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Morbid Obesity and Diabetes Increase the Risk of Reoperation following Microvascular Decompression: A National Surgical Quality Improvement Program Analysis of 1,303 Patients J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-18 Alper Dincer, Joanna K. Tabor, Alexandros F. Pappajohn, Joseph O'Brien, Saul Morales-Valero, Miri Kim, Jennifer Moliterno
Background Microvascular decompression (MVD) is the preferred treatment for refractory trigeminal neuralgia (TN) and hemifacial spasm (HFS). MVD provides long-lasting results for these conditions with a relatively low risk of postoperative complications. However, reoperation rates are reported up to 11%, an unacceptably high rate for an elective procedure. We determined what factors may increase the
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Primary Extracranial Meningiomas of the Sinonasal Tract: A Systematic Review J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-08 Xin L. Goh, Justin Rui Tzen Chee, Alex C. Tham
Background Primary extracranial meningiomas (PEMs) of the sinonasal tract with no intracranial extension are rare. Our study presents the largest systematic review to date, providing a comprehensive overview and comparison of the characteristics, treatment, and prognosis of PEMs, with comparison to primary intracranial meningiomas (PIMs). Methods A systematic review was conducted according to the PRISMA
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Complications of Endonasal Odontoidectomy in Pediatric versus Adult Populations: A Systematic Review and Meta-Analysis J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-01 Nikitha Kosaraju, Christine K. Lee, Z. Jason Qian, Juan C. Fernandez-Miranda, Jayakar V. Nayak, Michael T. Chang
Introduction Endonasal odontoidectomy (EO) is a procedure for addressing compressive pathology of the craniovertebral junction. While EO has been well established in adults, its complications and cervical fusion practices are less understood in pediatric patients, despite differences in sinonasal and craniocervical anatomy. This study summarizes and compares EO complications and need for cervical fusion
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Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-01 Anouk Frederique Heesters, Carli Tops, Thomas Potjer, Eleonora P.M. Corssmit, Jean-Pierre Bayley, Erik Hensen, Jeroen Jansen
Background SDHx variant carriers have an increased risk of developing head and neck paraganglioma. The Dutch guidelines state that these patients require lifelong follow-up, but no clear recommendation is made about the frequency of screening. Objective To determine the annual risk of developing head and neck paraganglioma in SDHx variant carriers after a negative initial screening. Methods We conducted
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Utilization of Polydioxanone Plate for Endoscopic Anterior Skull Base Repair: Operative Technique and Long-Term Cohort Outcomes J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-01 Jorge A. Gutierrez III, Zachary M. Soler, Thomas Larrew, Nikita Chapurin, Jeffrey E. Wessell, Rodney J. Schlosser, W. Alexander Vandergrift III
Objective The purpose of this study is to report the technical procedure and our experience using a polydioxanone suture (PDS) plate with dural substitute as part of a fully resorbable gasket seal technique to repair anterior skull base defects. Methods A series of patients undergoing anterior skull base reconstruction utilizing our resorbable gasket seal technique from January 2014 to July 2022 was
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Abducens Nerve Duplication: Novel Intraoperative and Radiographic Observation of a Rare Anatomical Variant J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-01
Objectives The abducens nerve has a long, serpentine subarachnoid course with complex topographical relationships, rendering abducens nerve palsy the most common ocular motor cranial nerve palsy in adults and second most common in pediatric patients, with anatomical variants reported in the literature. Preoperative awareness of abducens nerve variant anatomy may help prevent inadvertent intraoperative
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Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-03-01 Francois H. Cornelis, Eric Lis, Viviane Tabar, Andrew Lin
Purpose To assess the feasibility and safety of cone-beam computed tomography (CBCT) advanced navigation for optimizing intra-arterial chemotherapy infusion (IACI) in patients with skull base tumors. Materials and Methods Retrospective review on 10 consecutive IACI procedures performed in five patients (four women, 1 man) over a 1-year period. The median age of the patients was 71 years (interquartile
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Visual Outcomes after Suprasellar Meningioma Resection: A Retrospective Cohort Study and a Machine Learning-Based Predictive Model J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-23
Objectives In this research, the authors provide a retrospective cohort study of 82 patients with suprasellar meningiomas to identify predictors of the visual outcome following surgery. We also conducted a matched retrospective case–control analysis. Methods This retrospective cohort study included all patients who underwent craniotomy for surgical excision of suprasellar meningiomas at our institution
