MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Skull Base' source. Thu, 18 Mar 2010 14:20:32 +0100 http://www.medworm.com/index.php?rid=3360777&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249249 Skull BaseDOI: 10.1055/s-0030-1249249ABSTRACTCerebrospinal fluid leaks of the temporal bone are rare, often occult, and sometimes challenging to localize and repair. This is a retrospective study of eight patients with spontaneous cerebrospinal fluid leak and six patients with cerebrospinal fluid leak or encephalocele discovered during chronic ear surgery who were treated in a tertiary medical center over a 5-year period. All received preoperative temporal bone computed tomography, and six also underwent magnetic resonance imaging, one computed tomography cisternography, and one radionuclide cisternography. All patients initially underwent a transmastoid surgical approach. Additional exposure was necessary in three patients; two underwent middle fossa craniotomy and another required minicr... Skull Base journals http://www.medworm.com/rss/comments.php?id=3360777 Sat, 13 Mar 2010 14:19:55 +0100 3360777 http://www.medworm.com/index.php?rid=3360776&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249574 Skull BaseDOI: 10.1055/s-0030-1249574ABSTRACTPostoperative temporalis muscle atrophy from injury to the neurovascular supply can cause significant cosmetic disfigurement, and avoidance of electrocautery use has become a common practice in minimizing this outcome. We attempted to quantify the effects of electrocautery on temporalis atrophy by retrospectively reviewing postoperative magnetic resonance images in patients having undergone an orbital frontal craniotomy. We reviewed medical records and compared volumetric measurements of the temporalis muscle in 25 patients using the contralateral temporalis muscle as an internal control. The mean size of the nonsurgical temporalis muscle was 24.6 cm as compared with 23.6 cm on the operated side. The difference of 1.0 cm was not statistically si... Skull Base journals http://www.medworm.com/rss/comments.php?id=3360776 Sat, 13 Mar 2010 14:19:55 +0100 3360776 http://www.medworm.com/index.php?rid=3360775&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249573 Skull BaseDOI: 10.1055/s-0030-1249573ABSTRACTThe purpose of this report is to present indications and risks of endoscopic transsphenoidal approach to treat petrous apex cholesteatoma. This is a retrospective analysis of two cases of petrous apex cholesteatoma presenting with double vision who underwent an endoscopic transsphenoidal approach at Lariboisiere Hospital, Paris, France. Control of the lesion was satisfactory in both cases. However, a minor pontic stroke resulted in transient hemiparesis in the case with dehiscent dura around the petrous apex cholesteatoma. To our knowledge, there are the first cases of petrous apex cholesteatoma reported to be removed by an endoscopic transsphenoidal approach, using image guidance system, with minimal morbidity.[...]© Thieme Medical PublishersG... Skull Base journals http://www.medworm.com/rss/comments.php?id=3360775 Sat, 13 Mar 2010 03:17:37 +0100 3360775 http://www.medworm.com/index.php?rid=3356011&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249571 Skull BaseDOI: 10.1055/s-0030-1249571ABSTRACTWe quantitatively compared relative merits of lateral approaches to the pontomesencephalic junction (PMJ): anterior petrosectomy, subtemporal transtentorial, posterior petrosectomy, and retrosigmoid transtentorial. In dissected cadaveric heads, lengths of exposure were measured anteriorly from CN V along the pontomesencephalic sulcus (PMS); posterosuperiorly along the lateral mesencephalic sulcus (LMS); and posteroinferiorly along the interpeduncular sulcus (IPS). Subtemporal transtentorial approach provided best anterior exposure along the PMS (23.8 ± 4.5 mm). Posterosuperior exposures were comparable for all approaches except anterior petrosectomy (limited). Posteroinferior exposure was most with subtemporal transtentorial approac... Skull Base journals http://www.medworm.com/rss/comments.php?id=3356011 Fri, 12 Mar 2010 14:22:12 +0100 3356011 http://www.medworm.com/index.php?rid=3356010&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249248 Skull BaseDOI: 10.1055/s-0030-1249248ABSTRACTTo assess the severity and evolution of sinonasal symptoms in patients following endoscopic anterior skull base surgery to define the typical postoperative course. Design: Cross sectional study. Participants include 69 patients who underwent endoscopic skull base surgery by a dual surgeon team (otolaryngologist and neurosurgeon) from January 2008 to August 2009. Main outcome measures: Sinonasal Outcomes Test (SNOT)-20 survey scores at preoperative and at three postoperative time points. An ordinal logistic regression model was used to analyze the data, summarizing the relationship between the outcome (SNOT score) and the predictor (time point) using an odds ratio. Scores for the symptoms of need to blow nose, sneezing, runny nose, postnasal disc... Skull Base journals http://www.medworm.com/rss/comments.php?id=3356010 Fri, 12 Mar 2010 14:22:12 +0100 3356010 http://www.medworm.com/index.php?rid=3356009&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249572 Skull BaseDOI: 10.1055/s-0030-1249572ABSTRACTSubfrontal schwannomas, sometimes referred to as olfactory groove schwannomas, are rare tumors (34 cases reported to date). Despite the name and several theories proposed in the literature, there is no officially recognized description of the tumor's cell origin. Yasuda proposed the concept of an olfactory ensheathing cell (OEC) tumor in 2006. Olfactory ensheathing cells are glial cells that ensheath the axons of the first cranial nerve. Microscopically, both olfactory ensheathing cells and Schwann cells have similar morphological and immunohistochemical features. However, immunohistochemically olfactory ensheathing cells are negative for Leu7 and Schwann cells positive. A 30-year-old woman presented with a subfrontal, extraaxial, enhancing tumo... Skull Base journals http://www.medworm.com/rss/comments.php?id=3356009 Fri, 12 Mar 2010 14:22:12 +0100 3356009 http://www.medworm.com/index.php?rid=3356008&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249244 Skull BaseDOI: 10.1055/s-0030-1249244ABSTRACTOsteoradionecrosis of the cervical spine is a rare complication of radiation treatment of head and neck tumors that requires a multidisciplinary approach to management and reconstruction. The case of a 57-year-old man with osteoradionecrosis of the cervical spine secondary to radiation for metastatic hepatocellular carcinoma is presented. Operative debridement of the necrotic bone was performed and the nasopharyngeal soft tissue defect was reconstructed with a radial forearm free flap. The management and reconstruction options for osteoradionecrosis of the cervical spine are discussed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3356008 Fri, 12 Mar 2010 14:22:12 +0100 3356008 http://www.medworm.com/index.php?rid=3356007&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249570 We present a case of an atypical clival meningeal melanoma treated with a multidisciplinary staged transcrusal and transsphenoidal endoscopic surgical approach. A 45-year-old woman presented with a 15-month history of visual symptoms, neck pain, and unsteadiness. Magnetic resonance imaging of the head revealed a clival mass with both intracranial and extracranial involvement. Endoscopic clival biopsy suggested a melanocytic tumor. Extensive imaging and dermatological workup did not demonstrate a primary source. A multidisciplinary staged surgical resection included a transcrusal approach to resect the intracranial component, followed by transsphenoidal endoscopic resection of the extracranial component. Postoperatively, she received adjuvant radiation. At 1 year following surgery, the pati... Skull Base journals http://www.medworm.com/rss/comments.php?id=3356007 Fri, 12 Mar 2010 03:12:06 +0100 3356007 http://www.medworm.com/index.php?rid=3324284&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249246 We present the case of a 52-year-old male patient, who showed isolated palsies of the tenth and twelfth nerve without any other symptoms. Magnetic resonance imaging (T1) depicted a hyperintense lesion surrounding the internal carotid artery, which was mistaken for a cervical mass, and the patient underwent unnecessary surgical exploration of the neck. Angiography performed afterward could reveal the dissection of the internal carotid artery. This case shows that even in cases with mild and atypic symptoms, internal carotid artery dissection has always to be ruled out in lower cranial nerve palsies.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3324284 Wed, 03 Mar 2010 03:14:47 +0100 3324284 http://www.medworm.com/index.php?rid=3319497&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249247 Skull BaseDOI: 10.1055/s-0030-1249247ABSTRACTTo describe a minimally invasive approach to anterior cranial vault pathology using a transpalpebral exposure with a miniorbitofrontal craniotomy. Design: Case series. Setting: Tertiary referral hospital with multidisciplinary skull base program. Participants include patients with intra-axial and extra-axial anterior skull base lesions who underwent the transpalpebral minicraniotomy approach. Main Outcome measures: Feasibility of the approach to permit adequate exposure of targeted lesion. We applied this approach in seven patients for the repair of persistent cerebrospinal fluid leaks, pneumocephalus, and the biopsy or resection of midline brain tumors along the anterior cranial base. The approach allowed bimanual instrumentation working with e... Skull Base journals http://www.medworm.com/rss/comments.php?id=3319497 Tue, 02 Mar 2010 14:27:38 +0100 3319497 http://www.medworm.com/index.php?rid=3319496&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249243 Skull BaseDOI: 10.1055/s-0030-1249243ABSTRACTApoplexy of pituitary tumors is a common occurrence. In addition to commonly known presentations, cerebral infarcts and consequent focal neurologic deficits are a rare presentation. A rare case of pituitary apoplexy with associated subarachnoid bleed and bilateral anterior cerebral artery infarcts is described. Vasospasm leading to cerebral infarcts and consequent focal neurologic deficits as a presentation of pituitary apoplexy needs to be better appreciated.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3319496 Tue, 02 Mar 2010 14:27:38 +0100 3319496 http://www.medworm.com/index.php?rid=3319495&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249245 We present a case of intractible trigeminal neuralgia caused by lipomatosis of the trigeminal nerve. Clinical case: A 25-year-old male presented with severe right-sided trigeminal neuralgia. Imaging showed a lesion involving the trigeminal nerve with signal characteristics of fat. At surgery the lesion was found to be a fatty infiltration of the nerve itself. Surgery was therefore limited to arachnoid adhesiolysis. The patient remains symptom-free and neurologically intact to date. Correctly identifying these lesions as lipomatosis of nerve rather than lipoma of the cerebellopontine angle make it clear that even partial surgical excision will inevitably result in neurological deficit and should not be attempted. However, in the case of intractable trigeminal neuralgia we demonstrate that s... Skull Base journals http://www.medworm.com/rss/comments.php?id=3319495 Tue, 02 Mar 2010 03:27:21 +0100 3319495 http://www.medworm.com/index.php?rid=3256446&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247631 We describe a case of a dermoid cyst involving the orbit and frontal sinus of an adult treated at our tertiary referral center, and we review the literature on dermoid cysts of the orbit and frontal sinus. A 28-year-old Caucasian man presented with right-sided supraorbital swelling resulting in diplopia and reduced visual acuity. Computed tomography and magnetic resonance imaging scans were preformed. Although a definitive diagnosis was unclear, the imaging findings were consistent with a dermoid cyst. The lesion was excised through an upper-lid incision. Postoperatively, the patient had a patent frontal sinus and his visual symptoms resolved. Dermoid cysts of the orbit are uncommon lesions that occur primarily in the pediatric population. Lesions extending into the frontal sinus have not ... Skull Base journals http://www.medworm.com/rss/comments.php?id=3256446 Wed, 10 Feb 2010 02:46:39 +0100 3256446 http://www.medworm.com/index.php?rid=3221816&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247630 Skull BaseDOI: 10.1055/s-0030-1247630ABSTRACTWe evaluated the utility of a three-dimensional (3-D) endoscopic system for skull base surgery. We performed a retrospective case series in a tertiary care medical center. Thirty-six patients underwent skull base (nonpituitary) resections via 3-D endoscopic system. Fifteen patients (42%) were operated for excision of malignant tumors, 19 (53%) for excision of benign lesions, and 3 (8.3%) for skull base reconstruction. The tumors involved the cribriform plate ( = 13), sphenoid sinus and planum ( = 17), clivus ( = 7), and sella ( = 7). Complete tumor resection was achieved in 31 patients and subtotal resection in two. Five patients (14%) had postoperative complications. There was one case of meningit... Skull Base journals http://www.medworm.com/rss/comments.php?id=3221816 Sat, 30 Jan 2010 14:19:14 +0100 3221816 http://www.medworm.com/index.php?rid=3221815&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247634 Skull BaseDOI: 10.1055/s-0030-1247634ABSTRACTWe reviewed the outcome of and determined prognostic factors for patients undergoing combined lateral skull base resection for advanced lateral skull base malignancies. We performed a retrospective, single-institution case series in an academic tertiary care hospital. Seventy-nine patients with combined temporal bone resection and parotidectomy for advanced lateral skull base malignancy were included. Main outcome measures were overall survival and disease-free survival. The mean follow-up time was 18.3 months, with an overall survival of 64.5 months and disease-free survival of 42.6 months. Disease-free survival was 36.2 months for skin tumors, 42.7 months for salivary glands tumors, and 8.5 months for tumors of mesenchymal origin. Log-rank tes... Skull Base journals http://www.medworm.com/rss/comments.php?id=3221815 Sat, 30 Jan 2010 14:19:14 +0100 3221815 http://www.medworm.com/index.php?rid=3221814&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247632 Skull BaseDOI: 10.1055/s-0030-1247632ABSTRACTExtradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely r... Skull Base journals http://www.medworm.com/rss/comments.php?id=3221814 Sat, 30 Jan 2010 14:19:14 +0100 3221814 http://www.medworm.com/index.php?rid=3221813&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247629 We report a rare case of herniation of a basilar artery into the sphenoid sinus after a traumatic skull base fracture. Computed tomographic angiography, magnetic resonance imaging, and cerebral angiogram demonstrated patency of the basilar artery through the fractured clivus at the time of injury, a very rare occurrence. The following day, the patient developed pontine and cerebellar infarcts. In a patient with clival fracture, we advocate fast assessment of vertebrobasilar system with CTA and early anticoagulation treatment in those with vascular entrapment.