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Acousticofacial–Glossopharyngeal Triangle: An Anatomic Model for Rapid Surgical OrientationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Skull Base - October 31, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Geniculate Ganglion MeningiomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Skull Base - October 31, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Transcondylar Fossa (Supracondylar Transjugular Tubercle) Approach: Anatomic Basis for the Approach, Surgical Procedures, and Surgical ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 neu...
Source: Skull Base - October 30, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

A Case of High-Grade Undifferentiated Sarcoma after Surgical Resection and Stereotactic Radiosurgery of a Vestibular SchwannomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Skull Base - October 30, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Median Facial Cleft with a Frontoethmoidal Encephalocele Treated with Craniofacial Bipartition and Free Radial Forearm Flap: A Case ReportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Skull Base - October 30, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Results of Anterior Skull Base Surgery in Pediatric and Young Adult PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Skull Base - September 27, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Light at the End of the Tunnel: The Learning Curve Associated with Endoscopic Transsphenoidal Skull Base SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ce...
Source: Skull Base - September 23, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Sinonasal Undifferentiated Carcinoma: A 13-Year Experience at a Single InstitutionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, th...
Source: Skull Base - September 23, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Intracochlear SchwannomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 f...
Source: Skull Base - August 13, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Surgery for Malignant Maxillary Tumors Involving the Middle Cranial FossaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 reconstru...
Source: Skull Base - July 21, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Chondromyxoid Fibroma of the Skull Base Invading the Occipitocervical Junction: Report of a Unique Case and DiscussionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - July 21, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Vagoglossopharyngeal-Associated Syncope Due to a Retained Bullet in the Jugular ForamenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 remo...
Source: Skull Base - July 11, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Clivus Chordoma: Is It Enough to Image the Primary Site?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Skull Base - July 11, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Transoral Surgical Approach for Retropharyngeal Node Involvement in I-131-Negative 18-fluoro-2-deoxyglucose Positron Emission Tomography–Positive Recurrent Thyroid CancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 feas...
Source: Skull Base - June 30, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Dissectable Modified Three-Dimensional Temporal Bone and Whole Skull Base Models for Training in Skull Base ApproachesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 struct...
Source: Skull Base - June 7, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Benign Osteoblastoma of the Sphenoid BoneEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - June 7, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Comparative Analysis of Extensions of Transbasal Approaches: Effect on Access to Midline and Paramedian StructuresEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 mos...
Source: Skull Base - May 27, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Catecholamine-Secreting Paragangliomas: Recent Progress in Diagnosis and Perioperative ManagementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 u...
Source: Skull Base - May 27, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Dissemination of Prostate Adenocarcinoma to the Skull Base Mimicking Giant Trigeminal Schwannoma: Anatomic Relevance of the Extradural Neural Axis ComponentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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:Ta...
Source: Skull Base - May 27, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Presentation AbstractsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Skull Base 2009; S 02Get connected:Table of contents | Congress (Source: Skull Base)
Source: Skull Base - May 12, 2009 Category: ENT & OMF Source Type: journals

Mandibular Metastasis from a Skull Base Chordoma: Report of a Case with Review of LiteratureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Skull Base - April 29, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Long-Term Outcomes after Surgical Treatment of Jugular Foramen SchwannomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 pati...
Source: Skull Base - April 28, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Microsurgical and Endoscopic Anatomy of the Retrosigmoid Intradural Suprameatal Approach to Lesions Extending from the Posterior Fossa to the Central Skull BaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Acoustic Neuroma or Vestibular Schwannoma?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Skull BaseDOI: 10.1055/s-0029-1220205© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Skull Base)
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: LETTER TO THE EDITOR Source Type: journals

Vertigo and Tinnitus Caused by Vascular Compression of the Vestibulocochlear Nerve, Not Intracanalicular Vestibular Schwannoma: Review and Case PresentationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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,...
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Endoscopic Transnasal Transpterygoid Approach For Parasphenoidal MyxomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ap...
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Concurrent Vestibular Schwannoma and Meningioma Mimicking a Single Cerebellopontine Angle TumorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Efficacy of Proton Beam Therapy in the Treatment of Ewing's Sarcoma of the Paranasal Sinuses and Anterior Skull BaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 endosco...
Source: Skull Base - April 18, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Presentation AbstractsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Skull Base 2009; 01Get connected:Table of contents | Congress (Source: Skull Base)
Source: Skull Base - April 15, 2009 Category: ENT & OMF Source Type: journals

Importance of Complete Pterygomaxillary Separation in the Le Fort I Osteotomy: An Anatomic ReportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 sku...
Source: Skull Base - April 7, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Cochlear Nerve Action Potential Monitoring with the Microdissector in Vestibular Schwannoma SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 resect...
Source: Skull Base - April 7, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Glossopharyngeal and Limited Vagal Neurectomy for Cancer-Related Carotid Sinus SyncopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 Publishe...
Source: Skull Base - April 7, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Trigeminal Neuralgia Due to a Small Meckel's Cave Epidermoid Tumor: Surgery Using an Extradural CorridorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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�...
Source: Skull Base - April 7, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Giant Intracranial Medullary Thyroid Carcinoma Metastasis Presenting as ApoplexyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - April 4, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Morphological Characteristics of the Anterior Ethmoidal Artery in Ethmoid Roof and Endoscopic LocalizationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - February 18, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals

Osteoblastoma of the Temporal BoneEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - February 18, 2009 Category: ENT & OMF Tags: CASE REPORT Source Type: journals

Consensus Statement and Guidelines on the Management of Paragangliomas of the Head and NeckEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 th...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Rehabilitation after Treatment for Jugular Foramen LesionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Treatment of Recurrent and Residual Glomus Jugulare TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 compr...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Evolving Concepts in the Management of Jugular Paraganglioma: A Comparison of Radiotherapy and Surgery in 88 CasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 s...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Transmastoid-Infralabyrinthine Tailored Surgery of Jugular ParagangliomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 f...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Nonvascular Lesions of the Jugular Foramen: The Gruppo Otologico ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 res...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

The Petro-Occipital Trans-Sigmoid Approach for Lesions of the Jugular ForamenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 defici...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Juxtacondylar Approach in Temporal Paraganglioma Surgery: When and Why?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Combined Endovascular-Surgical Management of the Internal Carotid Artery in Complex Tympanojugular ParagangliomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Clinical Features of Paraganglioma SyndromesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 si...
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Differential Diagnosis of Jugular Foramen LesionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - January 13, 2009 Category: ENT & OMF Source Type: journals

Jugular Foramen TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Skull Base 2009; 19: 001-001DOI: 10.1055/s-0028-1124015© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Skull Base)
Source: Skull Base - January 13, 2009 Category: ENT & OMF Tags: PREFACE Source Type: journals

Titanium Mesh Reconstruction to Maintain Scalp Contour after Temporalis Musculofascial Flap Reconstruction of the Floor of the Middle Cranial Fossa: A Technical Note and Report of Two CasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - January 10, 2009 Category: ENT & OMF Tags: TECHNICAL NOTE Source Type: journals

Surgery for Optic Nerve Injury: Should Nerve Sheath Incision Supplement Osseous Decompression?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Skull Base - January 10, 2009 Category: ENT & OMF Tags: ORIGINAL ARTICLE Source Type: journals