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A CT Radiologic Assessment of the Incidence of Cochlear–Facial Dehiscence and the Thickness of Bone between the Cochlea and Facial Nerve among Normal Temporal Bones J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-19 Diba Nayeri, Quinton Gopen
Cochlear–facial dehiscence (CFD) is a relatively new diagnosis which occurs when the bony partition between the labyrinthine segment of the facial nerve and the cochlea is dehiscent. This is considered one of several third window lesions which produce varying degrees of auditory and vestibular symptoms. Imaging studies have identified a consistently higher incidence of CFD when compared with the only
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Temporal CT Evaluation of the Relationships between Basic Anatomical Structures and the Round Window: Importance for the Cochlear Implant Surgery J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-19 Neşe Asal, Nuray Bayar Muluk, Pelin Zeynep Bekin Sarikaya
Objectives In the present study, we investigated the round window (RW) and neighboring anatomical structures using temporal computed tomography (CT) which are important for cochlear implant (CI) electrodes. Methods In this retrospective study, the temporal CT images of 112 adult patients (45 males and 67 females) were evaluated. We classified mastoid pneumatization, and measured RW diameter, RW–carotid
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Prediction of Survival in the Elderly Patients with Glioblastoma using Cumulative Inflammatory Markers Score J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-12 Kun Song, Chunjui Chen, Hao Xu, Lingchao Chen, Hongzhi Xu, Xi Han, Hong Chen, Zhiyong Qin
Objectives This retrospective study aimed to explore the prognostic effect of cumulative score based on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and fibrinogen in older adults diagnosed with glioblastoma (GBM). Design Retrospective study. Setting Huashan Hospital. Participants Patients aged over 60 years and diagnosed with GBM between 2010 and 2017. Main Outcome Measures Results
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Neuro-ophthalmologic Outcomes of Orbital Apex Syndrome Caused by Invasive Fungal Rhinosinusitis J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-09 Minhae Park, Joongbo Shin, Eunkyu Lee, Gwanghui Ryu, Min Chae Kang, Kyung-Ah Park, Doo-Sik Kong, Kyungmin Huh, Kyunga Kim, Hyo-Yeol Kim, Yong Gi Jung, Sang Duk Hong
Objectives Orbital apex syndrome (OAS) is characterized by visual loss, ophthalmoplegia, ptosis, and orbital pain. This study aims to analyze neuro-ophthalmologic outcomes of OAS resulting from invasive fungal rhinosinusitis (IFS). Methods This retrospective study analyzed 25 patients diagnosed with OAS resulting from IFS between January 2018 and July 2022. Patient's visual acuity, degree of ophthalmoplegia
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Reliability of Neuronavigation in Localizing the Internal Acoustic Canal during Middle Fossa Approach J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-09 Tufan Agah Kartum, Baris Kucukyuruk, Alperen Kaya, Levent Aydin, Necmettin Tanriover, Galip Zihni zihni Sanus
Objective The absence of precise landmarks in the middle fossa floor and frequent anatomical variations make it difficult to localize the internal acoustic canal (IAC) during the middle fossa approach (MFA). We aimed to investigate the reliability and utility of the neuronavigation system (NNS) in the MFA and to delineate specific technical considerations regarding NNS during the approach. Method One-millimeter-thin
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C2 Vertebra: An Enigma for Young Spine/Neurosurgeons J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-09 Mayank Garg, Raghavendra K. Sharma, Vikas Janu, Mohit Agrawal, Ashutosh Jha, Pushpinder Khera, Deepak K. Jha
Background Instrumentation of C2 vertebra is considered the most difficult for young neurosurgeons and trainees due to its complex anatomical structures, variety of surgical approaches and techniques, and proximity to important neurovascular structures. Key points from a surgical perspective for midline posterior approach is described in the era of neuroradiological advancements. Method Computed tomography
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Risk Factors for Development of Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Transsphenoidal Resection of Pituitary Adenoma J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-02-02 Gabrielle Petito, Alex Hu, Grace Zhang, Susie Min, Siddhant H. Tripathi, Adithya Kumar, Geet Shukla, Sanjit Shah, Katie M. Phillips, Suman Jana, Jonathan A. Forbes, Mario Zuccarello, Norberto O. Andaluz, Ahmad R. Sedaghat
Background We aimed to determine the incidence and risk factors for development of diabetes insipidus (DI) and syndrome of inappropriate antidiuretic hormone secretion (SIADH) after transsphenoidal hypophysectomy (TSH) for resection of a pituitary adenoma. Methods This was a retrospective study of 403 adult patients undergoing TSH for pituitary adenoma. Clinical variables, tumor characteristics, and
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Reporting of Participants' Sex, Race, Ethnicity, and Socioeconomic Status in Pituitary Surgery Literature J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-29 Anahita Nourmahnad, Julian A. Purrinos, Renata Grozovsky, Angela M. Richardson, Corinna G. Levine