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3221813 Sat, 30 Jan 2010 02:52:35 +0100 3221813 http://www.medworm.com/index.php?rid=3214071&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247633 Skull BaseDOI: 10.1055/s-0030-1247633ABSTRACTA 72-year-old man with a known left acoustic neuroma, left-sided deafness, and a recently diagnosed right infratemporal fossa (ITF) hemangiopericytoma, presented with sudden deafness in his right ear. Imaging revealed right-sided skull base extension and a large intracranial tumor component. The patient underwent a frontotemporal crainiotomy with concomitant ITF approach. Complete tumor resection was possible, though invasion of the otic capsule was present. Immediately postresection, a cochlear implant (CI) was performed via a transmastoid approach. Full electrode insertion was achieved and confirmed by visualization through the dehiscent middle fossa floor. Mastoid obliteration was then performed with a free fat graft. Postoperative imaging co... Skull Base journals http://www.medworm.com/rss/comments.php?id=3214071 Thu, 28 Jan 2010 14:25:25 +0100 3214071 http://www.medworm.com/index.php?rid=3214070&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247628 We report two cases of complex middle cerebral artery aneurysms that were surgically treated using the orbitopterional approach in a two-piece method. The objective of this work is to discuss the usefulness of the orbitopterional approach in the surgical management of large and giant middle cerebral artery aneurysms. A 32-year-old man with a giant aneurysm and a 50-year-old woman with a large and complex aneurysm presented with subarachnoid hemorrhages. Both aneurysms were successfully clipped through an orbitopterional approach. This approach permits a more basal view of the vascular structures with only a minor retraction of frontal lobe. It also increases the view angle and amount of working space available. This approach should be considered as an alternative to the classic pterional c... Skull Base journals http://www.medworm.com/rss/comments.php?id=3214070 Thu, 28 Jan 2010 02:38:32 +0100 3214070 http://www.medworm.com/index.php?rid=3199217&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242985 Skull Base 2010; 20: 047-054DOI: 10.1055/s-0029-1242985ABSTRACTWith the emergence of three effective management options for vestibular schwannoma and the drastic reduction in mortality rate, the last two decades have seen increasing attention being paid to health-related quality of life. The vast majority of quality of life studies have been retrospective. We prospectively assessed quality of life of vestibular schwannoma patients before and after conservative or microsurgical management. We performed a prospective observational study conducted at a tertiary referral center between October 2001 and October 2003. Patients were divided into two groups: conservative management and microsurgery. Quality of life was assessed using the Medical Outcome Study 36-Item Short Form (SF-36) and Glasgow... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199217 Sat, 23 Jan 2010 14:11:20 +0100 3199217 http://www.medworm.com/index.php?rid=3199216&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242984 We present our results and lessons learned from surgeries performed between 1982 and 2007 in the National Hospital for Neurology and Neurosurgery, London. Patients undergoing transfacial, transoral, and transmandibular surgeries for chordomas of the craniocervical junction were enrolled in this study. Chi-square, Fisher exact tests, and log-rank survival analysis were used to determine significant adverse factors ( < 0.05). In our series, 80 operations were performed in 66 patients; 37 patients were male, 29 female. Age at presentation was commonly 40 to 60 years. After surgery, pain was the same or better in 98.1% of patients; 18.6% of patients presented with myelopathy, of whom 27.8% improved, 44.4% remained unchanged, 27.8% deteriorated. Complication rates were as follows... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199216 Sat, 23 Jan 2010 14:11:20 +0100 3199216 http://www.medworm.com/index.php?rid=3199215&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242983 Skull Base 2010; 20: 035-040DOI: 10.1055/s-0029-1242983ABSTRACTThe importance of quality of life (QOL) outcomes following treatments for head and neck tumors are now increasingly appreciated and measured to improve medical and surgical care for these patients. An understanding of the definitions in the setting of health care and the use of appropriate QOL instruments and measures are critical to obtain meaningful information that guides decision making in various aspects of patient health care. QOL outcomes following cranial base surgery is only recently being defined. In this article, we describe the current published data on QOL outcomes following cranial base surgery and provide preliminary prospective data on QOL outcomes and sinonasal morbidity in patients who underwent endonasal cran... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199215 Sat, 23 Jan 2010 14:11:20 +0100 3199215 http://www.medworm.com/index.php?rid=3199214&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242982 Skull Base 2010; 20: 027-033DOI: 10.1055/s-0029-1242982ABSTRACTWe evaluated the health-related quality of life (QOL) of patients undergoing anterior skull base tumor resection. The Anterior Skull Base Surgery QOL questionnaire, a disease-specific multidimensional instrument dedicated to this population, was used to collect and prospectively analyze demographic, medical, and QOL data on 48 patients. Thirty-nine patients completed the questionnaire preoperatively and at 6 and 12 months postoperatively. Seventeen patients (44%) had malignant histology and 22 (56%) had benign tumors. The overall QOL score decreased significantly at 6 months postoperatively ( < 0.05) and improved significantly at 12 months postoperatively ( < 0.04). The emotional domain improved si... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199214 Sat, 23 Jan 2010 14:11:20 +0100 3199214 http://www.medworm.com/index.php?rid=3199213&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242981 This article introduces the use of a Web-based data collection method that can function as a collaborative registry and a tool for collection of quality of life data.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3199213 Sat, 23 Jan 2010 14:11:20 +0100 3199213 http://www.medworm.com/index.php?rid=3199212&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242980 Skull Base 2010; 20: 019-022DOI: 10.1055/s-0029-1242980ABSTRACTOutcomes research has become an integral part of most clinical studies today. Extent of resection, increased median survival, and “time to progression” are no longer the only important end points in need of assessment. Identifying the long-term adverse effects of treatment has become increasingly important as patients try to resume previous activities and an independent lifestyle. The measurement of functional states and health-related quality of life issues are at the forefront of medicine and have become necessary measures of functional outcome following the treatment of a variety of medical and surgical disorders. In this article, we review the most recent studies on the functional outcome of patients undergoing ... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199212 Sat, 23 Jan 2010 14:11:20 +0100 3199212 http://www.medworm.com/index.php?rid=3199211&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242979 Skull Base 2010; 20: 011-018DOI: 10.1055/s-0029-1242979ABSTRACTIn selection of the right treatment for a specific patient, the surgeon should consider not only the best approach to remove a tumor but also the impact of treatment on the quality of life (QOL) of the patient. Procedures involving extirpation of skull base tumors may be associated with high morbidity. It is therefore important to study patients with skull base neoplasms, because survival differences between various treatment modalities may be small, yet larger differences are expected regarding morbidity. The overall QOL in the majority of patients after skull base tumor resection can be classified as “good,” with significant improvement taking place within 12 months following surgery. Patients with carcinomas, aco... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199211 Sat, 23 Jan 2010 14:11:20 +0100 3199211 http://www.medworm.com/index.php?rid=3199210&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242978 Skull Base 2010; 20: 005-010DOI: 10.1055/s-0029-1242978ABSTRACTWith advances in treatment of patients with tumors of the skull base and associated improvement in length of survival, the need for assessment of quality of life (QOL) is becoming increasingly apparent. A thorough assessment of QOL, including functional, physical, social, and emotional status, as well as disease-specific symptoms, allows for comparison of treatments and informs treatment decisions. In addition, it allows for problems following intervention to be identified and addressed, thereby assisting patients in their pursuits of returning to their normal activities and level of functioning. Although health care providers and researchers are increasingly aware of the need to assess patients' QOL, few standardized measures ... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199210 Sat, 23 Jan 2010 14:11:20 +0100 3199210 http://www.medworm.com/index.php?rid=3199209&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242977 Skull Base 2010; 20: 003-004DOI: 10.1055/s-0029-1242977© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3199209 Sat, 23 Jan 2010 14:11:20 +0100 3199209 http://www.medworm.com/index.php?rid=3199208&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242976 Skull Base 2010; 20: 001-001DOI: 10.1055/s-0029-1242976© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3199208 Sat, 23 Jan 2010 14:11:20 +0100 3199208 http://www.medworm.com/index.php?rid=3199207&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246223 We report two new cases of chordoid glioma of the third ventricle and review all previously published cases of this rare tumor with regard to presentation, optimum management, and outcome. Two new cases are reported with the radiological and histopathologic findings. We searched and cross-referenced PubMed and published reports of this tumor to retrieve an additional 51 cases of this tumor, which were then analyzed according to a proforma. Chordoid glioma has consistent radiological features, although some atypical elements including a cystic component are well described. The insidious presentation and morbidity of attempted surgical resection combine to give high overall morbidity. There is a high incidence of postoperative thromboembolic disturbance. Adjuvant radiosurgery has a promising... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199207 Sat, 23 Jan 2010 14:11:20 +0100 3199207 http://www.medworm.com/index.php?rid=3199206&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246219 In this report, we discuss the possible reasons for the absence of hypoglossal nerve palsy and the potential mechanism of the formation of the fluid-fluid level, and we consider the treatment of this lesion.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3199206 Sat, 23 Jan 2010 14:11:20 +0100 3199206 http://www.medworm.com/index.php?rid=3199205&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246220 Skull BaseDOI: 10.1055/s-0029-1246220ABSTRACTAnterior access to the craniocervical junction has traditionally been through a transoral approach. With the advent of newer techniques, recent literature suggests a possible role for a transnasal endoscopic approach to the craniocervical junction. A review of the literature primarily consists of case reports and three anatomic cadaveric studies demonstrating the feasibility of an endonasal approach. In this retrospective review, we report our experience with four patients who underwent an endoscopic transnasal approach to the C1–C2 region. The surgical technique using a binasal endoscopic approach is described. The results indicate that the procedure is well tolerated with no significant deleterious sequelae. Although the use of this tech... