieber, Stefan Fernandez-Miranda, Juan C. Tags: Review Article Source Type: research

Sinonasal Quality of Life Outcomes after Endoscopic Endonasal Transsphenoidal Surgery with Posterior Septum Free Mucosal Graft Reconstruction
This study was a retrospective review. Setting This study was conducted at tertiary care academic center. Participants This study group consisted of patients undergoing EETS for pituitary adenomas from 2013 to 2018. Main Outcome Measures Tumor and surgical factors were included, along with postoperative complications. Patients completed Sinonasal Outcome Test-22 (SNOT-22) questionnaires. Pre- and postoperative scores were compared among the entire cohort using linear multilevel regression. A subcohort analysis was performed among patients who completed questionnaires during the preoperative visit an...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Wu, Tara J. Chen, Angela Wells, Christine Heaney, Anthony P. Bergsneider, Marvin Wang, Marilene B. Tags: Original Article Source Type: research

Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery
Conclusion NAG can significantly reduce inadequate visualization during EEA to the skull-base and has the potential to reduce instances of nasal trauma. Participants assessed its overall utility as being “excellent.” [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 9, 2020 Category: Neurosurgery Authors: Velasquez, Nathalia Ahmed, Omar H. Lavigne, Philippe Goldschmidt, Ezequiel Gardner, Paul A. Snyderman, Carl H. Wang, Eric W. Tags: Original Article Source Type: research

Anatomical Limits of the Endoscopic Contralateral Transmaxillary Approach to the Petrous Apex and Petroclival Region
Conclusion The techniques and anatomical landmarks for CTM to the PA and PCR are described. Compared with a purely EEA, the CTM provides significant “angle” and “reach” advantages for the PA and PCR. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 9, 2020 Category: Neurosurgery Authors: Mangussi-Gomes, Jo ão Alves-Belo, Jo ão T. Truong, Huy Q. Nogueira, Gustavo F. Wang, Eric W. Fernandez-Miranda, Juan C. Gardner, Paul A. Snyderman, Carl H. Tags: Original Article Source Type: research

Radiological Anatomy of the Olfactory Fossa: Is Skull Base Anatomy Really Ever “Safe”?
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716690 Objective Computed tomography (CT) is a powerful tool for delineating the anatomy of the anterior skull base. The goal of this study is to further characterize the relevant anatomical features of this area, along with other parameters important for endoscopic sinus surgery. Design Retrospective case review. Setting Tertiary care hospital. Participants Thirty patients who had CT scans of the paranasal sinuses. Main Outcome Measures The following features were assessed using image analysis software: olfactory fossa depth, the lengt...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Hamour, Amr F. Kus, Lukas Monteiro, Eric Scheffler, Patrick Lee, John Vescan, Allan Tags: Original Article Source Type: research

Health Care Utilization in Patients Undergoing Repeat Stereotactic Radiosurgery for Vestibular Schwannoma with 5-Year Follow-up: A National Database Analysis
Conclusion More than half of the re-SRS procedures were noted within first year of initial SRS for VS. Overall payments at 5 years for repeat SRS was more than double that for nr-SRS. Repeat SRS was also associated with more re-admissions and outpatient services at annual follow-up time points. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 9, 2020 Category: Neurosurgery Authors: Dietz, Nicholas Sharma, Mayur Ugiliweneza, Beatrice Wang, Dengzhi Boakye, Maxwell Williams, Brian Andaluz, Norberto Tags: Original Article Source Type: research

Size Matters: Rethinking of the Sizing Classification of Pituitary Adenomas Based on the Rates of Surgery: A Multi-institutional Retrospective Study of 29,651 Patients
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1716673 Objective Pituitary adenomas are historically classified into microadenoma or macroadenomas based on size less than or greater than/equal to 1c m. “Giant” adenomas describe tumors ≥4 cm. The aim of this study is to present an evidence-based approach to size classification based on national trends. Design The design involved is multi-institutional retrospective study. Participants A total of 29,651 patients were studied from National Cancer Institute's SEER program from 2004 to 2016 across the United States. Main Outcome ...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Bhimani, Abhiraj D. Schupper, Alexander J. Arnone, Gregory D. Chada, Deeksha Chaker, Anisse N. Mohammadi, Nicki Hadjipanayis, Costas G. Mehta, Ankit I. Tags: Original Article Source Type: research

Morphometric Study of the Posterior Fossa: Identification of Practical Parameters for Tailored Selection of Surgical Routes to the Petroclival Region
We present the results of the morphometric analysis of the posterior fossa and a prediction model to enable skull base surgeons to choose an optimal surgical corridor considering patient's bony anatomy. Methods Ninety patients (14 to assess interobserver reliability) with temporal bone computed tomography were selected. Exclusion criteria included patients
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Aljuboori, Zaid Alhourani, Ahmad Nuru, Mohammed Nguyen, Candice Yeo, Heegook Williams, Brian Andaluz, Norberto Tags: Original Article Source Type: research

Endoscopic Transnasal Resection of Midline Skull Base Meningiomas: Tumor Consistency and Surgical Outcomes
J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1714111 Background The endoscopic transnasal approach (ETA) has proven to be of great value in the resection of midline skull base meningiomas when compared with traditional approaches. Our objective was to assess tumor consistency in relation to surgical outcomes for midline meningiomas (MMs) resected using ETA. Methods Radiological preoperative features, including the tumor to cerebellar peduncle T2-weighted magnetic resonance imaging (MRI) ratio (TCTI), were evaluated. The intraoperative consistency assessment was performed by the surgeon, which determined i...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Al Abdulsalam, Hissah K. Aldahish, Aljohara K. Albakr, Abdulrahman Hussain, Sajjad Alroqi, Ahmad Alromaih, Saud Alsaleh, Saad Ajlan, Abdulrazag M. Tags: Original Article Source Type: research

Beyond Antoni: A Surgeon's Guide to the Vestibular Schwannoma Microenvironment
Conclusion Observational research has revealed a complex and heterogeneous tumor microenvironment in VS. The functional landscape and roles of macrophages and other immune cells in the VS inflammatory infiltrate are, however, yet to be established. The antiangiogenic drug bevacizumab has shown the efficacy of targeted molecular therapies in VS and there is hope that agents targeting another major component of the VS microenvironment, inflammation, will also find a place in their future management. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  | &...
Source: Journal of Neurological Surgery Part B: Skull Base - September 9, 2020 Category: Neurosurgery Authors: Hannan, Cathal J. Lewis, Daniel O'Leary, Claire Donofrio, Carmine A. Evans, Dafydd G. Stapleton, Emma Freeman, Simon R. Lloyd, Simon K. Rutherford, Scott A. Hammerbeck-Ward, Charlotte Brough, David Allan, Stuart M. Coope, David King, Andrew T. Pathmanaban Tags: Invited Review Source Type: research

Transconjunctival and Transcaruncular Approaches to the Orbit
This article reviews the surgical steps of these approaches. The indications for each approach and case examples are illustrated. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle 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 - September 8, 2020 Category: Neurosurgery Authors: Wolkow, Natalie Freitag, Suzanne K. Tags: Review Article Source Type: research