Introduction Social determinants of health (SDOH) are associated with differential outcomes after pituitary tumor treatment. However, the specific impact of SDOH is not well characterized. One reason may be the lack of collection and reporting of sociodemographic variables in the literature. This study aims to evaluate the frequency of reporting and distribution of participants' sex, race, ethnicity
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Audiometric Outcomes of Auditory Brainstem Implantation during Vestibular Schwannoma Resection in NF2 Patients J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-29 Víctor Alfonso de Cos, Madeline Gibson, Vivienne Li, Olivia La Monte, Omid Moshtaghi, Peter Dixon, Usman Khan, Rick Friedman, Marc S. Schwartz
Background Many patients with neurofibromatosis type 2 (NF2) suffer from sensorineural hearing loss, and associated cochlear nerve compromise in NF2 patients makes auditory brainstem implant (ABI) an attractive treatment option. The long-term outcomes and benefits of the device are still being explored. Methods A retrospective review was conducted for 11 ABI recipients at a single-institution tertiary
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Residency Education Practices in Endoscopic Skull Base Surgery J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-23 Rose Dimitroyannis, Sharanya Thodupunoori, Sean Polster, Paramita Das, Christopher Roxbury
Background There has been increased interest in how residents train in the subspecialty of skull base surgery. Examining which training methods are popular and effective to optimize residency learning is necessary, especially with new training adjuncts available to the modern trainee. In this study, we survey North American Skull Base Society (NASBS) members to analyze endoscopic skull base surgery
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Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 1: The Retrosigmoid Approach) J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-22 Joachim Starup-Hansen, Simon C. Williams, Alexandra Valetopoulou, Danyal Z. Khan, Hugo Layard Horsfall, Jigishaa Moudgil-Joshi, Oliver Burton, Hala Kanona, Shakeel R. Saeed, William Muirhead, Hani J. Marcus, Patrick Grover
Objective Despite advances in skull-base reconstruction techniques, cerebrospinal fluid (CSF) leaks remain a common complication following retrosigmoid (RS) vestibular schwannoma (VS) surgery. We aimed to review and classify the available strategies used to prevent CSF leaks following RS VS surgery. Methods A systematic review, including studies of adults undergoing RS VS surgery since 2000, was conducted
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Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 2: The Translabyrinthine Approach) J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-22 Joachim Starup-Hansen, Simon Williams, Alexandra Valetopoulou, Danyal Z Khan, Hugo Layard Horsfall, Jigishaa Moudgil-Joshi, Oliver Burton, Hala Kanona, Shakeel Saeed, William Muirhead, Hani J Marcus, Patrick Grover
Objectives Despite advances in skull base reconstruction techniques, cerebrospinal fluid (CSF) leaks remain a relatively common complication after translabyrinthine (TL) vestibular schwannoma (VS) surgery. We conducted a systematic review to synthesize the repair techniques and materials used in TL VS surgery to prevent CSF leaks. Design A systematic review of studies published since 2000 reporting
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Ipsilateral Nasoseptal Flaps in a Transpterygoid Approach: Technical Pearls and Reconstruction Outcomes J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-22 Michael T. Chang, David Grimm, Karam Asmaro, Michael Yong, Christopher Low, Christine K. Lee, Jayakar V. Nayak, Peter H. Hwang, Juan C. Fernandez-Miranda, Zara M. Patel
Background Transpterygoid approaches to the skull base require dissection of the sphenopalatine artery, potentially compromising the option to harvest an ipsilateral nasoseptal flap (NSF) for reconstruction. In cases where other reconstructive options are limited, it may be necessary to utilize a NSF ipsilateral to the transpterygoid approach. Here, we describe the technique of NSF pedicle preservation
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Induction Chemotherapy for Locoregionally Advanced Sinonasal Squamous Cell Carcinoma J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-09 Arash Abiri, Derek H. Liu, Theodore V. Nguyen, Jonathan C. Pang, Sina J. Torabi, Edward C. Kuan
Background There is emerging evidence to suggest the role of induction chemotherapy (IC) in definitive management of locoregionally advanced sinonasal squamous cell carcinoma (SNSCC). We evaluated the influence of IC on survival and predictors of its use in SNSCC patients. Methods The 2004 to 2017 National Cancer Database was queried for patients with locoregionally advanced SNSCC (T4/M0). Treatments
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Burr Hole Endoscopic Mastoidectomy: A Morphometric Cadaveric Study J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2024-01-04 Pascal Lavergne, Tawfiq Khoury, KiChang Kang, Anish Sathe, Patrick Kelly, James Evans
