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Endoscopic endonasal surgery

Gian-Luca Fadda, Giovanni Succo, Paolo Moretto, Andrea Veltri, Paolo Castelnuovo, Maurizio Bignami, Giovanni Cavallo
Introduction: Paranasal sinus fungus ball (PSFB) is a non-invasive mycosis, which appears in immunocompetent patients, along with unilateral lesion. The purpose of this study was to analyse various symptoms of PSFB and its radiological, pathological, and microbiological findings. In addition, this study involved the investigation of the incidence of bacterial coinfection and surgical techniques applied for this infection and to report the modern developments in this domain. Materials and Methods: This retrospective study was carried out on 40 consecutive patients referring for PSFB treatment to the Ear, Nose, and Throat Department in San Luigi Gonzaga University Hospital, Turin, Italy, from April 2014 to 2017...
January 2019: Iranian Journal of Otorhinolaryngology
Paolo Castelnuovo, Alberto D Arosio, Federico Leone, Arianna Ravasio, Claudio Azzolini, Federico De Maria, Andrea Pistochini, Luca Volpi, Maurizio Bignami
BACKGROUNDS: Cryoprobe devices are used by ophthalmic and orbital surgeons for the extraction of fluid-filled intraorbital lesions. No series described cryo-dissection via an exclusive transnasal approach. The authors describe two cases of purely endoscopic transnasal removal of intraconal orbital hemangiomas with the aid of a dedicated cryoprobe. METHODS: All the transnasal endoscopic intraorbital procedures were collected and analyzed. The cases in which the intraorbital dissection was performed with the use of Optikon® Cryo-line probe were considered, analyzing clinical features, histology, size and location of the lesion, early and late complications, time of the surgical procedures and hospital stay...
February 13, 2019: World Neurosurgery
Ivan Radovanovic, Amir R Dehdashti, Mazda K Turel, Joao Paulo Almeida, Bruno L Godoy, Francesco Doglietto, Allan D Vescan, Gelareh Zadeh, Fred Gentili
BACKGROUND: The role of expanded endonasal endoscopic surgery for primary and recurrent craniopharyngioma is not yet fully established. OBJECTIVE: To report and evaluate our experience with the endoscopic endonasal approach (EEA) for the resection of primary and recurrent craniopharyngiomas. METHODS: This is a retrospective cohort analysis of 43 consecutive EEA procedures in 40 patients operated from September 2006 to February 2012 for suprasellar craniopharyngiomas...
February 15, 2019: Operative Neurosurgery (Hagerstown, Md.)
Francesco Doglietto, Francesco Belotti, Carlotta Ginevra Nucci, Elena Roca, Pier Paolo Mattogno, Francesca Zappa, Karol Migliorati, Pier Paolo Panciani, Giannantonio Spena, Claudio Cereda, Claudio Cornali, Marco Maria Fontanella
BACKGROUND: Three-dimensional (3D), high-definition (HD) endoscopy has been recently introduced in neurosurgery and its value extensively discussed in endonasal skull base surgery. There is no reported clinical series on the use of a recent 3D-HD ventriculoscope. OBJECTIVE: Aim of this study is to describe our initial experience with this novel device. METHODS: Patients consecutively operated on from June 2016 to June 2018 with a 3D-HD ventriculoscope were prospectively collected...
February 11, 2019: World Neurosurgery
Kiyohiko Sakata, Nobuyuki Takeshige, Yui Nagata, Hidenobu Yoshitake, Satoru Komaki, Naohisa Miyagi, Motohiro Morioka
BACKGROUND: Tuberculum sellae meningiomas frequently extend into the optic canals, which leads to a progressive longitudinal visual loss. Therefore, in addition to tumor removal, unroofing and exploration inside the optic canal are important procedures. OBJECTIVE: To perform endoscopic endonasal tumor removal with optic canal decompression for small primary or recurrent meningiomas associated with a progressive visual loss at the inferior-medial optic canal, which corresponded to a blind corner in the ipsilateral pterional/subfrontal approach...
February 7, 2019: Operative Neurosurgery (Hagerstown, Md.)