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199205 Sat, 23 Jan 2010 14:11:20 +0100 3199205 http://www.medworm.com/index.php?rid=3199204&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246224 Skull BaseDOI: 10.1055/s-0029-1246224ABSTRACTEwing's sarcoma, which accounts for 6 to 9% of malignant bone neoplasms in children, typically affects the trunk and long bones and less often affects the skull (i.e., maxilla, frontal, parietal, ethmoid, temporal bones). Adding to literature of five previously reported cases, we now describe the case of the oldest child, a 16-year-old boy, with a primary Ewing's sarcoma of the petrous temporal bone. When this patient presented after 1 week of right-sided facial paralysis and new-onset headache, imaging studies showed a mass that originated in the right petrous temporal bone. During biopsy and surgical excision, the mass was found to involve the facial nerve, which then required nerve grafting. Postoperatively, he then underwent radiotherapy wit... Skull Base journals http://www.medworm.com/rss/comments.php?id=3199204 Sat, 23 Jan 2010 02:42:11 +0100 3199204 http://www.medworm.com/index.php?rid=3147285&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246218 Skull BaseDOI: 10.1055/s-0029-1246218ABSTRACTThe literature regarding recurrences in patients with cranial chondrosarcoma is limited to small series performed at single institutions, raising the question if these data precisely reflect the true recurrence of this tumor for guiding the clinician in the management of these patients. An extensive systematic review of the English literature was performed. The patients were stratified according to treatment modality, treatment history, histological subtype, and histological grade, and the recurrence rates were analyzed. A total of 560 patients treated for cranial chondrosarcoma were included. Five-year recurrence rate among all patients was 22% with median follow-up of 60 months and median disease-free interval of 16 months. Tumor recurrence wa... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147285 Thu, 07 Jan 2010 14:11:54 +0100 3147285 http://www.medworm.com/index.php?rid=3147284&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246228 We present the management of a series of petrous bone cholesteatomas. We performed a retrospective analysis on 28 patients with petrous bone cholesteatoma who underwent surgery between 1991 and 2008 at Lariboisiere Hospital, Paris, France. Main outcome measures included age of patients, surgical approaches, complications, and recurrence. The mean age was 47 years. Five were congenital cholesteatomas and 23 were acquired ones. Seventeen patients had undergone previous mastoid surgery elsewhere. Ninety-six percent of patients presented with hearing loss and 37.5% with facial nerve palsy. The surgical approaches varied according to the classification. Postoperatively, four patients developed facial nerve palsy; two patients, XII nerve paresis; one patient, X nerve paresis; and eight patients,... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147284 Thu, 07 Jan 2010 14:11:54 +0100 3147284 http://www.medworm.com/index.php?rid=3147283&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246227 Skull BaseDOI: 10.1055/s-0029-1246227ABSTRACTWe sought to quantify the mean surface area of the exposed diaphragma sellae and the mean sellar volume in the subfrontal and anterolateral approaches to pituitary adenomas and to detail our expansion of the superficial and deep window in the anterolateral approach. We performed a retrospective data analysis and cadaveric study in a clinical and skull base laboratory. We studied eight patients who had anterolateral approach for transcranial resection of pituitary macroadenoma and seven cadaveric specimens. Main outcome measures were degree of tumor resection, cerebrospinal fluid (CSF) leak, cranial nerve outcome, and quantification of the exposed sella via the anterior (subfrontal) and anterolateral approach. We observed complete resection in on... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147283 Thu, 07 Jan 2010 14:11:54 +0100 3147283 http://www.medworm.com/index.php?rid=3147282&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246221 Skull BaseDOI: 10.1055/s-0029-1246221ABSTRACTOsteosarcomas (OSs) account for 40 to 60% of primary malignant bone tumors. About 10% occur in the head and neck region, frequently in the mandibula or maxilla. We treated a 30-year-old patient with 26-month history of right-sided facial pain and paresthesia. Investigation showed high-grade OS of the right mandibular coronoid process, affecting the mandibular nerve, middle cranial fossa, internal jugular vein, and internal carotid artery (ICA). True en bloc resection was performed after upfront adjuvant chemotherapy. The ICA was trap-ligated intradurally, whereafter the floor of the middle fossa, including the mandibular nerve and the glenoid fossa, was detached from the skull base in one piece. Subsequently, a hemimandibulectomy, total parotide... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147282 Thu, 07 Jan 2010 14:11:54 +0100 3147282 http://www.medworm.com/index.php?rid=3147281&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246226 We describe an unusual case of a foreign body penetrating the skull base and lodging in the posterior fossa. A 38-year-old woman fell onto a chopstick while eating, causing it to impact into her mouth. The chopstick penetrated the oropharynx and the occipital bone via the jugular foramen to enter the posterior fossa intracranially, piercing the tentorium cerebelli and leaving a fractured tip in the occipital lobe. Three-dimensional reconstructive computed tomographic scans were obtained to view the trajectory and position of the chopstick. Reconstructed angiography revealed the proximity of the carotid artery and the jugular vessels to the foreign object. Safe access to the chopstick was via an occipital craniotomy to retrieve the distal portion and an ipsiplateral retrosigmoid craniectomy... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147281 Thu, 07 Jan 2010 14:11:54 +0100 3147281 http://www.medworm.com/index.php?rid=3147280&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246229 We present a case of localized invasive petrous apical and Meckel's cave disease in an immunocompetent patient who presented with hemicranial neuralgic pain.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=3147280 Thu, 07 Jan 2010 14:11:54 +0100 3147280 http://www.medworm.com/index.php?rid=3147279&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246225 Skull BaseDOI: 10.1055/s-0029-1246225ABSTRACTWe propose a surgical approach for select patients that minimizes morbidity while allowing gross total resection of lesions in the anterior portion of the infratemporal fossa. The approach we describe is an extradural approach through a subtemporal craniectomy or craniotomy with the possible addition of a zygomatic osteotomy. Lesions that have a well-defined capsule and a texture that permits manipulation are ideal for this less invasive approach. We retrospectively reviewed six cases from the primary author (C.B.H.) using a temporal craniectomy or craniotomy alone to resect lesions in the infratemporal fossa. All six cases had good clinical outcomes with no unexpected neurological deficits while achieving gross total resections. The only compli... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147279 Thu, 07 Jan 2010 14:11:54 +0100 3147279 http://www.medworm.com/index.php?rid=3147278&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1246222 We report a novel technique for closure using titanium mesh cranioplasty in addition to hydroxyapatite cement and abdominal fat graft for acoustic neuroma. We reviewed 15 patients who underwent translabyrinthine craniectomy for resection of acoustic neuroma. Hearing loss was documented prior to surgical procedure. Over 2 years, patients underwent titanium mesh and hydroxyapatite cranioplasty with abdominal fat graft. Participants included seven men and eight women, age range 38 to 65. Main outcome measures included cosmetic outcome and incidence of cerebrospinal fluid (CSF) leak. The lesion was right-sided in seven patients and left-sided in eight. Cosmetic outcome was excellent in all. There were no cases of CSF leak. Closure used one-third the hydroxyapatite required for traditional clos... Skull Base journals http://www.medworm.com/rss/comments.php?id=3147278 Thu, 07 Jan 2010 02:31:21 +0100 3147278 http://www.medworm.com/index.php?rid=2945268&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242194 This study examined the relationship between the glossopharyngeal nerve (CN IX) and the acousticofacial complex (AFC). Retrosigmoid suboccipital dissections were preformed on 10 cadaveric specimens. A triangle formed by the AFC, CN IX, and the skull base was consistently observed. The cisternal portions of the AFC and CN IX formed two sides of the triangle. The base was formed by a line traversing the respective dural portals of these nerves at the skull base. Triangular proportions were utilized to predict distances from five points along the course of CN IX to a corresponding point along the course of the AFC. Predicted distances were not statistically different when compared with cadaveric measurements in all 10 specimens ( > 0.05). A table of predicted distances between ... Skull Base journals http://www.medworm.com/rss/comments.php?id=2945268 Sat, 31 Oct 2009 14:09:25 +0100 2945268 http://www.medworm.com/index.php?rid=2945267&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242196 We present a case of meningioma intrinsic to the geniculate ganglion that presented peculiar features on high-resolution computed tomography (HRCT) and magnetic resonance imaging. On HRCT, we found erosion of the geniculate ganglion with enlargement of the facial canal associated with the appearance of some calcifications within the lesion. These latter findings were confirmed at histological examination. In our patient, the T1- and T2-weighted magnetic resonance images had an intermediate signal and a mild hyperintensity, respectively. Although intracranial meningiomas can have calcifications within the mass, none of the cases of geniculate ganglion meningiomas described in the literature presented with calcifications. To our knowledge, our case is the first with this combination. The pre... Skull Base journals http://www.medworm.com/rss/comments.php?id=2945267 Sat, 31 Oct 2009 02:43:41 +0100 2945267 http://www.medworm.com/index.php?rid=2941137&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242193 Skull BaseDOI: 10.1055/s-0029-1242193ABSTRACTThe authors clarify the anatomic basis and the usefulness of the transcondylar fossa approach (T-C-F A), in which the posterior portion of the jugular tubercle is removed extradurally through the condylar fossa with the atlanto-occipital joint intact. The authors first performed an anatomic study to identify the area to be removed using cadaveric specimens and then applied the T-C-F A to foramen magnum surgeries. The surgeries included clipping a vertebral artery–posterior inferior cerebellar artery aneurysm in 11 cases, microvascular decompression for glossopharyngeal neuralgia in 15 cases, and removing intradural foramen magnum tumors in 17 cases. Only the condylar fossa was removed, but the approach offered very good visualization of th... Skull Base journals http://www.medworm.com/rss/comments.php?id=2941137 Fri, 30 Oct 2009 14:13:08 +0100 2941137 http://www.medworm.com/index.php?rid=2941136&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242195 Skull BaseDOI: 10.1055/s-0029-1242195ABSTRACTStereotactic radiosurgery has become a more frequently used treatment modality for vestibular schwannomas; a few reports of malignant transformation and/or radiation-associated tumors have surfaced. The majority of these reported cases were in patients with underlying neurofibromatosis. The authors report a case of a 74-year-old man with rapid progression of a cerebellar-pontine angle tumor 14 years after surgical resection of a vestibular schwannoma (VS) from the same site, and 6 years after stereotactic radiosurgery. A pathological study of the recent tumor showed a high-grade spindle cell neoplasm that bore no resemblance to the initial schwannoma. The patient had no diagnosis of neurofibromatosis. Secondary malignancy occurred in a non-neuro... Skull Base journals http://www.medworm.com/rss/comments.php?id=2941136 Fri, 30 Oct 2009 14:13:08 +0100 2941136 http://www.medworm.com/index.php?rid=2941135&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1238216 We describe a patient with a median facial cleft with a frontoethmoidal encephalocele, hypertelorism, hydrocephalus, and cerebrospinal fluid (CSF) leakage referred to our department due to numerous complications after previous surgical treatments. An 8-year-old girl, born with median cleft syndrome, underwent neurosurgical repair of the encephalocele at another hospital and cleft lip/palate repair later in the same year. Her hydrocephalus was treated with a ventriculoperitoneal shunt, but she underwent numerous shunt revisions due to recurrent intracerebral infections. In 2008, she was rehospitalized due to a gram-negative meningitis and cerebral abscess. She underwent surgery where part of her frontal bone was removed due to osteomyelitis. She was referred to our department due to persist... Skull Base journals http://www.medworm.com/rss/comments.php?id=2941135 Fri, 30 Oct 2009 08:11:23 +0100 2941135 http://www.medworm.com/index.php?rid=2835129&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1238215 Skull BaseDOI: 10.1055/s-0029-1238215ABSTRACTWe sought to better define the results of anterior skull base surgery in pediatric and young adult patients. We performed a single-institution, retrospective cohort study in a tertiary-care academic cancer center. Between 1973 and 2005, 234 patients underwent anterior skull base surgery at Memorial Sloan-Kettering Cancer Center. Of these, 19 patients were <21 years of age. Surgical indications, findings, and complications were reviewed. Survival outcomes were analyzed using the Kaplan-Meier method and compared with patients ≥21 years old. Nineteen patients <21 years old underwent a total of 20 procedures for lesions of the anterior skull base. Sarcoma was the most common indication for surgery including 6 (32%) patients