PubMed Central (PMC3 - NLM DTD)
(2,081,148 recursos)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
Mostrando recursos 161 - 180 de 551
161.
The OnePiece Orbitopterional Approach - Andaluz, Norberto; van Loveren, Harry R.; Keller, Jeffrey T.; Zuccarello, Mario
The orbitopterional approach is an anterior skull base extension of the pterional approach that provides greater exposure to the anterior cranial fossa, supra and parasellar regions, and anterior communicating artery complex. We describe the surgical technique in a stepwise manner to create a onepiece orbitopterional craniotomy flap; keyholes for the bone cuts are the MacCarty burrhole and the anterolateral portion of the inferior orbital fissure. This onepiece technique is less complicated than the twopiece orbitopterional craniotomy and eliminates the need for complex reconstruction of cosmetically important areas (i.e., the orbit and forehead).
163.
Cadaveric Dissections Based on Observations of Injuries to the Temporal Bone Structures following Head Trauma - Wysocki, Jaros?aw
One hundred temporal bones obtained from forensic autopsies were dissected to expose injured structures. Longitudinal fractures were present in 82%, transverse fractures in 11%, and mixed fractures in 7% of the cases. Facial canal injuries were present in almost half of the bones with longitudinal fractures (36/82), although cuts of the facial nerve stem were rarely encountered. Damages to the facial canal associated with longitudinal fractures were most frequently seen in the region of the geniculum. However, transverse fractures with facial canal involvement (7/11) most frequently occurred in the labyrinthine portion, causing a complete cut of the facial nerve. Injuries...
164.
Aspergillus Mastoiditis in a Patient with Systemic Lupus Erythematosus: A Case Report - Amonoo-Kuofi, Kwamena; Tostevin, Phillipa; Knight, Jeff R.
Fungal mastoiditis caused by Aspergillus fumigatus predominantly occurs in immunocompromised patients. Invasive temporal bone mycoses are rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal. Treatment consists of antifungal chemotherapy, surgical debridement, and attempts to control the underlying immunological condition. Published reports describe patients with previous ear pathology and associated facial nerve dysfunction. We report a case in a patient with systemic lupus erythematosus. A good outcome followed surgical debridement and the use of a new triazole antifungal agent, voriconazole. Our patient's facial nerve function was unaffected. The presence of normal facial...
165.
Malignant Myoepithelioma of the Rhinopharynx: Case Report - Magliulo, Giuseppe; Pulice, Gianna; Fusconi, Massimo; Cuiuli, Giuseppe
Malignant myoepitheliomas are rare tumors of salivary glands. Most occur in the parotid gland; few other sites of origin are described. Malignant myoepithelioma of the rhinopharynx has only been reported twice. Because the lesion is so rare, there are no specific indications for its treatment. We present a third case of malignant myoepithelioma in the rhinopharynx and discuss its diagnostic and therapeutic aspects.
166.
Revascularization with Saphenous Vein Bypasses for Complex Intracranial Aneurysms - Quiñones-Hinojosa, Alfredo; Du, Rose; Lawton, Michael T.
Most intracranial aneurysms can be managed with either microsurgical clipping or endovascular coiling. A subset of complex aneurysms with aberrant anatomy or fusiform/dolichoectatic morphology may require revascularization as part of a strategy that occludes the aneurysm or parent artery or both. Bypass techniques have been invented to revascularize nearly every intracranial artery. An aneurysm that will require a saphenous vein bypass is one that cannot be treated with conventional microsurgical clipping or endovascular coiling and also requires deliberate sacrifice of a major intracranial artery as part of the alternative treatment strategy. In the past 7 years the senior author (MTL)...
167.
Superficial Temporal Artery to Middle Cerebral Artery Bypass - Newell, David W.
The superficial temporal artery to middle artery bypass is a technique that allows the blood supply from the extracranial carotid circulation to be routed to the distal middle cerebral artery branches. The procedure allows blood flow to bypass proximal lesions of the intracranial vasculature. The performance of this bypass requires specialized microvascular training and the use of microvascular techniques. The techniques involved in performing these procedures include microdissection of the superficial temporal artery in the scalp, microdissection of the recipient middle cerebral artery branches near the sylvian fissure, and anastomosis techniques using either microvascular sutures or a microanastomotic device. The...