Introduction Traditional open mastoidectomy is performed through a retro-auricular incision to expose the mastoid cortex. Few have addressed the possibility of performing an endoscopic minimally invasive mastoidectomy. Objective Our objective was to test the feasibility of performing an endoscopic mastoidectomy through a 1 cm incision and burr hole. Methods Ten cadaver heads (20 mastoids) were used
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Analysis of Treatment Modalities for Advanced Stage Squamous Cell Carcinoma of the Maxillary Sinus: A National Cancer Database Study J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-27 Kue T. Lee, Duncan Kleinbub, Camilo R. Gelves
Introduction Stage cT4a and cT4b squamous cell carcinomas (SCCa) typically require multimodal treatment with adjuvant or neoadjuvant therapy. This study aims to evaluate the impact of different treatment modalities on survival outcomes in patients with stage cT4a-b SCCa exclusively of the maxillary sinus. Methods A multivariate survival analysis was conducted, evaluating treatment modalities for patients
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Diagnostic Accuracy of Contrast-Enhanced MRI for Detection of Perineural Spread in Head and Neck Cancer: A Systematic Review and Meta-Analysis J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-22
Objectives The aim of this study was to determine the diagnostic accuracy of contrast-enhanced magnetic resonance imaging (CE-MRI) for the detection of perineural spread (PNS) in head and neck cancer patients. Methods A systematic review of PubMed, Embase, Scopus, Web of Science and Cochrane Library databases was performed up to May 20, 2022. We included diagnostic accuracy studies that used CE-MRI
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A Comprehensive Analysis of Academic Attributes of the Presidents of the North American Skull Base Society J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-22 Tritan Plute, Othman Bin-Alamer, Arka N. Mallela, Georgios A. Zenonos, Eric W. Wang, Paul A. Gardner, William T. Couldwell, Carl H. Snyderman, Hussam Abou-Al-Shaar
Objectives Our objective was to elucidate the demographic, academic, and career attributes of North American Skull Base Society (NASBS) presidents and determine how leadership of this society has changed over time. Design Thirty-one NASBS presidents have served between 1990 and 2021. Demographic and scholarly variables were recorded from publicly available sources. To determine how trends in NASBS
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Outcomes of Extended Middle Fossa Approach for Petroclival Tumors in the Elderly J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-22 Vivian F. Kaul, Micah K. Harris, Masanari Kato, Guilherme Finger, Thomas Gao, Douglas A. Hardesty, Daniel M. Prevedello, Yin Ren, Oliver F. Adunka
Objective The aims of the study are (1) to evaluate the extended middle fossa approach (eMCF) for resection of tumors in the petroclivus and anterior cerebellopontine angle (CPA) and (2) to compare surgical outcomes between elderly (≥65 years) and nonelderly patients. Design Retrospective cohort. Setting Tertiary referral center. Participants Adults with petroclival, anterior CPA, or posterior fossa
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Gender Differences in Quality-of-Life Outcome in Patients Undergoing Endoscopic Endonasal Skull Base Surgery J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-13 Parker Tumlin, Zayd Al-Asadi, Meghan Turner, Hassan H. Ramadan, Chadi A. Makary
Background Prior studies showed that female patients with chronic rhinosinusitis (CRS) suffer a worse disease-specific quality of life (QoL). Goal The aim of this study is to investigate gender differences in sinonasal QoL outcomes in patients requiring endoscopic endonasal skull base surgeries (EESBS). Methods Cross-sectional analysis of patients presenting to our clinic from August 2020 to December
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Outcomes after Surgical Resection of Jugular Foramen Schwannomas: Systematic Review and Meta-Analysis J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-13 Haydn Hoffman, Brendan B. Maloney, Dan Y. Draytsel, Harish Babu
Objectives We sought to perform a systematic review and meta-analysis of outcomes after surgical resection of jugular foramen schwannomas (JFSs). Design A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Setting PubMed, Scopus, and Embase databases were searched. Participants Case series of at
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Outcome Measures for Medical and Surgical Treatment of Prolactinomas. Is the Role of Surgery Underestimated? J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-13 Andrius Anuzis, Kevin O. Lillehei
Introduction The first line treatment for prolactinomas is currently dopamine agonists (DAs). Medical management is prolonged, associated with side effects, financial, and psychological burdens. In dedicated centers, pituitary surgery is a low-risk alternative. We evaluated outcome measures of medical and surgical treatment, to assess, if the role of surgery is underestimated. Methods We reviewed the
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Outcomes of the Endoscopic Endonasal Approach for the Treatment of Clival Chordomas: A Single-Center Experience J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-12-04