treated for r... Skull Base journals http://www.medworm.com/rss/comments.php?id=2835129 Sun, 27 Sep 2009 00:33:22 +0100 2835129 http://www.medworm.com/index.php?rid=2821954&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1238214 We report the introduction of this technique to our unit, including the learning curve recognized for this procedure, comparing techniques in a concurrent case-control fashion. All patients operated on for sellar, suprasellar, or clival lesions were considered for endoscopic surgery, with 51 patients undergoing endoscopic surgery and 46 having microscopic surgery with the operating method determined by the availability of the ear, nose, and throat surgeon involved with the procedures. Endoscopic surgery compared favorably with microscopic surgery with respect to endocrine control, length of stay, diabetes insipidus, and cerebrospinal fluid leakage. A learning curve was found with a significant fall in complication rates between the first third and most recent third of the cohort. Endoscopi... Skull Base journals http://www.medworm.com/rss/comments.php?id=2821954 Wed, 23 Sep 2009 16:31:49 +0100 2821954 http://www.medworm.com/index.php?rid=2821953&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236165 We present our experience with sinonasal undifferentiated carcinoma at the University of Michigan over 13 years and review prior published data. We conducted a retrospective review of 19 patients who presented to a tertiary care academic center multidisciplinary skull base clinic with sinonasal undifferentiated carcinoma between 1995 and 2008. Overall survival was 22% at 5 years, and the estimated 5-year distant metastasis-free survival was 35%. At 2 years, local control was 83%, regional control was 50%, and distant control was 83%. Local control was best in those patients treated nonsurgically, as was median survival, though this was not statistically significant. Nodal disease in the neck, either at presentation or at recurrence, was noted in 26% of patients. Survival for sinonasal undi... Skull Base journals http://www.medworm.com/rss/comments.php?id=2821953 Wed, 23 Sep 2009 00:46:28 +0100 2821953 http://www.medworm.com/index.php?rid=2693326&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236166 Skull BaseDOI: 10.1055/s-0029-1236166ABSTRACTIntralabyrinthine schwannomas are benign, slow-growing tumors that originate from Schwann cells lining the terminal ends of the cochlear and vestibular nerves. Magnetic resonance imaging (MRI) with gadolinium is considered the best diagnostic tool for this disease. Kennedy et al proposed a classification system, based upon the MRI observations, that identifies seven different classes according to the site of the tumor: intravestibular, intracochlear, intravestibulocochlear, transmodiolar, transmacular, transotic, and tympanolabyrinthine. A case of a patient undergoing a 2-year follow-up with serial MRI and managed with a wait-and-see strategy is described. The rationale of the diagnosis and the different treatments of choice are discussed.[...]�... Skull Base journals http://www.medworm.com/rss/comments.php?id=2693326 Thu, 13 Aug 2009 10:50:55 +0100 2693326 http://www.medworm.com/index.php?rid=2618019&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234021 This study was a retrospective analysis in a tertiary referral center and included 62 patients with maxillary malignant tumors invading the MCF (stage T4b) treated with surgery with or without postoperative radiotherapy. All patients had sharp pain and involvement of at least one branch of the trigeminal nerve. Twenty-eight patients had not been treated previously, and 34 had previously been treated elsewhere. The MCF dura was infiltrated and resected in 36 cases, and in nine of these, there was an intradural extension of the tumor, with temporal lobe and/or cavernous sinus invasion. Thirty-six patients underwent reconstruction with a temporalis muscle pedicled flap, and 26 patients with a free flap. There was a 22% overall rate of postoperative complications, but no intraoperative deaths.... Skull Base journals http://www.medworm.com/rss/comments.php?id=2618019 Tue, 21 Jul 2009 10:57:28 +0100 2618019 http://www.medworm.com/index.php?rid=2618018&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225534 We present the first case of CMF originating in the clivus and extending into the atlas and discuss the surgical management of this case.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2618018 Tue, 21 Jul 2009 10:57:28 +0100 2618018 http://www.medworm.com/index.php?rid=2589779&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225532 We report the case of a bullet in the jugular foramen causing recurrent syncope that resolved after surgical removal of the bullet. The medical records from a patient who suffered a GSW to the head were retrospectively reviewed and the treatment and outcome documented. In 2000, a 20-year-old man suffered a GSW to the head. Immediate evaluation revealed the bullet in the right skull base at the jugular foramen, but no parenchymal brain injury. One year after the GSW, he began to experience stereotypical spells resulting in loss of consciousness. Extensive cardiovascular workup was normal. In 2002, the patient underwent removal of the bullet. He has been syncope-free since the operation and returned to his career in the military. We believe the retained bullet in this patient was irritating ... Skull Base journals http://www.medworm.com/rss/comments.php?id=2589779 Sat, 11 Jul 2009 10:54:34 +0100 2589779 http://www.medworm.com/index.php?rid=2589778&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225533 Skull BaseDOI: 10.1055/s-0029-1225533ABSTRACTChordomas are rare malignant tumors arising from embryonic remnants of the primitive notochord, around which the skull base and vertebral column develop. They are locally aggressive but metastasize rarely. To our knowledge, this is the first reported case of synchronous intraosseous chordomas. A 32-year-old man presented with intermittent double vision secondary to a right-side abducent nerve palsy. Imaging revealed a clivus chordoma and an asymptomatic synchronous second primary chordoma in the fifth lumbar vertebra. Both chordomas were surgically excised: the clivus using the endonasal, endoscopic route and the L5 vertebra by total vertebral excision and replacement with a titanium prosthesis. The patient made an uneventful and complete recove... Skull Base journals http://www.medworm.com/rss/comments.php?id=2589778 Sat, 11 Jul 2009 10:54:34 +0100 2589778 http://www.medworm.com/index.php?rid=2554201&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224772 Skull BaseDOI: 10.1055/s-0029-1224772ABSTRACTTransoral pharyngotomy is a viable minimally invasive approach for resection of metastatic thyroid cancer in retropharyngeal lymph nodes in highly select patients. A few authors have already reported on its safe application with excellent outcomes. We herein describe a case where the technique is assisted with the Omniguide CO laser system to safely access and remove a metastatic node in the retropharyngeal space of a 24 year-old Caucasian woman. Furthermore, her disease was I-131-negative and positron emission tomography–positive, demonstrating the technique is still feasible in this dedifferentiated cancer state.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2554201 Tue, 30 Jun 2009 15:21:13 +0100 2554201 http://www.medworm.com/index.php?rid=2460029&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224862 Skull BaseDOI: 10.1055/s-0029-1224862ABSTRACTTraining in dissection of the skull base is essential for anatomical understanding and correct surgical techniques, but chances for cadaver dissection are limited, so a substitute is very desirable. Modifications of commercially available three-dimensional (3D) temporal bone and whole skull base models made from surgically dissectable artificial bone are proposed to include artificial dura mater, venous sinuses, carotid artery, and cranial nerves as educational tools for training in skull base surgery. These 3D models precisely reproduce the surface details and inner bony structures such as the cranial foramina, inner ear organs, air cells, and so on. Dura mater and venous sinuses are made from silicone, cranial nerves from rubber fibers, and th... Skull Base journals http://www.medworm.com/rss/comments.php?id=2460029 Sun, 07 Jun 2009 19:47:57 +0100 2460029 http://www.medworm.com/index.php?rid=2460028&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224861 We report a case of an 11-year-old girl with a histologically confirmed benign osteoblastoma in an unusual location and an atypical aspect on the imaging studies.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2460028 Sun, 07 Jun 2009 19:47:57 +0100 2460028 http://www.medworm.com/index.php?rid=2434378&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224773 Skull BaseDOI: 10.1055/s-0029-1224773ABSTRACTWe sought to quantitate the effect of extensions of transbasal approaches (TBAs) on midline and paramedian targets of the cranial base. Eight silicone-injected cadaveric heads were dissected with extensions of TBA level I removal of the orbital bar. Objective measures were the comparisons of the accessibility of midline and paramedian targets with progressive dissections by level II detachment of the medial canthal ligaments and removal of the nasal bone and by level III removal of the lateral orbital walls with lateral orbital retraction. Mean areas of freedom increased for most targets with progressive bone removal. For midline targets, the most effective freedom increment was at the pituitary gland (level II: 28.8%,  = 0.05; level... Skull Base journals http://www.medworm.com/rss/comments.php?id=2434378 Wed, 27 May 2009 00:57:55 +0100 2434378 http://www.medworm.com/index.php?rid=2434377&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224771 Skull BaseDOI: 10.1055/s-0029-1224771ABSTRACTCatecholamine-secreting paragangliomas (CSPs) present challenges for the managing team of surgeons and anesthesiologists. Without proper preoperative management and planning, the patient is at high risk for complications and significant morbidity. A review of the literature looking at all aspects of the care of patients with CSP was performed to provide a consensus on the comprehensive care of these difficult patients. A case study is also provided to illustrate the management algorithm. Specific recommendations are made with regards to preoperative workup, including serum and urine testing, tumor localization, angiography, and embolization. Preoperative and intraoperative management techniques by the surgical and anesthesiology teams are discus... Skull Base journals http://www.medworm.com/rss/comments.php?id=2434377 Wed, 27 May 2009 00:57:55 +0100 2434377 http://www.medworm.com/index.php?rid=2434376&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224774 We report an unusual case of a large metastatic lesion from prostate adenocarcinoma with its epicenter located in Meckel's cave. The patient presented with acute neurological deterioration due to pontomesencephalic, cranial nerve, and temporal lobe compression. This lesion radiologically mimicked a giant trigeminal schwannoma. Complete surgical resection was achieved with improvement in the performance status of the patient. The anatomic relevance the extradural neural axis component in the process of dissemination of prostate adenocarcinoma to the skull base is highlighted.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2434376 Wed, 27 May 2009 00:47:33 +0100 2434376 http://www.medworm.com/index.php?rid=2407747&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2Fejournals%2Ftoc%2Fsbs%2F93505%2Fgrouping%2F93155 Skull Base 2009; S 02Get connected:Table of contents  |  Congress (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2407747 Tue, 12 May 2009 01:02:22 +0100 2407747 http://www.medworm.com/index.php?rid=2371111&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220203 This article reports an unusual presentation wherein the first evidence of distant failure from a locally controlled, recurrent skull base chordoma was a metastasis to the mandible. We present a case report from a tertiary-care academic skull base referral center and a review of literature. A 33-year-old woman with a locally recurrent spheno-occipital chordoma that was stabilized with multimodality therapy presented with a right mandibular mass. Immunohistochemical stains demonstrated the tumor cells staining positive for vimentin, cytokeratin, epithelial membrane antigen (EMA), and S100 consistent with metastatic chordoma. Positron emission tomography–computed tomography imaging further revealed widespread distant failure. Chordomas are rare tumors with only four previous reports of... Skull Base journals http://www.medworm.com/rss/comments.php?id=2371111 Wed, 29 Apr 2009 01:46:35 +0100 2371111 http://www.medworm.com/index.php?rid=2371110&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220197 Skull BaseDOI: 10.1055/s-0029-1220197ABSTRACTThe purpose of this article is to clarify long-term outcomes following surgery for jugular foramen schwannomas. Fifteen adult patients underwent surgery, predominantly via the lateral suboccipital approach, for jugular foramen schwannomas between December 1987 and May 2007. All information was collected retrospectively from patient medical records at a university hospital. The main outcome measures were tumor regrowth and IX-X nerve function at median 84.3 months (range, 12 to 166 months) following surgery. Near total removal was achieved in 10 patients, and the remaining 5 patients had subtotal removal. Tumor regrowth was observed in 9 of 15 patients at 6 to 89 months (mean, 31.2 months) after surgery. The actual tumor control rate was 70.0&#82... Skull Base journals http://www.medworm.com/rss/comments.php?id=2371110 Tue, 28 Apr 2009 00:42:36 +0100 2371110 http://www.medworm.com/index.php?rid=2333453&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220199 This article evaluates the accessibility