S G Lum, B S Gendeh, S Husain, H S Gendeh, M R Ismail, C J Toh, A Izaham, H J Tan
Iatrogenic internal carotid artery injury is a catastrophic but uncommon complication of endonasal sinus surgery. We present our experience in managing this emergency situation. A 52-year-old man underwent revision endoscopic repair of recurrent cerebrospinal fluid leak that was complicated with profuse haemorrhage during removal of the anterior wall of sphenoid sinus using a Hajek sphenoid punch forceps. Immediate packing of the sphenoid sinus controlled the haemorrhage. Urgent angiography revealed injury at the paraclival segment of the left internal carotid artery...
January 31, 2019: Acta Otorhinolaryngologica Italica
Ke Wang, Xiu-Jian Ma, Shu-Yu Hao, Jiang Du, Li-Wei Zhang, Jun-Ting Zhang, Zhen Wu
OBJECTIVES: The diagnosis and management for juvenile psammomatoid ossifying fibroma of the skull base (JPOF) are challenging, and clinical data is limited. PATIENTS AND METHODS: A retrospective review of the JPOF was performed, and the clinical characteristics, treatment strategy and prognosis were analyzed. RESULTS: There were 23 patients pathologically confirmed with JPOF, most of which (19/23, 82.6%) were located at the skull base area; and 43...
February 8, 2019: World Neurosurgery
Jawad Yousaf, Fardad T Afshari, Shahzada K Ahmed, Swarupsinh V Chavda, Paul Sanghera, Alessandro Paluzzi
PURPOSE: Clival Chordomas are locally aggressive tumours which pose a significant treatment challenge. Endoscopic endonasal approach for clival chordomas is correlated with higher resection rates and lower morbidity rates in comparison to open approaches. We present our initial single institution experience and short-term patient outcomes following endoscopic endonasal approach for resection of clival chordomas. MATERIALS AND METHODS: This is a retrospective analysis of ten patients undergoing endoscopic endonasal approach for clival chordomas in our neurosurgical unit over a 6 year period between August 2010 and September 2016...
February 11, 2019: British Journal of Neurosurgery
Nicolas K Khattar, Shawn Wc Adams, Alexandra S Schaber, Andrew C White, Mohammed Al Ghamdi, Rob T Hruska, Jesse J Savage, Richard K Downs, Eyas M Hattab, Brian J Williams
Cavernous hemangiomas with an intrasellar extension are very rare, generally benign lesions that manifest by the compression of nearby structures. The presenting symptoms usually range from visual disturbances to an endocrine imbalance. Occasional extension into the cavernous sinus has been reported, which can cause cranial nerve compression. We present the case of a 69-year-old man presenting with facial pain and decreased libido. On investigation, a lesion was identified and the parasellar region was homogeneously hyper-intense on gadolinium-enhanced magnetic resonance imaging (MRI)...
November 30, 2018: Curēus
Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim
OBJECTIVEEndonasal surgery of the skull base requires watertight reconstruction of the skull base that can seal the dural defect to prevent postoperative CSF rhinorrhea and consequent intracranial complications. Although the incidence of CSF leakage has decreased significantly since the introduction in 2006 of the vascularized nasoseptal flap (the Hadad-Bassagasteguy flap), reconstruction of extensive skull base dural defects remains challenging. The authors describe a new, modified vascularized nasoseptal flap for reconstruction of extensive skull base dural defects...
February 8, 2019: Journal of Neurosurgery
Kimberley J Pollock
No abstract text is available yet for this article.
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Kimberley J Pollock, Roy R Casiano, Adam J Folbe, John G Golfinos, Carl H Snyderman
No abstract text is available yet for this article.
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Roy R Casiano, Adam J Folbe, John G Golfinos, Carl H Snyderman
No abstract text is available yet for this article.
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Krishnan Ravindran, Brandon M Zsigray, Michael P Wemhoff, John D Spencer, Ewa Borys, Chirag R Patel, Anand V Germanwala
Background: Pituitary metastasis of cervical adenocarcinoma is an exceedingly rare phenomenon. Case Description: The authors present a case of a 66-year-old female with cervical adenocarcinoma who was discovered to have a rapidly growing intrasellar mass in the work-up of adrenal insufficiency and hypothyroidism. The patient underwent subsequent endoscopic endonasal subtotal resection of the mass. Histopathological analysis of the resected lesion demonstrated features consistent with metastatic mucinous adenocarcinoma of the cervix...