Objective Chordoma is a low-grade malignant tumor that originates from the remnant tissue of the embryonic notochord. Postoperative or definitive radiotherapy (RT) has been used to enhance local control. This study aims to assess the outcomes of the expanded endoscopic endonasal approach (EEA) for maximal removal of clival chordomas followed by RT for visualized residual or tumor recurrence. Materials
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Surgical Nuances and Predictors of Requirement for Suprameatal Tubercle Removal in Microvascular Decompression for Trigeminal Neuralgia J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-28 Koichi Iwasaki, Minami Uezato, Namiko Nishida, Naoya Yoshimoto, Kazushi Kitamura, Masanori Gomi, Hirokuni Hashikata, Isao Sasaki, Hiroki Toda
Objective Suprameatal tubercle (SMT), a bony prominence located above the internal acoustic meatus, is reported to impede the microscopic view during microvascular decompression (MVD) for trigeminal neuralgia (TN). For an enlarged SMT, removal of the SMT may be required in addition to the routine MVD to precisely localize the offending vessels. The objective of this study is to investigate the predictive
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Idiopathic Intracranial Hypertension Is Associated with Recurrent CSF Leak and Reoperation for Spontaneous Temporal Encephalocele J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-28
Objective Spontaneous temporal encephaloceles (STEs) are increasingly recognized as sequelae of idiopathic intracranial hypertension (IIH), which in turn may further complicate their management. We endeavored to review the University of Pennsylvania institutional experience on operative management of STEs, with a focus on factors which may influence surgical outcomes, particularly IIH. Design Retrospective
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Vestibular Prehabilitation—A Single UK Center Experience and Literature Review J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-24 Lucie Ferguson, Victoria Ruane, Nitin Mukerji, Jenna Quail, Hussein Mansoor, K. S. Manjunath Prasad, Noweed Ahmad
Objectives To assess whether vestibular prehabilitation with intratympanic gentamicin is a useful preoperative adjunct in allowing for early mobilization and short length of stay in patients with vestibular schwannoma (VS). Design Retrospective single-center study and literature review. Setting Tertiary neurosurgical center. Participants Adult patients undergoing surgery for VS. Main Outcome Measures Our
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Association of Decreased Enhancement of Nasoseptal Flap on Postoperative Magnetic Resonance Imaging with the Risk of Complication J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-15 Peter M. Wingrove, Keerthi N. Arani, Carl H. Snyderman, Paul A. Gardner, David T. Fernandes Cabral, Georgios A. Zenonos, Eric W. Wang, Joseph Chabot, Juan C. Fernandez-Miranda, Yue-Fang Chang, Marion A. Hughes
Objectives Our objective was to determine if decreased contrast enhancement on postoperative magnetic resonance imaging (MRI) is associated with an increased risk of complication in patients who have undergone nasoseptal flap (NSF) reconstruction. Design/Setting This was a single-institution retrospective study of patients who underwent a first-time endoscopic endonasal approach (EEA) with NSF reconstruction
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Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Lateral Supraorbital Approach with Expanded Indications J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-08 Xiaochun Zhao, Kiana Y. Prather, Andrew M. Bauer, Ian F. Dunn, Christopher S. Graffeo
Objectives The lateral supraorbital (LSO) approach is a less-invasive alternative to the pterional craniotomy that provides rapid transsylvian access. Establishing familiarity with the LSO technique and its features as compared with other anterolateral approaches is an important component of advanced skull base training. We present a step-by-step demonstration of the LSO approach using cadaveric dissection
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Epidural Interlay Graft for Pituitary Surgery: A 4-Year Institutional Experience J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-08
Objective Sellar repair techniques with varying complexity and effectiveness have been employed to reduce the incidence of postoperative cerebrospinal fluid (CSF) leaks following endoscopic transsphenoidal pituitary surgery. This study describes our institutional experience with a minimalistic, highly effective approach to sellar repair. Methods The authors performed a retrospective review of consecutive
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Significant Underreporting of Preoperative Hyposmia in Patients Undergoing Endoscopic Skull Base Surgery: Discrepancies Between Subjective and Objective Measurements J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-08 Lindsey F. Jackson, Jennifer K. Mulligan, Jeb M. Justice, Steven N. Roper, Jason E. Blatt, Brian C. Lobo
Objective The assessment of baseline olfactory function before endoscopic skull base surgery (ESBS) has been relatively limited compared with analysis before functional endoscopic sinus surgery (FESS). Our study addresses this knowledge gap, assessing preoperative olfactory function in ESBS and FESS and elucidating any differences. Study Design We conducted a retrospective review of patients undergoing