of the posterior part of the central skull base via the extended retrosigmoid intradural suprameatal approach. In formaldehyde-fixed specimens, the retrosigmoid intradural suprameatal approach was performed, and the feasibility of reaching central skull base structures was analyzed. Microscopic and endoscopic techniques were used. The main outcome measures were digital films and screenshots, which were analyzed regarding quantitative and qualitative aspects of visual structures. By drilling off the suprameatal tubercle and part of the petrous apex, Meckel's cave may be opened, the trigeminal nerve mobilized, and the tentorium divided. Thus the parasellar area may be exposed and the posterosuperior space of the cavernous sinus approached. Using an en... Skull Base journals http://www.medworm.com/rss/comments.php?id=2333453 Sat, 18 Apr 2009 03:57:12 +0100 2333453 http://www.medworm.com/index.php?rid=2333452&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220205 Skull BaseDOI: 10.1055/s-0029-1220205© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2333452 Sat, 18 Apr 2009 03:57:12 +0100 2333452 http://www.medworm.com/index.php?rid=2333451&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220209 Skull BaseDOI: 10.1055/s-0029-1220209ABSTRACTMicrovascular compression of the vestibulocochlear nerve is known to cause disabling tinnitus and vertigo. A review of the literature shows that the compression is usually located in the cerebellopontine angle, and that it is usually caused by an artery. The authors add the case of a 46-year-old man with venous compression of the vestibulocochlear nerve inside the internal auditory canal (IAC). The patient presented with a 2-year history of recurrent attacks of disabling vertigo and intermittent high-frequency tinnitus on the right side. Magnetic resonance images showed a small, contrast-enhancing lesion in the fundus of the right IAC, which was suspicious for vestibular schwannoma. During surgical exploration, a large venous loop was found exte... Skull Base journals http://www.medworm.com/rss/comments.php?id=2333451 Sat, 18 Apr 2009 03:57:12 +0100 2333451 http://www.medworm.com/index.php?rid=2333450&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220200 Skull BaseDOI: 10.1055/s-0029-1220200ABSTRACTThe parasphenoidal region is a difficult location to gain access to and contains a lot of vital neurovascular structures that have risk of injury during surgery. The transnasal endoscopic approach for this region has been described in several cadaveric studies in recent years. Herein we present a case of parasphenoidal myxoma, extending to the anteroinferior border of the cavernous sinus in a 48-year-old woman. The tumor was completely removed by the endoscopic transnasal transpterygoid approach. No postoperative complication was seen. The endoscopic transnasal transpterygoid approach may be a good alternative to external approaches in selective skull base tumors.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract ... Skull Base journals http://www.medworm.com/rss/comments.php?id=2333450 Sat, 18 Apr 2009 03:57:12 +0100 2333450 http://www.medworm.com/index.php?rid=2333449&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220206 Skull BaseDOI: 10.1055/s-0029-1220206ABSTRACTVestibular schwannomas account for ~;80% of cerebellopontine angle (CPA) tumors, with meningiomas being the second most common tumor of the CPA. The occurrence of both a schwannoma and a meningioma in the cerebellopontine angle is rare. After obtaining Institutional Review Board approval, we present a case of a concurrent vestibular schwannoma and meningioma in the CPA mimicking a single tumor.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2333449 Sat, 18 Apr 2009 03:57:12 +0100 2333449 http://www.medworm.com/index.php?rid=2333448&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220207 Skull BaseDOI: 10.1055/s-0029-1220207ABSTRACTEwing's sarcoma involving the sinonasal cavity and anterior skull base is very rare. The purpose of this article is to present our experience with two such cases, which were both treated with combined chemotherapy and proton beam radiation therapy. The patients were selected from a retrospective medical record analysis that was conducted of all patients who were diagnosed with Ewing's sarcoma of the sinonasal cavity at the Massachusetts Eye & Ear Infirmary/Massachusetts General Hospital Cranial Base Center from 2004 to 2008. One of the patients underwent pretreatment endoscopic subtotal resection to facilitate proton beam radiation therapy. Response to treatment was assessed, post-treatment endoscopic biopsies were performed to assure eradic... Skull Base journals http://www.medworm.com/rss/comments.php?id=2333448 Sat, 18 Apr 2009 03:57:12 +0100 2333448 http://www.medworm.com/index.php?rid=2333447&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2Fejournals%2Ftoc%2Fsbs%2F78190%2Fgrouping%2F91278 Skull Base 2009; 01Get connected:Table of contents  |  Congress (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2333447 Wed, 15 Apr 2009 00:45:03 +0100 2333447 http://www.medworm.com/index.php?rid=2308598&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220198 This article reports on the presence of an anatomic feature of the extracranial skull base that may result in internal carotid artery injury if secure and complete pterygomaxillary separation is not achieved before maxillary downfracture in the Le Fort I osteotomy. The extracranial skull base of 129 adult skulls and 10 pediatric skulls was examined in the region near the foramen lacerum. This region was inspected for the presence or absence of a bony protrusion that projected posteriorly from the base of the sphenoid, lying inferior to the foramen lacerum. The bony protrusion was present bilaterally in 71% of the adult skulls and 60% of the pediatric skulls. The protrusion was a bony “spike” that pointed posteriorly and was located inferior to the foramen lacerum on the extracr... Skull Base journals http://www.medworm.com/rss/comments.php?id=2308598 Tue, 07 Apr 2009 21:27:15 +0100 2308598 http://www.medworm.com/index.php?rid=2308596&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220208 Skull BaseDOI: 10.1055/s-0029-1220208ABSTRACTWe developed a cochlear nerve action potential (CNAP) monitoring technique using a microdissector and compared the results of CNAP and auditory brainstem response (ABR) monitoring. Thirty-six patients underwent vestibular schwannoma resection via the retrosigmoid approach to preserve hearing. Both CNAP with the microdissector and surface ABR were recorded during the operation. We used the microdissector as an intracranial electrode for CNAP monitoring. The CNAP waveform was classified into four types: triphasic, biphasic, positive, and flat. At the completion of the tumor resection, the triphasic waveform was observed in 11 patients and the biphasic waveform was observed in 11 patients. Hearing function was preserved in all of them, although it ... Skull Base journals http://www.medworm.com/rss/comments.php?id=2308596 Tue, 07 Apr 2009 21:27:15 +0100 2308596 http://www.medworm.com/index.php?rid=2308594&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220204 The objectives of this report are to highlight the difficulties of managing cancer-related CSS, to present a highly effective surgical intervention, and to review the literature regarding the pathophysiology and treatment options for patients with cancer-related CSS. Two patients with cancer-related CSS continued to experience syncopal episodes despite medical and pacemaker therapy. Consequently, these patients underwent a suboccipital craniotomy for glossopharyngeal and limited vagal neurectomy. After surgery, both patients had uncomplicated postoperative courses with resolution of syncope. [...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2308594 Tue, 07 Apr 2009 21:27:15 +0100 2308594 http://www.medworm.com/index.php?rid=2308592&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220201 Skull BaseDOI: 10.1055/s-0029-1220201ABSTRACTTumors at the petrous apex are associated with a variety of symptoms, which most often involve the trigeminal nerve. The authors present a rare case of a small epidermoid tumor in Meckel's cave that caused medically refractory trigeminal neuralgia. The surgical challenge associated with approaches to such lesions is discussed. The skull base tumor was excised completely through a small temporal craniotomy. The practicality of neuronavigation in reaching the petrous apex using a small extradural window is presented.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2308592 Tue, 07 Apr 2009 21:27:15 +0100 2308592 http://www.medworm.com/index.php?rid=2308590&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220202 We present a case of a giant sellar and suprasellar skull base-invasive metastasis from a medullary carcinoma of the thyroid gland. Radiographic features were similar to atypical/malignant meningioma or pituitary macroadenoma. Intracranial metastases from medullary thyroid carcinoma are very rare. Unusual features of our case are discussed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2308590 Sat, 04 Apr 2009 00:44:45 +0100 2308590 http://www.medworm.com/index.php?rid=2195077&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115323 Conclusion: As a result of these dissections, we found that the AEA's course in the ethmoid roof varies. The morphological characteristics—that the AEA runs parallel to the ethmoid roof, forming a slight posterolateral to anteromedial curve as it passes from the orbit to the cribriform plate—are the most reliable factors used to identify the artery during surgery.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2195077 Wed, 18 Feb 2009 22:37:26 +0100 2195077 http://www.medworm.com/index.php?rid=2195076&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114298 We report a case of benign osteoblastoma involving the temporal bone and the middle ear and a review of the literature.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2195076 Wed, 18 Feb 2009 02:48:14 +0100 2195076 http://www.medworm.com/index.php?rid=2098089&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103131 This article is the distillation of consensus opinion derived from current published and unpublished data in this field, with particular reference to the management of temporal bone PGLs. We propose guidelines for the management of both sporadic and hereditary PGLs. A multidisciplinary team approach to the management of this complex disorder is advocated. Progress could be made by adopting these guidelines and by widespread dissemination of standardized information. Collaborative research should be promoted with the aim of harnessing advances in molecular genetics to develop targeted therapies for patients, particularly those with hereditary PGL.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2098089 Tue, 13 Jan 2009 09:17:13 +0100 2098089 http://www.medworm.com/index.php?rid=2098088&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103122 We describe this technique, which has proved beneficial to our patients. Guidelines for management are proposed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2098088 Tue, 13 Jan 2009 09:17:13 +0100 2098088 http://www.medworm.com/index.php?rid=2098087&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103130 Skull Base 2009; 19: 092-098DOI: 10.1055/s-0028-1103130ABSTRACTResidual and recurrent glomus jugulare tumors are rare but challenging. Treatment options include microsurgical resection, stereotactic radiotherapy, a combination of modalities, and “observation.” Choice of treatment must be made on a case-by-case basis, considering patient age, health status, location and size of tumor, status of the lower cranial nerves, and, of course, patient desire. Surgery is preferred when total resection of the tumor with preservation of function is deemed achievable. When function of the lower cranial nerves has been compromised, total surgical resection may also be possible, provided that the patient's health allows it. Cases where function is still preserved despite presence of a large t... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098087 Tue, 13 Jan 2009 09:17:13 +0100 2098087 http://www.medworm.com/index.php?rid=2098086&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103125 Skull Base 2009; 19: 083-091DOI: 10.1055/s-0028-1103125ABSTRACTSurgery for jugular paraganglioma (PGL) tumors often results in the acquisition of neurological deficits where none had been present previously. This has a significant impact on the quality of life. Radiotherapy is a recognized alternative therapy. The aim of this study was to compare the results of radiotherapy and surgery for the management of jugular PGL in terms of function and tumor control to define a treatment algorithm. We conducted a retrospective and comparative analysis of the treatment of 41 patients by conventional radiotherapy and 47 patients by surgery via tertiary referral at an academic medical center. Forty-seven patients with type C and/or D jugular PGLs (mean age, 46 years) underwent surgery after endovascul... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098086 Tue, 13 Jan 2009 09:17:13 +0100 2098086 http://www.medworm.com/index.php?rid=2098085&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103128 This article presents our experience with the management and outcomes of patients with sporadic glomus jugular tumors using a tailored surgical approach. We conducted a retrospective study of 49 patients with sporadic jugular paragangliomas. Thirty-eight patients (78%) were treated using the transmastoid-infralabyrinthine (TM-IL) approach, and 11 (22%) were treated with the infratemporal fossa type A (IFT-A) approach. Mean follow-up period was 8.2 years. Surgical cure was achieved in all but 6 patients using the TM-IL approach (84%) and in 8 of 11 patients with the IFT-A approach (73%). A House-Brackmann grade of I or II facial nerve function was obtained postoperatively in 84% of TM-IL cases and in 56% of the IFT-A cases. The incidence of other complications—meningitis and transient... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098085 Tue, 13 Jan 2009 09:17:13 +0100 2098085 http://www.medworm.com/index.php?rid=2098084&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103124 Skull Base 2009; 19: 057-074DOI: 10.1055/s-0028-1103124ABSTRACTTumors other than paragangliomas in the jugular foramen are uncommon. Of these, schwannomas and meningiomas predominate. Little clinical data are available in the literature on these tumors at this site. The purpose of this article is to review our experience at the Gruppo Otologico of the management of these tumors. A retrospective series is presented of 32 consecutive patients affected by jugular foramen schwannomas and meningiomas in which their clinical and radiological signs, together with surgical techniques and outcomes, were reviewed. A single-stage resection was possible for the majority of patients when the petro-occipital trans-sigmoid (POTS) approach was used. This allowed resection of both intra- and extradural com... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098084 Tue, 13 Jan 2009 09:17:13 +0100 2098084 http://www.medworm.com/index.php?rid=2098083&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103127 This study's goals were twofold: (1) to analyze the author's experience with the petro-occipital trans-sigmoid (POTS) approach for the resection of tumors arising in or adjacent to the jugular foramen, and (2) to define the anatomical sites exposed by this approach. A retrospective review was conducted of 61 patients with jugular fossa tumors that included lower cranial nerve schwannomas, paragangliomas, meningiomas, chordomas, cholesteatomas, and other benign or low-grade malignant tumors. Outcome measures were mortality, morbidity, and long-term outcomes. No deaths were found in this study. The major morbidity was deficits of the glossopharyngeal, vagus, and accessory nerves. Hearing and facial nerve function were largely preserved. The resections were undertaken as single-stage procedur... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098083 Tue, 13 Jan 2009 09:17:13 +0100 2098083 http://www.medworm.com/index.php?rid=2098082&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103129 Skull Base 2009; 19: 043-047DOI: 10.1055/s-0028-1103129ABSTRACTAs it became clear that patients with paraganglioma (PGL) syndromes had a higher risk of multifocal tumors, we changed our surgical strategy to avoid the possibility of bilateral cranial nerve paralysis. The juxtacondylar approach offers advantages for some jugular foramen tumors, including types C and D temporal PGLs. This approach allows exposure of the jugular foramen without skeletonizing or transposing the facial nerve. It improves the surgeon's ability to distinguish between the pars vascularis and the pars nervosa at the jugular foramen, and it helps to save functioning of the lower cranial nerves. There is already considerable experience using the juxtacondylar approach for patients suffering from schwannomas and mening... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098082 Tue, 13 Jan 2009 09:17:13 +0100 2098082 http://www.medworm.com/index.php?rid=2098081&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103126 This study evaluates our experience with 20 patients affected by TJP in which the ICA has been subjected to preoperative interventions. Ten patients underwent a preoperative balloon occlusion and the other 10 patients had their ICAs reinforced with stents. Problems that arose during embolization necessitated that one patient with a stent required ligation of their ICA. No other problems were encountered during endovascular treatment or surgical resection. In one patient with a stent, it was impossible to establish a cleavage plane between their recurrent tumour and the ICA. These early results are encouraging and suggest that intra-arterial stents have a part to play in the surgical management of large TJPs.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract ... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098081 Tue, 13 Jan 2009 09:17:13 +0100 2098081 http://www.medworm.com/index.php?rid=2098080&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103123 The objective of this study is to review distinct clinical features of the different PGLs. An international registry for HNPs was founded in Freiburg, Germany, in 2000. The data presented in this article have been acquired from registered HNP patients who have been screened for mutations of the genes , , and . Approximately 30% of apparent sporadic HNPs are caused by a germline mutation in one of these genes. Patients with PGL 1 or 4 have a very high lifetime risk of developing HNPs as well as thoracic and abdominal pheochromocytomas. Compared with sporadic HNPs, tumors developing in , , and mutation carriers arise at a significantly younger age. The mutations are associated with a high percentage of malignant paraganglionic tumors. We recommend molecular genetic screening of all HNP patie... Skull Base journals http://www.medworm.com/rss/comments.php?id=2098080 Tue, 13 Jan 2009 09:17:13 +0100 2098080 http://www.medworm.com/index.php?rid=2098079&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1103121 Skull Base 2009; 19: 003-016DOI: 10.1055/s-0028-1103121ABSTRACTThe anatomy of the jugular foramen is complex. It contains the lower cranial nerves and major vascular structures. Tumors that develop within it, or extend into it, provide significant diagnostic and surgical challenges. In this article, we describe the anatomy of the jugular foramen and outline an imaging protocol that can differentiate between lesions, thereby aiding diagnosis and facilitating management.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2098079 Tue, 13 Jan 2009 09:17:13 +0100 2098079 http://www.medworm.com/index.php?rid=2098078&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1124015 Skull Base 2009; 19: 001-001DOI: 10.1055/s-0028-1124015© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2098078 Tue, 13 Jan 2009 09:17:13 +0100 2098078 http://www.medworm.com/index.php?rid=2092816&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114300 Conclusion: The temporalis musculofascial flap, combined with titanium mesh and autologous adipose reconstruction, provided excellent closure of defects of the floor of the middle cranial fossa while preserving normal cosmetic scalp contour.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092816 Sat, 10 Jan 2009 09:45:46 +0100 2092816 http://www.medworm.com/index.php?rid=2092815&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114299 Conclusion: The addition of optic nerve sheath incision to osseous decompression may improve recovery in optic nerve injury, especially in subjects without optic canal fracture.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092815 Sat, 10 Jan 2009 09:45:46 +0100 2092815 http://www.medworm.com/index.php?rid=2092814&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114293 Conclusion: The fallopian bridge technique should be added to surgical armamentarium for the jugular foramen tumors confined only to the jugular fossa or tumors with middle ear extension.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092814 Sat, 10 Jan 2009 09:45:46 +0100 2092814 http://www.medworm.com/index.php?rid=2092813&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115321 Conclusion: SNMM remains a disease that has eluded breakthroughs in treatment. Patients are typically treated with wide local resection; however unique to our institution was the frequent use of interferon and chemoradiation. Further research in adjuvant therapies will be necessary to improve outcomes.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092813 Sat, 10 Jan 2009 09:45:46 +0100 2092813 http://www.medworm.com/index.php?rid=2092812&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114295 Conclusions: Preliminary results of the phase II clinical study of CIRT for skull base chordoma showed local control at 5 years at 100%, and normal tissues showed a mild reaction without any severe morbidity of important organs.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092812 Sat, 10 Jan 2009 09:45:46 +0100 2092812 http://www.medworm.com/index.php?rid=2092811&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114296 Conclusions: Due to a high rate of recurrent bleeding, we concluded that early treatment by either surgical or endovascular route is indicated in patients who present with SAH secondary to spontaneous intradural VADs. Treatment decisions should take into account the site and type of dissection, vertebral artery dominance, and involvement of posterior inferior cerebellar artery.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092811 Sat, 10 Jan 2009 09:45:46 +0100 2092811 http://www.medworm.com/index.php?rid=2092810&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115325 Conclusion: We concluded that in the diabetic or immunocompromised patient, a scenario of headache, cranial neuropathy, and bony destruction on imaging should raise the possibility of skull base osteomyelitis, even in the absence of an obvious infective source. The primary goal should still be to exclude an underlying malignant cause.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092810 Sat, 10 Jan 2009 09:45:46 +0100 2092810 http://www.medworm.com/index.php?rid=2092809&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114294 Conclusion: As was the case with this patient, we believe that CA should be included in the differential diagnosis of petrous region pathology with bony involvement. Surgery is warranted due to its expansive nature and to decompress the adjacent neural structures.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092809 Sat, 10 Jan 2009 09:45:46 +0100 2092809 http://www.medworm.com/index.php?rid=2092808&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115324 Conclusion: Based on these results, we concluded that gross total removal and curettage of GCTs in the temporal bone is a viable treatment option. This finding is contrary to previous studies.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092808 Sat, 10 Jan 2009 09:45:46 +0100 2092808 http://www.medworm.com/index.php?rid=2092807&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115322 Conclusion: The transoral freehand technique with stereotactic navigation was found to be a simple, safe, fast, and effective way to biopsy a clival lesion.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092807 Sat, 10 Jan 2009 09:45:46 +0100 2092807 http://www.medworm.com/index.php?rid=2092806&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1114297 Conclusion: Neuronavigation-assisted decompression should be considered as an effective means of removing superior orbital fissure fractures.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092806 Sat, 10 Jan 2009 09:45:46 +0100 2092806 http://www.medworm.com/index.php?rid=2092805&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1115326 Conclusions: Refractory, spontaneous CSF leak must prompt aggressive investigation for multiple causes of elevated ICP. A cerebral transit time can be obtained from scout imaging when a magnetic resonance angiogram or MRV is performed, and this may disclose elevated ICP if it is prolonged. If endoscopic transnasal repair fails, craniotomy and direct suture repair and autologous tissue reinforcement of the skull base may prove successful and durable, even if BIH persists.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=2092805 Sat, 10 Jan 2009 02:41:37 +0100 2092805 http://www.medworm.com/index.php?rid=1924768&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096196 Skull BaseDOI: 10.1055/s-0028-1096196ABSTRACTThe posterior clinoid process, a bony prominence at the superolateral aspect of the dorsum sellae, has a strategic importance in a transcavernous approach to basilar tip aneurysms. To further optimize this microsurgical technique during posterior clinoidectomy, we performed a cadaveric study of this regional anatomy, describe a technique called dural tailoring, and report initial results in the surgical treatment of upper basilar artery (BA) aneurysm. After 10 adult cadaver heads (silicone-injected) were prepared for dissection, a posterior clinoidectomy with dural tailoring was performed. The dura overlying the upper clivus was coagulated with bipolar electrocoagulation and incised. Stripping dura off the clivus and lateral reflection then expo... Skull Base journals http://www.medworm.com/rss/comments.php?id=1924768 Sat, 01 Nov 2008 12:35:44 +0100 1924768 http://www.medworm.com/index.php?rid=1924767&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096205 We report an unusual case of epidermal inclusion cyst of the styloid process which presented to us with decreased hearing and tinnitus. The patient underwent complete excision via a combined postaural cervical approach. The unusual location of the tumor and the absence of a history of trauma or intervention in that area added confusion to the diagnosis, which was finally made on histopathology.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1924767 Sat, 01 Nov 2008 12:35:44 +0100 1924767 http://www.medworm.com/index.php?rid=1924766&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096206 Conclusion: Although extremely rare, adult patients can develop growing skull fractures or leptomeningeal cysts of the orbital roof. Such lesions should be included in the differential diagnosis when a patient presents with orbital pain or exophthalmos and a history of head trauma as a child.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1924766 Sat, 01 Nov 2008 12:35:44 +0100 1924766 http://www.medworm.com/index.php?rid=1924765&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096208 Skull BaseDOI: 10.1055/s-0028-1096208ABSTRACTChordomas are tumors commonly of extradural origin associated with bone destruction; their central nervous system invasion has rarely been reported. The authors describe a rare case of a 37-year-old man presenting with a clivial chordoma invading the brainstem with a large pontine cyst. A median suboccipital approach was selected to remove the tumor.