169.
Missile Injuries of the Anterior Skull Base - Bhatoe, Harjinder Singh
Missile injuries of the anterior skull base usually occur during war or warlike situations. These injuries may be isolated or associated with multiple traumatic injuries. We report 23 such cases managed during military conflicts and peacekeeping operations. All were adult males. Four of these patients sustained bullet injuries; the rest were injured from shrapnel. Eighteen patients had injury to the visual apparatus with permanent blindness. Proptosis was seen in 16, cerebrospinal fluid (CSF) leak from the wound in seven, and CSF orbitorrhea in three patients. Sixteen had irreparable injury to the eye necessitating evisceration/enucleation, and two had retrobulbar optic nerve...
170.
Surgical Approaches to the Petrous Apex: Distances and Relations with Cranial Morphology - Meneses, Murilo S.; Moreira, Ana Lucila; Bordignon, Kelly C.; Pedrozo, Ari A.; Ramina, Ricardo; Nikoski, Jeziel G.
Different pathologies may be located at the petrous apex. The primary surgical approaches used to remove such lesions are the pterional, subtemporal, presigmoid, and retrosigmoid. Each has advantages and disadvantages, and the distance to the petrous apex varies with the approach. Anatomical variations in cranial morphology may interfere with these distances. Dolichocephalic skulls have a longer anteroposterior axis than brachycephalic ones.
171.
Guidelines for the Ligation of the Sigmoid or Transverse Sinus during Large Petroclival Meningioma Surgery - Hwang, Sung-Kyun; Gwak, Ho-Shin; Paek, Sun-ha; Kim, Dong Gyu; Jung, Hee-Won
The authors present guidelines for the ligation of the transverse or sigmoid sinus during the surgical removal of petroclival meningiomas. The medical records and venograms of 14 patients with a petroclival meningioma requiring transverse or sigmoid sinus ligation treated in the Department of Neurosurgery, Seoul National University Hospital between 1986 and 1999 were reviewed. All patients successfully received a sinus trial clamping during the operation. The drainage pattern of the confluens of Herophili was classified into four types: Type A, confluens and equal on both transverse sinuses; Type B, confluens and nondominant transverse sinus on the tumor side; Type C,...
172.
Intraorbital Arteriovenous Malformation: Case Report - Gil-Salú, J. L.; González-Darder, J. M.; Vera-Román, J. M.
An intraorbital arteriovenous malformation became symptomatic without exophthalmos but with chemosis and bruit of the left eye. The patient underwent only surgical treatment. The orbital rim was removed through a fronto-orbital approach. The chemosis was corrected and postoperative magnetic resonance imaging and angiography confirmed complete removal of the malformation. Histopathological examination disclosed an arteriovenous malformation in the extrabulbar fatty tissue without invasion of the extraocular muscles or optic nerve. The differences between various types of intraorbital malformations are discussed.
173.
Verrucous Carcinoma of the Temporal Bone: A Wolf Clothed in Wool - Pleat, Jonathon Michael; Bradley, Michael; Orlando, Antonio; Rigby, Howard
Verrucous carcinomas are rare tumors that predominantly affect the head and neck region. A paradox of slow, aggressive invasion, apparent lymphadenopathy, yet seemingly bland histopathology, they can beguile unwary clinicians into multiple diagnostic biopsies and regional lymphadenectomy. We report a rare verrucous carcinoma of the temporal bone associated with extensive destruction around the skull base. Placed in the context of the few reports involving this site, extratemporal spread may be associated with a uniformly poor prognosis regardless of the treatment modality. Given new insights into the pathophysiology of this tumor, palliative radiotherapy may be a more appropriate primary treatment compared...
174.