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Assessing the Quality of Recruitment Information on Skull Base Surgical Fellowship Program Websites J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-11-03 Hana Sung, Emily Ton, Nolan J. Brown, Zach Pennington, Sachiv Chakravarti, Dontre M. Douse, Julian Gendreau, Siviero Agazzi, Matthew L. Carlson, Michael J. Link, Jamie J. Van Gompel
Introduction The American Association of Neurological Surgeons (AANS), North American Skull Base Society (NASBS), American Rhinologic Society (ARS), and American Neurotology Society (ANS) fellowship directories are important information repositories for skull base surgical fellowship programs. However, there is limited research on the amount and depth of information available through these resources
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Endoscopic Endonasal Approach for Clival Chordomas in Elderly Patients: Clinical Characteristics, Patient Outcome, and Recurrence Rate J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-10-30
Introduction The endoscopic endonasal route has demonstrated to be the approach of choice for a large majority of clival chordomas (CCs). However, its results in elderly patients are under-evaluated in the literature. The aim of this study is to assess the surgical outcome for these patients, determining the factors associated with a larger tumor resection in this population. Materials and Methods Our
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Cost of Vestibular Schwannoma Treatment: A Systematic Review and Meta-Analysis J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-10-18 Stefan W. Koester, Robert J. Dambrino IV, Akshay Bhamidipati, Gunther Wong, Campbell Liles, Michael Feldman, Lola B. Chambless
Introduction Research furthering treatment efficacy for microsurgical resection and stereotactic radiosurgery for vestibular schwannoma (VS) is ever-growing; however, there remains a paucity of research addressing treatment costs. Our aim is to define the reported costs of different treatment modalities used for VS. Methods A systematic review of the literature for VS treatment cost was conducted in
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Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Bifrontal Transbasal Approach, Surgical Principles, and Illustrative Cases J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-10-09 Larissa Vilany, Danielle D. Dang, Edoardo Agosti, Pedro Plou, Luciano C. P. C. Leonel, Stephen Graepel, Carlos D. Pinheiro-Neto, Giuseppe Lanzino, Michael J. Link, Maria Peris-Celda
Introduction The transbasal approach traditionally uses a bicoronal scalp incision with bifrontal craniotomy to establish an extradural midline skull base working corridor. Depending on additional craniofacial osteotomies, this approach can expand its reach to the nasal cavity and paranasal sinuses and may be employed for the resection of particularly complex sinonasal and midline skull base tumors
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Neurocognitive Functioning of Patients with Sinonasal and Nasopharyngeal Cancers Treated With Multimodality Therapy J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-27
Importance Few recent studies have examined neurocognitive functioning (NCF) in patients with sinonasal and nasopharyngeal cancers (NPCs) prior to and following multimodality therapy or the potential differences in NCF by disease variables such as disease site. Objective The objective of this study is to determine rates of NCF impairments prior to and following multimodality therapy, declines in NCF
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The Role of the Transeptal Window in Endoscopic Endonasal Access to the Contralateral Orbit J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-27 Juan M. Revuelta-Barbero, Alejandra Rodas, Edoardo Porto, Jackson R. Vuncannon, Youssef M. Zohdy, Justin Maldonado, C. Arturo Solares, Oswaldo Henriquez, Gustavo Pradilla
Objective This study aimed to objectively compare maneuverability at the contralateral medial orbit when approached through the traditional endoscopic endonasal approach (EEA) and EEA with transeptal window (TW). Study Design Anatomic dissections were performed bilaterally on three latex-injected cadaveric heads. Approaches were performed sequentially; initially, an EEA was fashioned. Binostril access
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Clinical Study of Symptomatic Nonacute Intracranial Large Arterial Occlusion with Endovascular Recanalization J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-27 Bitang Dan, Bifeng Zhu, Wei Zeng, Tao Peng, Jing Liu, Xin Li, Junjian Zhang
Objectives This study reported a single-center clinical trial of endovascular treatment for symptomatic nonacute occlusion of the intracranial large artery (NA-ILAO). The aim of this study was to evaluate the safety, feasibility, and clinical effect of simple balloon dilatation and stent implantation. Methods The patients diagnosed with symptomatic NA-ILAO were enrolled. A total of 40 cases were included
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Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Endoscopic Endonasal Approach to the Anterior Cranial Fossa J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-27 Edoardo Agosti, A. Yohan Alexander, Luciano C. P. C. Leonel, Stephen Graepel, Garret Choby, Carlos D. Pinheiro-Neto, Maria Peris Celda