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1924765 Sat, 01 Nov 2008 12:35:44 +0100 1924765 http://www.medworm.com/index.php?rid=1918231&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096204 Conclusions: Vascularized mastoid cortical bone flap cranioplasty is a simple and effective technique to ameliorate the pinna and retroauricular deformities after translabyrinthine VS excision without increased surgical cost or the use of alloplastic materials.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918231 Thu, 30 Oct 2008 12:42:47 +0100 1918231 http://www.medworm.com/index.php?rid=1918230&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096200 Discussion: The combined neurorhinosurgical transcranial approach to the anterior skull base and nasal and paranasal sinuses, avoiding trans-facial approaches, enables a multidiciplinary team to resect malignant tumors of the anterior skull base directly without unnecessary destruction of facial structures. It appears to provide better access than other more destructive methods like midfacial degloving or subfrontal approaches. Our single-stage approach also facilitates safe and effective reconstruction of the skull base. The technique can be employed for tumors of all sizes and is also used for orbital resections and decompression of the optic nerve and chiasma.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918230 Thu, 30 Oct 2008 12:42:47 +0100 1918230 http://www.medworm.com/index.php?rid=1918229&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096195 Conclusions: Patients with esthesioneuroblastoma whose initial treatment consists of surgical resection followed by radiation therapy have a longer disease-free survival than patients treated with surgery alone. However, initial treatment modality did not have an effect on survival. Long-term, close follow-up is necessary to identify recurrences, which can be treated with a high degree of success.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918229 Thu, 30 Oct 2008 12:42:47 +0100 1918229 http://www.medworm.com/index.php?rid=1918228&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096201 Conclusions: Craniofacial resection is a safe and effective treatment for skull base tumors. However, additional care is required in patients with extended resection (especially dural) and those who have undergone prior therapy.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918228 Thu, 30 Oct 2008 12:42:47 +0100 1918228 http://www.medworm.com/index.php?rid=1918227&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096197 Conclusion: The far-lateral approach without drilling of the occipital condyle adequately exposed the lower basilar artery for successful clipping of aneurysms and was associated with minimal morbidity.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918227 Thu, 30 Oct 2008 12:42:47 +0100 1918227 http://www.medworm.com/index.php?rid=1918226&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096209 Conclusion: Progressive and rapid involvement of the cavernous sinus, vascular structures and intracranial contents is the usual evolution of rhinocerebral mucormycosis. In the context of immunosupression, a pattern of nasal cavity, maxillary sinus, ethmoid cells, and orbit inflammatory lesions should prompt the diagnosis of mucormycosis. Multiplanar magnetic resonance imaging shows anatomic involvement, helping in surgery planning. However, the prognosis is grave despite radical surgery and antifungals.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918226 Thu, 30 Oct 2008 12:42:47 +0100 1918226 http://www.medworm.com/index.php?rid=1918225&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096202 Conclusions: Prior radiation is a risk factor for necrosis. The NSF is easily harvested endonasally, reliably covers a range of skull base defects, and should be considered the first line closure after expanded endonasal skull base resections.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918225 Thu, 30 Oct 2008 12:42:47 +0100 1918225 http://www.medworm.com/index.php?rid=1918224&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096198 Conclusions: There is histopathological evidence for the expression of VEGF in vestibular schwannomas but not for ER and PR. Further studies are necessary to determine the role of VEGF and other molecular pathways in the growth of vestibular schwannomas and the application of anti-VEGF therapy as a potential treatment option in the future.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918224 Thu, 30 Oct 2008 12:42:47 +0100 1918224 http://www.medworm.com/index.php?rid=1918223&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096207 We report three cases of hydatid disease of the skull base and the treatment thereof. The first involved the anterior cranial fossa and paranasal sinuses. The second was located in the infratemporal fossa. The last involved the temporal bone and posterior cranial fossa. Hydatid disease is endemic in many parts of the world where livestock farming is practiced and is highly endemic in sub-Saharan Africa. Although hydatid disease of the head and neck is rare, it should be considered in the differential diagnosis of cystic disease in the head and neck region. Of the three forms of hydatid disease, is most common and gives rise to cystic hydatid disease. Most hydatid cysts are “silent,” but become clinically apparent because of their mass effects, when they rupture, or if they beco... Skull Base journals http://www.medworm.com/rss/comments.php?id=1918223 Thu, 30 Oct 2008 12:42:47 +0100 1918223 http://www.medworm.com/index.php?rid=1918222&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096199 This report details a technique for spheno-orbital reconstruction after meningioma resection. The approach uses a life-size skull model generated from a thin-slice craniomaxillofacial computed tomogram. On this skull model, the planned area of bone removal of the involved orbit and sphenoid is outlined on the normal side opposite the lesion. A three-dimensional implant is then generated by reversing the anticipated area of bone resection on the normal side to create a mirror-image implant. This technique resulted in minimal intraoperative implant contouring, decreased surgical time, and satisfactory functional and cosmetic outcome.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1918222 Thu, 30 Oct 2008 12:42:47 +0100 1918222 http://www.medworm.com/index.php?rid=1918221&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1096203 Skull BaseDOI: 10.1055/s-0028-1096203ABSTRACTVestibular schwannomas are benign, slow-growing tumors that originate from Schwann cells lining the vestibular nerves, most commonly the superior vestibular nerve. They arise at the neurilemmal/neuroglial junction which is situated within the internal auditory canal. They have an incidence of 1 per 100,000 per year and a prevalence of around 700 per million. A case of a patient undergoing a period of observation for a vestibular schwannoma whose hearing improved despite growth of the tumor is described. This raises interesting questions regarding the pathophysiology of hearing loss in patients with vestibular schwannomas. Possible hypotheses are discussed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  F... Skull Base journals http://www.medworm.com/rss/comments.php?id=1918221 Thu, 30 Oct 2008 12:42:47 +0100 1918221 http://www.medworm.com/index.php?rid=1871154&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087220 Conclusions: The keyhole retrosigmoid approach is a versatile one. It can be used to deal with different pathologies through a unified access, and with the increasing exclusive use of endoscopes, a truly minimally invasive surgery can be achieved.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1871154 Mon, 13 Oct 2008 12:33:09 +0100 1871154 http://www.medworm.com/index.php?rid=1871153&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087223 Conclusions: Transnasal endoscopic removal of complicated foreign bodies involving the orbit, paranasal sinuses, and anterior skull base can be successfully accomplished given appropriate patient selection and careful technique.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1871153 Mon, 13 Oct 2008 12:33:09 +0100 1871153 http://www.medworm.com/index.php?rid=1859805&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087218 Skull BaseDOI: 10.1055/s-0028-1087218ABSTRACTThe maxillary swing procedure provides an excellent approach to the anterior skull base region and to the clivus. The osteotomy should not be standard; it should vary with the size and position of the central skull base tumor being resected. The main reason for publishing this article is to draw attention to a method of preventing ascending infection from the oral cavity to the intracranial area using the palatal overlap flap. Examples of this approach are provided.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1859805 Wed, 08 Oct 2008 14:19:37 +0100 1859805 http://www.medworm.com/index.php?rid=1859804&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087219 We report a 9-day-old male infant in whom an intranasal glioma that mimicked an encephalocele was successfully excised by endoscopic approach after failure to excise it through a craniotomy. After more than a 5-year follow-up, the patient is still free from the disease. An endoscopic intranasal approach provides a safe and effective method for the management of nasal glioma and does not result in postoperative facial scaring or deformity. Endoscopic techniques provide excellent visualization and are preferable to the classic frontal craniotomy to excluding intracranial extension of nasal glioma.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1859804 Wed, 08 Oct 2008 14:19:37 +0100 1859804 http://www.medworm.com/index.php?rid=1859803&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087217 Skull BaseDOI: 10.1055/s-0028-1087217ABSTRACTTo describe an unusual case of bilateral meningoencephaloceles with concurrent bilateral superior semicircular canal dehiscene (SSCD) and to discuss the clinical presentation, diagnosis, and treatment of SSCD. A 34-year-old man presented with unsteadiness and bilateral conductive hearing loss. He was diagnosed with bilateral meningoencephaloceles and underwent staged middle fossa approaches for repair. Following the second (right-sided) surgery, he developed sensorineural hearing loss and severe dizziness, indicating labyrinthine insult in the operated ear. He was then referred to our institution for further management. On our evaluation, the patient was continuing to experience disequilibrium and sensitivity to loud sounds. Examination revealed... Skull Base journals http://www.medworm.com/rss/comments.php?id=1859803 Wed, 08 Oct 2008 14:19:37 +0100 1859803 http://www.medworm.com/index.php?rid=1859802&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087224 We report a case of IMT of the temporal bone in a young man presenting with a progressive hearing loss. Three years after diagnosis, partial hearing improvement has been documented.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1859802 Wed, 08 Oct 2008 14:19:37 +0100 1859802 http://www.medworm.com/index.php?rid=1859801&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087222 Skull BaseDOI: 10.1055/s-0028-1087222ABSTRACTIntracranial aspergillus infection is an uncommon finding. The importance of a high index of clinical suspicion, coupled with an early diagnosis, can potentially be lifesaving. We illustrate the case in a patient who developed right-sided visual disturbance and facial paresthesia, where radiological diagnosis was meningioma but histopathology revealed an amyloid tumor with synchronous aspergillus infection and lymphoma at the same site. This diagnosis should always be considered, especially in immunodeficient patients, using a combination of neurological and thoracic imaging and histopathology of a resected specimen.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1859801 Wed, 08 Oct 2008 14:19:37 +0100 1859801 http://www.medworm.com/index.php?rid=1859800&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1087221 We describe the treatment for this rare situation and discuss its differentiation from chordoma, its malignant counterpart.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1859800 Wed, 08 Oct 2008 14:19:37 +0100 1859800 http://www.medworm.com/index.php?rid=1856426&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2Fejournals%2Ftoc%2Fsbs%2F64158%2Fgrouping%2F64159 Skull Base 2007; S 01Get connected:Table of contents  |  Congress (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1856426 Tue, 07 Oct 2008 14:10:22 +0100 1856426 http://www.medworm.com/index.php?rid=1826240&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2Fejournals%2Ftoc%2Fsbs%2F64435%2Fgrouping%2F64436 Skull Base 2008; S 01Get connected:Table of contents  |  Congress (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1826240 Wed, 24 Sep 2008 00:47:50 +0100 1826240 http://www.medworm.com/index.php?rid=1798549&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086060 We report the case of a 75-year-old patient with an IMFT located in the temporal bone. Symptoms included VI, X, XI, and XII cranial nerves palsies. Computed tomography and magnetic resonance images are described. The lesion was locally aggressive and outcome was fatal. IMFT was identified by analysis of postmortem specimen with histopathologic and immunohistochemical confirmation. Discussion: IMFT can be locally destructive lesions. Involvement of the skull base and cervical spine is indistinguishable from an aggressive infection or a malignant tumor and can be fatal as in our case report. The difficulties in establishing clinicopathologic diagnosis, radiological imaging characteristics, and treatment are discussed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Ab... Skull Base journals http://www.medworm.com/rss/comments.php?id=1798549 Wed, 17 Sep 2008 00:38:38 +0100 1798549 http://www.medworm.com/index.php?rid=1794701&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086057 Conclusion: Patients with clinically and radiologically established elongated styloid process can be managed successfully by surgical resection using an external approach.