2019: Case Reports in Neurological Medicine
H M Guo, W Hang, G Liu, X Lu, Q Zhang, T Han, H Liu
Objective: To investigate the safety and efficacy of endoscopic endonasal approach for removal of sellar tumors. Method: The clinical data of 18 patients with sellar tumors undergoing endoscopic endonasal surgery were analyzed retrospectively. This series consisted of ten pituitary adenomas, five craniopharyngiomas, three meningiomas. The headache, visual improvement, endocrine, extent of resection and surgical complications were evaluated. Result: Total removal was achieved in 14 patients (77.8%), almost total removal was achieved in one patient of pituitary adenoma with two craniopharyngiomas (16...
November 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Suwiphat Chalongwongse, Sorayouth Chumnanvej, Jackrit Suthakorn
BACKGROUND: Endoscopic Endonasal Transsphenoidal Surgery (EETS) is the standard method to treat pituitary adenoma, tumor in the pituitary gland which would affect human beings in terms of hormonal malfunction and other symptoms. This procedure provides extra minimal invasive access in severe cases. The objective of this paper is to design and develop a prototype of EET robot with navigation guidance system based on the study of EET workspace and pathway to determine a safe space for surgical tool insertion...
January 29, 2019: Asian Journal of Surgery
R Moreno-Luna, J Gonzalez-Garcia, J M Maza-Solano, E Molina-Fernandez, C D Pinheiro-Neto, A Del Cuvillo Bernal, C Langdon, S Sanchez-Gomez
BACKGROUND: We report a novel surgical technique based on an endonasal free mucosal graft (mucoplasty) for improving clinical results and local healing in chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: Patients diagnosed with bilateral CRSwNP scheduled for endoscopic sinus surgery were included. They underwent complete removal of anterior and posterior ethmoid cells, in addition to bilateral type III frontal sinusotomy. An endoscopic mucoplasty was performed in the left nasal cavity, whereas the right nasal cavity served as control...
January 28, 2019: Rhinology
Yisen Zhang, Zhongbin Tian, Chuzhong Li, Jian Liu, Ying Zhang, Xinjian Yang, Yazhuo Zhang
OBJECTIVEInternal carotid artery (ICA) injuries during endoscopic endonasal surgery (EES) are catastrophic complications. Alongside the advancements in medical instrumentation and material, there is a need to modify previous treatment modalities and principles.METHODSA retrospective review of 3658 patients who underwent EES performed at the authors' institution between January 2012 and December 2017 was conducted. Ultimately, 20 patients (0.55%) with ICA injury following EES were enrolled for analysis. Data collection included demographic data, preoperative diagnosis, injury setting, repair method, and immediate and follow-up angiographic and clinical outcomes...
January 25, 2019: Journal of Neurosurgery
Mostafa Ismail, Ahmed A Abdelaziz, Mohab Darwish
PURPOSE: Endoscopic endonasal transsphenoidal surgery (EETS) requires abundant collaborative work between neurosurgeon and ear, nose, and throat (ENT) surgeon. In low-volume centers, however, the surgery may be carried out completely and solely by a neurosurgeon. The current study evaluates the differences in both technique and complications in the approach to the sphenoid sinus for endoscopic endonasal approach (EEA) performed solely by a single neurosurgeon compared to collaborative effort between neurosurgery and otolaryngology...
January 24, 2019: European Archives of Oto-rhino-laryngology
Javan Nation, Alexander J Schupper, Adam Deconde, Michael Levy
INTRODUCTION: The endoscopic expanded endonasal approach (EEA) has been shown to be a safe and effective surgical technique in the resection of pediatric skull base lesions. Cerebrospinal fluid (CSF) leaks are among the most common complications of this approach. Here we review skull base resections using EEA in pediatric patients at our single institution, to identify potential risk factors for this surgical complication. METHODS: A retrospective chart review was conducted on pediatric patients at our single institution for patients 19 years-old and under, who underwent an EEA for resection of a skull base tumor...
January 11, 2019: International Journal of Pediatric Otorhinolaryngology
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