Introduction The development of endoscopic techniques has made endoscopic endonasal approaches (EEAs) to the anterior cranial fossa (ACF) increasingly popular. Still, the steps and nuances involved in the approach may be difficult to understand for trainees. Thus, we aim to didactically describe the EEAs to the ACF in an anatomically based, step-by-step manner with supplementary clinical cases. Methods Six
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Endoscopic Multiportal Approaches to Meckel's Cave: A Cadaveric Study and a Three-Dimensional Anatomical Video J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25 Eman H. Salem, Ahmed Musaad Abd El-Fattah, Hisham Atef Ebada, Kyle van Koevering, Douglas A. Hardesty, Daniel M. Prevedello, Mohamed Abd El-halem Al-Saddeik, Ricardo L. Carrau
Objective This cadaveric study aims to illustrate the lateral transorbital (LTO), transantral transpterygoid (TATP), and endoscopic endonasal approaches (EEA) to Meckel's cave (MC), defining their surgical freedom, area of exposure, and advantages and limitations; thus, refining their respective indications. Design Cadaveric study. Setting The Anatomical Laboratory for Visuospatial Innovations in Otolaryngology
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Functional and Radiographic Outcomes of Cavernous Meningiomas Based on Treatment Modality J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25 Brandon Laing, Christina Feller, Randall Treffy, Andrew Montoure, Benjamin Best, Nathan T. Zwagerman
Introduction Cavernous sinus meningiomas (CSMs) are challenging given their proximity to neurovascular structures. Treatments include surgery, radiation, or observation. There are little data comparing outcomes based on treatment. This study presents the radiographic and functional outcomes of patients with CSMs treated with either radiation, surgical resection ± radiation, or radiographic surveillance
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Multidisciplinary Management of Lateral Skull Base Paragangliomas: A 20-Year Experience J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25 Eoin F. Cleere, Laura Mc Loughlin, Orla McArdle, David Fitzpatrick, Seamus Looby, D. Rawluk, Mohsen Javadpour, Rory McConn-Walsh
Objectives Paragangliomas of the lateral skull base are rare, largely benign, neuroendocrine tumors. Little evidence exists to support clinicians in the management of these tumors. The present study evaluates considerations in the multidisciplinary workup and management of paragangliomas affecting the lateral skull base. Methods A STrengthening the Reporting of OBservational studies in Epidemiology
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Induction Chemotherapy for Sinonasal Tumors in Patients Presenting with Brain Invasion and/or Neurological Deficits J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25
Objective The aim of this study was to investigate the safety of induction chemotherapy (IC) for patients with sinonasal malignancies with brain invasion or a neurological deficit. Methods We conducted a retrospective analysis of patients who underwent IC for sinonasal malignancies with intracranial invasion or a neurological deficit at a single tertiary cancer center from 1992 to 2020. Results In
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Self-Reported Olfactory Outcomes in Transplanum and Transtuberculum Approaches J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25 Zainab Balogun, Harish Dharmarajan, Anandraj Kanwar, Paul A. Gardner, Georgios A. Zenonos, Carl H. Snyderman, Katie Traylor, Eric W. Wang
Objectives The aim of this study was to determine the clinical characteristics and cephalometric risk factors associated with decreased postoperative olfaction in patients in whom the transplanum and transtuberculum expanded endonasal approach (EEA) was performed. Methods A retrospective cohort of 41 patients treated with the transplanum and transtuberculum EEA was divided into two groups based on
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Comparison of Sinonasal Outcomes in Patients Undergoing Uni-nostril and Bi-nostril Endoscopic Trans-sphenoidal Excision of Pituitary Adenomas: A Prospective Study J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-25 Hemanth Vupputuri, Wilson Prashanth D'Souza, Zoremsangi Ralte, Vikram Malleshappa, Ari George Chacko, Vedantam Rupa, Vedantam Rajshekhar
Background Prospective studies comparing quality-of-life and olfaction in patients undergoing endoscopic uni-nostril versus bi-nostril trans-sphenoidal pituitary surgery have not been published. Methods We prospectively compared olfaction and quality-of-life at baseline and at 3 to 6 months follow-up using the Anterior Skull Base Nasal Inventory-12 (ASK-12) questionnaire, composite olfaction score
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Transorbital Microsurgery: An Anatomical Description of a Minimally Invasive Corridor to the Anterior Cranial Fossa and Paramedian Structures J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-09-04 Lena Mary Houlihan, Thanapong Loymak, Irakliy Abramov, Mohamed A. Labib, Michael G. J. O'Sullivan, Michael T. Lawton, Mark C. Preul
Objectives Transorbital neuroendoscopic surgery (TONES) has ignited interest in the transorbital access corridor, increasing its use for single and multi-portal skull base interventions. However, the crowding of a small corridor and two-dimensional viewing restrict this access portal. Design Cadaveric qualitative study to assess the feasibility of transorbital microsurgery (TMS). Setting Anatomical