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1794701 Tue, 16 Sep 2008 00:40:33 +0100 1794701 http://www.medworm.com/index.php?rid=1779703&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086059 Conclusion: This is the first report of a complete removal of a cavernous sinus hemangioma using an endoscopic transnasal approach. The endoscopic transnasal approach to the medial cavernous sinus may be less traumatic than the transcranial route based on the lateral location of the cranial nerves.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1779703 Wed, 10 Sep 2008 12:22:25 +0100 1779703 http://www.medworm.com/index.php?rid=1779702&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086055 Conclusions: This long-term study demonstrated the efficacy of nasal turbinate graft in sealing of CSF leak without any delayed complications. Other rigid materials may be considered in reconstruction of large skull base defect (more than 10 mm) to prevent dural prolapse and herniation. For any future endonasal procedure for those patients, who had previous endonasal endoscopic duraplasty, the surgeons should be fully aware of the state of duraplasty (e.g., dural prolapse) to avoid any intraoperative complication (e.g., penetration of the prolapsed dura during nasal packing).[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1779702 Wed, 10 Sep 2008 12:22:25 +0100 1779702 http://www.medworm.com/index.php?rid=1779701&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086058 Conclusions: The highlights of this case are an uncommon location of a rare pathological entity, which might constitute an important differential of fibro-osseous conditions affecting the craniofacial bones.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1779701 Wed, 10 Sep 2008 00:33:12 +0100 1779701 http://www.medworm.com/index.php?rid=1764259&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086056 Conclusion: The outcome is predominantly a function of tumor size, and these changes influence MCF surgery at an earlier stage than in the translabyrinthine or retrosigmoid approach. For the facial nerve, there is a cutoff at 5-mm extracanalicular extension. Also, chances for successful hearing preservation decrease rapidly with size, and in tumors beyond 1.5 cm are below 20%. Consequently, although an expectant policy with small tumors may be reasonable in some instances, it is not so for MCF candidates.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1764259 Fri, 05 Sep 2008 12:31:32 +0100 1764259 http://www.medworm.com/index.php?rid=1764258&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1086054 This report presents the management of five patients who presented with giant recurrent or residual cholesteatoma after periods of 2 to 50 years. Their case histories are highly diverse, but all provide evidence of the need for long-term follow-up.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1764258 Fri, 05 Sep 2008 00:56:45 +0100 1764258 http://www.medworm.com/index.php?rid=1408330&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1076098 Conclusion: ENB can be safely and effectively treated with CFR followed by proton beam irradiation. Proton irradiation may be associated with less toxicity than photon irradiation. The role of chemotherapy remains unclear.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1408330 Wed, 30 Apr 2008 09:08:52 +0100 1408330 http://www.medworm.com/index.php?rid=1408329&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1076099 Skull BaseDOI: 10.1055/s-2008-1076099© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1408329 Wed, 30 Apr 2008 09:08:52 +0100 1408329 http://www.medworm.com/index.php?rid=1256379&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1058367 Conclusions: Long-term follow-up data present the orbitopterional approach as an attractive alternative for ACoA aneurysm surgery given the low rates of surgery-related morbidity and good patient outcomes and functionality.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1256379 Tue, 26 Feb 2008 09:57:12 +0100 1256379 http://www.medworm.com/index.php?rid=1256378&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1058368 Skull BaseDOI: 10.1055/s-2008-1058368© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1256378 Tue, 26 Feb 2008 01:03:17 +0100 1256378 http://www.medworm.com/index.php?rid=1243556&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1043753 We present a case that illustrates some of the difficulties encountered in the management of NF-2 VS and provides a basis for discussion of a technique to assist intraoperative decision-making to achieve optimal hearing rehabilitation. In the setting of a negative fast auditory brainstem response (ABR), but preserved cochlear nerve action potential (CNAP), the option of a CI can be considered. However, where the fast ABR and the morphology and amplitude of the CNAP are significantly degraded at the brainstem, the placement of an ABI should be strongly considered at the time of tumor removal. This technique must be further evaluated, but it represents an adjunct in this difficult area for the neurotologist. To this end we propose that a multicenter trial be undertaken to further elucidate t... Skull Base journals http://www.medworm.com/rss/comments.php?id=1243556 Wed, 20 Feb 2008 01:10:16 +0100 1243556 http://www.medworm.com/index.php?rid=1196035&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1043752 Conclusion: Preoperative cranial modeling and implant design allows for a shorter, one-step resection and reconstruction procedure without compromising structural or cosmetic outcome.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1196035 Sat, 02 Feb 2008 01:12:25 +0100 1196035 http://www.medworm.com/index.php?rid=1137237&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-1023230 Skull BaseDOI: 10.1055/s-2007-1023230ABSTRACTIntracranial enterogenous cysts are rare. There have been only two cases reported of such cysts that extended into both the infratentorial and supratentorial compartments. We add a third case and review the literature to assess their pathogenesis, clinical features, and management.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1137237 Wed, 09 Jan 2008 01:16:49 +0100 1137237 http://www.medworm.com/index.php?rid=1137236&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-1023231 Conclusions: We conclude that this rare condition can be managed with good outcomes in terms of visual improvement, provided a high index of suspicion is maintained and the goals of surgery for emergency patients are maintained to include chiasmal decompression. Although complete resection of the lesion is frequently possible, it should not be the primary aim of surgery.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1137236 Wed, 09 Jan 2008 01:08:40 +0100 1137236 http://www.medworm.com/index.php?rid=1134025&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991112 Skull BaseDOI: 10.1055/s-2007-991112ABSTRACTThe goals of this retrospective case review were to analyze the long-term results of surgery for petrous temporal bone cholesteatomas and to propose a new classification system for these lesions. Patients with a surgically confirmed petrous temporal bone cholesteatoma were treated at Addenbrooke's Hospital, a tertiary referral center. Postoperative facial function, hearing, residual/recurrent cholesteatoma, and other complications were assessed in relation to preoperative signs, intraoperative findings, and surgical approach. Between 1983 and 2004, 43 patients were treated. There were no perioperative deaths. There was no long-term recurrence in 95.4% of the patients, possibly because of meticulous surgical technique, bipolar diathermy, and use o... Skull Base journals http://www.medworm.com/rss/comments.php?id=1134025 Tue, 08 Jan 2008 01:12:33 +0100 1134025 http://www.medworm.com/index.php?rid=1134024&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-1016960 We report a patient who sought treatment for progressive tinnitus and hearing loss. Magnetic resonance imaging showed a large (5-cm) schwannoma in the cerebellopontine angle. At surgery the lesion was found to originate from rootlets of cranial nerve X at the jugular foramen. The patient underwent gross total resection of the tumor. Immediately after surgery, his hearing improved dramatically. We believe that our patient represents an example of hearing impairment at least in part referable to direct compression of the brainstem. Importantly, the patient's hearing deficit was completely reversible. Some authors claim that surgery to preserve hearing may be contraindicated in patients with speech discrimination scores below 50%. However, when extrinsic brainstem compression may contribute t... Skull Base journals http://www.medworm.com/rss/comments.php?id=1134024 Tue, 08 Jan 2008 01:12:33 +0100 1134024 http://www.medworm.com/index.php?rid=1134023&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991107 Skull BaseDOI: 10.1055/s-2007-991107© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1134023 Tue, 08 Jan 2008 01:12:33 +0100 1134023 http://www.medworm.com/index.php?rid=1134022&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991113 Skull BaseDOI: 10.1055/s-2007-991113© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1134022 Tue, 08 Jan 2008 01:12:33 +0100 1134022 http://www.medworm.com/index.php?rid=1134021&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-1016961 Skull BaseDOI: 10.1055/s-2007-1016961© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Skull Base) Skull Base journals http://www.medworm.com/rss/comments.php?id=1134021 Tue, 08 Jan 2008 01:06:25 +0100 1134021 http://www.medworm.com/index.php?rid=1131221&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991108 Skull BaseDOI: 10.1055/s-2007-991108ABSTRACTWe compared the surgical outcomes of recent patients with cerebellopontine angle (CPA) epidermoids treated with advanced surgical tools with those of patients treated in earlier series. From November 2000 to June 2004, we treated 12 patients with epidermoid tumors. One patient had a strict CPA lesion. Tumors extended into the prepontine region in seven cases and supratentorially in two. In two cases the CPA was involved bilaterally. All patients but one underwent a lateral suboccipital approach in a semi-sitting position with microsurgical technique. Endoscopic assistance was used in cases with extensions beyond the CPA. In one case, a subtemporal route was used. The mean follow-up was 27 months (range, 8 to 50 months). There were no deaths. Tota... Skull Base journals http://www.medworm.com/rss/comments.php?id=1131221 Sat, 05 Jan 2008 12:40:50 +0100 1131221 http://www.medworm.com/index.php?rid=1131220&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991105 Skull BaseDOI: 10.1055/s-2007-991105ABSTRACTThe rate of symptomatic improvement of visual symptoms associated with hematogenous metastases to the sella and pituitary was evaluated retrospectively in seven patients (five men, two women; mean age, 52.3 years) with primarily visual symptoms (diplopia alone in three, diplopia with blurred vision in one, blurred vision alone in one, loss of peripheral vision in one, and unilateral complete blindness in one). Symptom duration ranged from 0.5 to 2 months. The primary diseases were non-small cell lung cancer in two patients, renal cell carcinoma in two patients, prostate cancer in two patients, and medullary thyroid carcinoma in one patient. All patients had widespread metastatic disease. Three patients had a suprasellar tumoral component. One pat... Skull Base journals http://www.medworm.com/rss/comments.php?id=1131220 Sat, 05 Jan 2008 12:40:50 +0100 1131220 http://www.medworm.com/index.php?rid=1131219&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991109 Skull BaseDOI: 10.1055/s-2007-991109ABSTRACTThe purposes of this retrospective case series study were to examine the outcome of the operative treatment of extracranial nerve sheath tumors (NSTs) of the skull base and to learn the optimal management. The study was conducted at a university teaching hospital and a regional referral center. A total of 19 cases of benign extracranial NSTs of the skull base who presented to the otolaryngology department over a period of 10 years were studied regarding the clinical, radiological, and pathological features and the operative and postoperative management. In the majority, these tumors originated from cranial nerves; postoperative complications were frequent and depended on the nerve of origin. Postoperative nerve deficit was apparent in 10 cases, a... Skull Base journals http://www.medworm.com/rss/comments.php?id=1131219 Sat, 05 Jan 2008 12:40:50 +0100 1131219 http://www.medworm.com/index.php?rid=1131218&cid=s_36598_16_f&fid=36598&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2007-991110 Skull BaseDOI: 10.1055/s-2007-991110ABSTRACTDuring retrosigmoid and far-lateral skull base surgical approaches, the head may be positioned at the extreme limits of rotation and flexion. In rare instances, patients may develop acute sialadenitis after surgery as a result of this positioning technique. Over a 4-year period, five patients developed postoperative sialadenitis after undergoing either a retrosigmoid craniotomy in the supine position ( = 4) or a far-lateral craniotomy in the park-bench position. Based on all the retrosigmoid and far-lateral approaches performed by the senior author (RFS), the incidence of sialadenitis was 0.84%. In all five patients, the acute sialadenitis was not clinically apparent at the conclusion of the operation. However, the diagnosis was evident within 4 ... Skull Base journals http://www.medworm.com/rss/comments.php?id=1131218 Sat, 05 Jan 2008 12:40:50 +0100 1131218