The effect of prior radiation on the success of ventral skull base reconstruction: A systematic review and meta‐analysis

Head & Neck ◽  
2021 ◽  
Author(s):  
Michael Yong ◽  
Yu Qi Wu ◽  
Shirley Su ◽  
Ehab Hanna ◽  
Eitan Prisman ◽  
...  
2020 ◽  
Vol 139 ◽  
pp. 460-470
Author(s):  
Arash Abiri ◽  
Parinaz Abiri ◽  
Khodayar Goshtasbi ◽  
Brandon M. Lehrich ◽  
Ronald Sahyouni ◽  
...  

Author(s):  
Christina Dorismond ◽  
Griffin D. Santarelli ◽  
Brian D. Thorp ◽  
Adam J. Kimple ◽  
Charles S. Ebert ◽  
...  

Abstract Objectives Presently, there are no standards for reporting outcomes of endoscopic endonasal skull base reconstruction (ESBR). This is problematic as a lack of consistent reporting makes synthesizing findings in systematic reviews and meta-analysis challenging. Thus, the aim of this study was to systematically review and describe the patterns of reporting outcomes in ESBR as a foundation for developing reporting guidelines. Study Design Present study is a systematic review. Methods Embase, PubMed, CINAHL, Cochrane Library, and Web of Science were searched for all publications with ≥25 patients and a focus on ESBR. The reporting patterns of each study's variables and outcomes were assessed. Results A total of 112 studies were included in the review. The most commonly reported demographic variables were the number of included patients (n = 112, 100%) and types of pathologies treated (n = 104, 92.9%). Meanwhile, the most routinely described preoperative variable was history of prior treatment (n = 48, 42.9%). Type of reconstruction was a commonly reported intraoperative variable (n = 110, 98.2%), though the rate of intraoperative cerebrospinal fluid (CSF) leak was noted in only 76 studies (67.9%). With regard to postoperative outcomes, postoperative CSF leak rate was routinely provided (n = 101, 90.2%), but reporting of other surgical complications was more inconsistent. Ultimately, of the 43 variables and outcomes reviewed, a median of 12 (range: 4–22) was reported in each study. Conclusions There is significant heterogeneity in the outcomes reported in studies relating to ESBR. This highlights the need for the development of standard reporting guidelines to minimize bias and improve interstudy comparability.


2014 ◽  
Vol 125 (4) ◽  
pp. 813-821 ◽  
Author(s):  
Stuti V. Desai ◽  
Eleonora F. Spinazzi ◽  
Christina H. Fang ◽  
Grace Huang ◽  
Senja Tomovic ◽  
...  

2019 ◽  
Vol 124 ◽  
pp. 267-276 ◽  
Author(s):  
Georgios P. Skandalakis ◽  
Christos Koutsarnakis ◽  
Nikos Pantazis ◽  
Aristotelis Kalyvas ◽  
Spyridon Komaitis ◽  
...  

2016 ◽  
Vol 96 ◽  
pp. 47-57 ◽  
Author(s):  
Jacob L. Freeman ◽  
Soliman Oushy ◽  
Jeffrey Schowinsky ◽  
Stefan Sillau ◽  
A. Samy Youssef

Neurosurgery ◽  
2010 ◽  
Vol 66 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Mihir R. Patel ◽  
Rupali N. Shah ◽  
Carl H. Snyderman ◽  
Ricardo L. Carrau ◽  
Anand V. Germanwala ◽  
...  

Abstract BACKGROUND One of the major challenges of cranial base surgery is reconstruction of the dural defect and prevention of postoperative cerebrospinal fluid (CSF) fistula. The introduction of endoscopic techniques and an endonasal approach to the ventral skull base has created new challenges for reconstruction. OBJECTIVE We have developed an endoscopic pericranial flap (PCF) for skull base reconstruction and hereby present the initial cohort of patients who had endonasal reconstruction with a PCF after endoscopic skull base resection. We also demonstrate a method to radiographically incorporate anticipated skull base defects for preoperative planning of PCF length. METHODS Dural defects after endonasal skull base resection of invasive tumors were reconstructed with an onlay PCF (n = 10). We performed radiological studies to assist preoperative planning for where to make incisions while harvesting a PCF for anterior skull base, sellar, and clival defects. RESULTS Each of the 10 patients had excellent healing of their skull base and had no evidence of any postoperative cerebrospinal fluid leaks. Eight patients had radiation therapy without flap complications. Radiographic studies demonstrate that the adequate PCF length, covering defects of the anterior skull base, sellar, and clival defects are 11.31 to 12.44 cm, 14.31 to 15.57 cm, and 18.5 to 20.42 cm, respectively. CONCLUSION The PCF provides an option for endonasal reconstruction of cranial base defects and can be harvested endoscopically. Pre-operative radiographic evaluation may guide surgical planning. There is minimal donor site morbidity, and the flap provides enough surface area to cover the entire ventral skull base.


2016 ◽  
Vol 30 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Brian D'Anza ◽  
Due Tien ◽  
Janalee K. Stokken ◽  
Pablo F. Recinos ◽  
Troy R. Woodard ◽  
...  

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