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).
42.
Skull Base Meningioma: Delayed Extracranial Presentation - Al-Sebeih, Khalid; Al-Dhahri, Saleh; Zeitouni, Anthony; Moola, Farhad; Lablanc, Richard; Lessard, Lucie
Meningiomas are common intracranial tumors that rarely extend to extracranial sites. When they occur extracranially near the skull base, their diagnosis and management represent tremendous challenges. Although the extracranial component tends to manifest at the same time as the intracranial component, this is not always the case. In the patient reported in this article, 13 years separated the diagnosis of the intracranial tumor from the appearance of an extracranial component. The clinical presentation, radiologic findings, and management of this large skull base meningioma are discussed with reference to the literature. A high index of suspicion and clinical acumen are needed...
44.
Symptomatic Subdural Hygroma and Temporal Lobe Edema After Translabyrinthine Removal of Acoustic Neuroma - Das, Kaushik; Murali, Raj; Lindstrom, Christopher J.; Couldwell, William T.
The translabyrinthine approach is familiar to most neurosurgeons and neuro-otologists and is frequently used to remove acoustic neuromas. Some of the complications associated with this surgery include cerebrospinal fluid (CSF) leaks, meningitis, and rarely fat graft prolapse. The authors report a 60-year-old woman who underwent a translabyrinthine approach and microsurgical resection of a right-sided 1-cm acoustic neuroma. Initially, she was discharged home after an uneventful postoperative course. Four days later, she sought treatment in the emergency room complaining of headaches, dizziness, and lethargy. A computed tomographic (CT) scan showed a large right-sided subdural hygroma and right temporal lobe edema. The...
45.
Prevention and Management of Cerebrospinal Fluid Fistula After Transtemporal Skull Base Surgery - Leonetti, John P.; Anderson, Douglas; Marzo, Sam; Moynihan, George
The incidence of cerebrospinal fluid (CSF) fistula after transtemporal skull base surgery can range from 4% to 19%. The risk of CSF leak may be related to tumor size and location, the extent of the dural defect, and the technical aspects of the wound reconstruction. Prevention of meningitis depends on the early detection and management of CSF leakage. Five hundred eighty-nine patients underwent a variety of transtemporal surgical approaches for the extirpation of skull base tumors at our institution from July 1988 to October 1999. The medical records were reviewed retrospectively to identify the tumor histology, size, and location, as...
46.
Stereotactic Radiotherapy of Central Nervous System and Head and Neck Lesions, Using a Conformal Intensity-Modulated Radiotherapy System (Peacock System) - Ammirati, Mario; Bernardo, Antonio; Ramsinghani, Nilam; Yakoob, Richard; Al-Ghazi, Matthew; Kuo, Jeffrey; Ammirati, Giuseppe
The objective of this article is to evaluate single-fraction or fractionated stereotactic radiotherapy of central nervous system (CNS) and head and neck lesions using intensity-modulated radiotherapy (IMRT) with a commercially available system (Peacock, Nomos Corporation, Sewickley, PA). This system allows tomotherapeutic delivery of intensity-modulated radiation, that is, the slice-by-slice treatment of the volume of interest with an intensity-modulated beam, making the delivery of highly conformal radiation to the target possible in both single or multiple fractions mode. During an 18-month period, 43 (21 males and 22 females) patients were treated, using a removable cranial screw-fixation device. Ages ranged from 10...
47.
Microsurgical and Endoscopic Approaches to the Basilar Bifurcation: Quantitative Comparison of Combined Pterional/Anterior Temporal and Orbitozygomatic Extended Approaches - Nanda, Anil; Vannemreddy, Prasad S.S.V.; Vincent, David A.
To determine the most effective route to the upper third of the basilar artery, 10 cadaver dissections were performed comparing the exposure gained using the combined pterional/anterior temporal approach and the orbitozygomatic extended approach. Endoscopic evaluation through an eyebrow incision in each dissection helped determine whether any advantage was conferred by the cranial base approach. This also served to assess the benefit of using the endoscope as an adjunct to open procedures in evaluating the opticocarotid and retrocarotid routes to the basilar artery. The results of cadaveric dissections suggest that compared with the exposure afforded by the combined pterional/anterior temporal...
48.
Evaluation of the Contribution of CAS in Combination with the Subcranial/Subfrontal Approach in Anterior Skull Base Surgery - Laedrach, Kurt; Remonda, Luca; Lukes, Anton; Schroth, Gerhard; Raveh, Joram
In this study, 31 cases with different anterior skull base lesions mandating broad exposure, including the sphenoidal, parasellar, and clival region, were surgically treated using the frameless computer assisted surgery (CAS) system. The contribution of navigated surgery in relation to the broad exposure and direct visualization of this region rendered by the subcranial-subfrontal approach was evaluated. In group I, consisting of extensive tumors, the contribution of CAS was only given in five cases for the exposure of the tumor extensions located to the parasellar sphenoclival complex with concomitant distortion of the anatomic landmarks. No advantages were experienced in the more...
49.
Endonasal Endoscopic Closure of Cerebrospinal Fluid Rhinorrhea - Schmerber, S.; Righini, Ch.; Lavielle, J.-P.; Passagia, J.-G.; Reyt, E.
The authors review their experience with endoscopic repair of skull base defects associated with cerebrospinal fluid (CSF) rhinorrhea involving the paranasal sinuses. A total of 22 patients was treated endoscopically between 1992 and 1998. The repair method consisted of closure of the CSF fistula with a free autologous abdominal fat graft and fibrin glue, supported with a sheet of silastic. The primary closure rate was 82% (18/22), and the overall closure rate was 95.5% (21/22) without recurrence or complications within an average follow-up of 5 years (14-83 months). A single patient still complains of cerebrospinal rhinorrhea, although this was never...