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Significant Variability in Postoperative Thromboprophylaxis in Cushing's Disease Patients: A Survey of the North American Skull Base Society and the AANS/CNS Joint Tumor Section J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-29 Alexandra J. White, João Paulo Almeida, Jordan C. Petitt, Divya Yogi-Morren, Pablo F. Recinos, Varun R. Kshettry
Introduction Cushing's disease (CD) is associated with hypercoagulability which is associated with an increased risk of venous thromboembolic events (VTEs) perioperatively. This risk persists even after successful transsphenoidal surgery (TSS). However, there are no current guidelines for pharmacologic thromboprophylaxis in this patient population. Objective Characterize existing thromboprophylaxis
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Endoscopic Reconstruction of the Sellar Floor by Extended Inferior Turbinate Flap in Recurrent Pituitary Tumors J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-29 Hatem M. Elsamouly, Ahmed Zaghloul, Ahmed Younis, Abdelgawad Hadeya, Ahmed Adel Ayad, Mansor Ali Hendawy, Islam M. Alaghory, Mohamed Barania, Mohamed Ellabbad, Mohamed Attia
Objective This aim of this study was to address the outcome of endoscopic reconstruction of the sellar floor by extended inferior turbinate flap. Patients and Methods This is a retrospective study of 34 patients with a recurrent pituitary tumor. They were treated between March 2018 and December 2021 by endoscopic extended endonasal approach with the reconstruction of the sellar floor by an extended
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Changing Spectrum of Invasive Fungal Infections of the Anterior Skull Base J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-29 Govind Shripad Bhuskute, Amit Kumar Keshri, Malathy Seduchidambaram, Abhishek Dubey, Nazrin Hameed, Kalyan Chidambaram, Manjul Muraleedharan, Kuntal Kanti Das, Anant Mehrotra, Arun Srivastava, Awadesh Jaiswal, Raj Kumar, Ravi Sankar Manogaran
Objective To study the etiological and anatomical factors in pathophysiology of invasive fungal rhinosinusitis affecting the skull base. Design Retrospective clinical study over 5 years. Setting Single-center tertiary referral hospital. Materials and Methods All cases of invasive fungal rhinosinusitis with clinicoradiological and/or operative evidence of anterior and central skull base, orbit, and
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Reestablishment of the Smile after Hypoglossal–Facial Nerve Transfer: What Can We Learn? J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-11 M.C. Kleijwegt, C. Wever, E.F. Hensen, J.C. Jansen, R.W. Koot, M.J.A. Malessy
Objective The aim of this study was to assess the ability to smile following a hypoglossal–facial nerve transfer (N12–N7). Design This is a retrospective chart review. Setting National tertiary referral center for skull base pathology. Participants Seventeen patients. Main Outcome Measures The ability to smile following an N12–N7 transfer was assessed by five medical doctors on photographs of the whole
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Neuroendoscopy-Assisted Minimal Invasive Management of Chiari 1 Malformation J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-11 Göksal Günerhan, Emin Çağıl, Zeynep Dağlar, Uğur Kemal Gündüz, Ali Dalgıç, Ahmet Deniz Belen
Objective The aim this study is to present the results of the minimal invasive neuroendoscopic-assisted system application as an alternative to traditional surgery in patients with Chiari malformation type 1 (CM type 1) with/without syringomyelia. Design, Setting, and Participants In the study, data of 22 symptomatic patients were prospectively collected. Before and after the operation, patient characteristics
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Reuse of Nasoseptal Flaps for Endoscopic Endonasal Skull Base Reconstruction J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-04 Ernest J. Bobeff, Dimitrios Mathios, Davide Longo, Joshua Estin, Shejoy Joshua, Abtin Tabaee, Ashutosh Kacker, Vijay K. Anand, Theodore H. Schwartz
Introduction Pedicled nasoseptal flap (NSF) placement is a critical component of skull base reconstruction after endoscopic endonasal approaches (EEAs). The effectiveness of NSF reuse has not been thoroughly studied. Prior reports using flaps harvested at one center and reused at another may have technical variability bias. Methods We identified patients who underwent both their initial and NSF-reused
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Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Endoscopic Endonasal Middle-Inferior Clivectomy, Odontoidectomy, and Far-Medial Approach J. Neurol. Surg. Part B Skull Base (IF 0.9) Pub Date : 2023-08-02 Edoardo Agosti, A. Yohan Alexander, Luciano C. P. C. Leonel, Jamie J. Van Gompel, Michael J. Link, Garret Choby, Carlos D. Pinheiro-Neto, Maria Peris-Celda
Introduction The clival, paraclival, and craniocervical junction regions are challenging surgical targets. To approach these areas, endoscopic endonasal transclival approaches (EETCAs) and their extensions (far-medial approach and odontoidectomy) have gained popularity as they obviate manipulating and working between neurovascular structures. Although several cadaveric studies have further refined