Iatrogenic Epidermal Inclusion Cyst of the Parapharyngeal Space: Unusual Complication of Ear Surgery - Ulku, Cagatay Han; Uyar, Yavuz; Kocaogullar, Yalc?n; Avunduk, Mustafa Cihat
A 46-year-old man presented with a 12-month history of a slow-growing mass at the right anterior temporal and superior parotid region. He had a history of chronic otitis media and had undergone a modified radical mastoidectomy for cholesteatoma 5 years earlier. Physical examination revealed a sinus tract and diffuse soft tissue mass measuring 4 cm in diameter spread throughout the region of the right anterior temporal and superior parotid areas. Magnetic resonance imaging (MRI) showed three separate masses, including contrast material in the right superior parotid region and lateral skull base. The patient underwent a preauricular infratemporal approach. Six months...
175.
Management of Benign Skull Base Meningiomas: A Review - Mendenhall, William M.; Friedman, William A.; Amdur, Robert J.; Foote, Kelly D.
The optimal management of benign meningiomas of the skull base is reviewed. Elderly patients with small, asymptomatic tumors can be observed and treatment can be initiated if and when progression occurs. Patients with tumors that appear to be amenable to complete resection with an acceptable rate of morbidity are optimally treated with surgery. Decompression of more extensive tumors through conservative subtotal resection and preservation of the involved cranial nerves may result in improved neurological function. Either alone or after subtotal resection, radiosurgery is indicated for tumors that can be treated adequately with this modality. Larger, ill-defined tumors and those that...
176.
Retrolabyrinthine Craniectomy: The Unsung Hero of Skull Base Surgery - Russell, Stephen M.; Roland, J. Thomas; Golfinos, John G.
Despite being the foundation of, or supplement to, many skull base exposures, the retrolabyrinthine approach has not been adequately illustrated in the skull base literature. As an aid to skull base surgeons in training, this article provides a step-by-step description of the microsurgical anatomy and operative nuances of this important technique.
178.
Technical Modifications of Suboccipital Craniectomy for Prevention of Postoperative Headache - Silverman, Damon A.; Hughes, Gordon B.; Kinney, Sam E.; Lee, Joung H.
A retrospective review of 53 consecutive patients who underwent a retrosigmoid vestibular nerve section (VNS) or microvascular decompression (MVD) through a modified suboccipital craniectomy with a minimum follow-up of 2 years was performed. Technical modifications to the suboccipital craniectomy included a skin incision designed to avoid the lesser and greater occipital nerves; a small, 2-cm diameter craniectomy with no intradural drilling of bone; and a simplified closure to prevent muscle adhesion to dura without the need for cranioplasty. The presence, duration, and severity of postoperative headache were the primary outcome measures. Craniectomy-related complications, operative time, and length of hospital stay...
179.
Cranial Nerve Preservation in Surgery for Large Acoustic Neuromas - Roland, J. Thomas; Fishman, Andrew J.; Golfinos, John G.; Cohen, Noel; Alexiades, George; Jackman, Alexis H.
Facial nerve outcomes and surgical complication rates for other cranial nerves were evaluated retrospectively after the resection of large acoustic neuromas. The charts of all patients who underwent surgical removal of an acoustic neuroma between 1992 and 2001 at New York University Medical Center were reviewed. Fifty-four patients with tumors measuring 3 cm or larger were included in the study. Four patients had neurofibromatosis type 2, two of whom underwent bilateral removal of acoustic neuromas. Translabyrinthine microsurgical removal of tumor was performed in 47 of 56 cases (84%). In all cases, EMG monitoring, improved sharp microdissection, and ultrasonic aspiration were...
180.
Virtual Cisternoscopy: 3D MRI Models of the Cerebellopontine Angle for Lesions Related to the Cranial Nerves - Rabinov, James D.; Barker, Frederick G.; McKenna, Michael J.; Curtin, Hugh D.
This study was conducted to show that high-resolution magnetic resonance imaging (MRI) can aid in the neurosurgical approach to lesions affecting the cranial nerves (CNs) in the cerebellopontine angle (CPA). Three patients with symptomatology related to CNs VII and VIII underwent MRI examinations performed on a 1.5-Tesla Siemens MR scanner. As part of these routine examinations, the imaging technique of constructive interference in the steady state (CISS) was used to collect a volume of data through the brainstem and internal auditory canals. This high-resolution technique acquires a three-dimensional (3D) volume of data at 0.7-mm intervals. Parameters included TR 12.3/TE 5.9,...
161.