50.
Trans-Sinusal Frontal Approach for Olfactory Groove Meningiomas - Hallacq, Paul; Moreau, Jean-Jacques; Fischer, Georges; Béziat, Jean-Luc
The authors report on their experience with the trans-sinusal frontal approach in removing olfactory groove meningiomas. Six tumors were operated on by the trans-sinusal frontal approach, using a bicoronal incision; two tumors developed on one side, and there were four bilateral olfactosellar tumors. Osteotomy of the anterior wall of the frontal sinus was performed with an oscillating saw without any burr hole. The posterior wall of the sinus was resected and the tumor was attacked through a real subfrontal route along the plane of the anterior skull base. Ethmoidal blood supply was controlled at the initial stages of the operation,...
51.
Neurinoma of the Greater Superficial Petrosal Nerve Developed Acute Facial Palsy: Case Report and Review of the Literature - Aihara, Noritaka; Yamada, Kazuo; Matsuda, Futoshi; Murakami, Shingo
The authors report on a patient with a greater superficial petrosal nerve neurinoma. The patient developed severe acute facial palsy and the palsy improved soon after removal of the tumor. We review of the literature and describe its rarity and surgical treatment with regard to other facial nerve neurinomas originating from the main trunk of the facial nerve.
53.
Endovascular Treatment of Transverse-Sigmoid Sinus Dural Arteriovenous Malformations Presenting as Pulsatile Tinnitus - Shownkeen, Harish; Yoo, Kevin; Leonetti, John; Origitano, T.C.
Transverse-sigmoid sinus dural arteriovenous malformations (DAVM) are uncommon vascular lesions for which complete cure may be difficult to obtain. A wide variety of treatments for these lesions include observation, arterial compression, surgical resection, and endovascular embolization. We propose that transverse-sigmoid sinus DAVM can be completely cured by occluding the ipsilateral dural sinus with detachable balloon and Guglielmi detachable coils (GDC) coils before arterial feeder embolization with histoacryl. Three patients who presented with pulsatile tinnitus and normal magnetic resonance imaging (MRI) studies underwent angiography, which demonstrated transverse-sigmoid sinus DAVM. All three patients wer treated with retrograde transvenous sinus embolization with complete...
56.
Comparison of Scientific Calipers and Computer-Enabled CT Review for the Measurement of Skull Base and Craniomaxillofacial Dimensions - Citardi, Martin J.; Herrmann, Brian; Hollenbeak, Chris S.; Stack, Brendan C.; Cooper, Margaret; Bucholz, Richard D.
Traditionally, cadaveric studies and plain-film cephalometrics provided information about craniomaxillofacial proportions and measurements; however, advances in computer technology now permit software-based review of computed tomography (CT)-based models. Distances between standardized anatomic points were measured on five dried human skulls with standard scientific calipers (Geneva Gauge, Albany, NY) and through computer workstation (StealthStation 2.6.4, Medtronic Surgical Navigation Technology, Louisville, CO) review of corresponding CT scans. Differences in measurements between the caliper and CT model were not statistically significant for each parameter. Measurements obtained by computer workstation CT review of the cranial skull base are an accurate representation of actual bony anatomy....
57.
Papillary Tumor of the Temporal Bone - Schick, Bernhard; Kronsbein, Hartmut; Kahle, Gabriele; Prescher, Andreas; Draf, Wolfgang
Papillary tumors of the middle and inner ear have been interpreted histogenetically in many ways. In 1989 Heffner proposed the endolymphatic sac epithelium as a possible origin. These rare tumors are clinically aggressive and can cause extensive temporal bone destruction. Because of this behavior, endolymphatic sac tumors (ELST) were classified as low-grade adenocarcinomas, although metastasis has not yet been documented. Two papillary neoplasms of the temporal bone are presented, which we believe are examples of adenomatous tumors arising from the epithelium of the endolymphatic sac. One was associated with a pituitary adenoma. A third case of a papillary middle ear...
59.
Exposure of the Petrous Segment of the Internal Carotid Artery Through the Extradural Subtemporal Middle Cranial Fossa Approach: A Systematic Anatomical Study - Mortini, Pietro; Mandelli, Carlo; Gerevini, Simonetta; Giovanelli, Massimo
The relationships between the horizontal segment of the internal carotid artery (ICA) and other petrous apex structures was studied in 14 anatomical specimens obtained from routine autopsies and on 10 magnetic resonance images obtained from healthy volunteers. The dissection was performed under an operating microscope using the middle fossa transpetrous approach. A pentagonshaped area of 67.91 mm2 posterior to the trigeminal nerve and bordered by anatomical structures was identified inside the petrous apex. The results suggest a method for exposing the ICA when the artery is not visible after dural elevation.
60.
The Architecture of the Arcuate EminenceA Microanatomical Study and Its Application to the Transpetrosal Approach - Katsuta, Toshiro; Matsushima, Toshio; Fukui, Masashi; Rhoton, Albert L.
This study was performed to determine if the arcuate eminence can be drilled down without opening the semicircular canal to obtain a flatter operative field during an anterior or posterior transpetrosal approach. The depth of the superior semicircular canal from the top of the arcuate eminence was measured in 43 dry temporal bones. We found that the arcuate eminence was situated approximately 20 mm from the petrosigmoid intersection, and the superior semicircular canal was located 2.0 mm deep from the top of the arcuate eminence (range, 0.2 mm to 4.2 mm). The arcuate eminence consists of either (1) the otic...
41.
