Schwannoma of the skull base with intracranial extension

Mucoceles of the paranasal sinuses cause progressive distension of the bony walls and induce compressive symptoms. Although rare, cases of massive intracranial extension have occurred. We believe that an endoscopic transnasal approach is the best choice for such huge mucoceles because it is the least invasive and can provide an adequate surgical field of view for wide marsupialization. However, the results of long-term follow-up after endoscopic transnasal surgery have not been reported. This study was designed to evaluate prospectively the postoperative course of patients with intracranially extended mucocele. In the last 5 years, we have operated on four patients with intracranially extended mucocele. Although postoperative scanning is not recommended routinely after surgery for inflammatory disease, we followed up two patients who consented by using magnetic resonance imaging (MRI) along with endoscopy. Dural descent to the original skull base plane necessitated long periods of follow-up, lasting 18 and 5 months, respectively. On the mucocele wall mucosa, which had been smooth during surgery, polyps and granulations developed after surgical drainage and lasted for a considerable time. Although endoscopic transnasal opening of mucocele is a method of choice, we recommend follow-up of such patients for long periods, at least until the frontal skull base dura returns to its original position.

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Ten cases of cholesteatoma with labyrinthine destruction, skull base involvement and intracranial extension: management and long-term follow-up

The Journal of Laryngology & Otology ◽

10.1017/s0022215116002085 ◽

2016 ◽

Vol 130 (S3) ◽

pp. S28-S28

Author(s):

Christina Cobb ◽

Douglas Backous

Keyword(s):

Skull Base ◽

Intracranial Extension ◽

Long Term Follow Up

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Anterior Skull Base Glomangioma-Induced Osteomalacia

Journal of Neurological Surgery Reports ◽

10.1055/s-0036-1597599 ◽

2017 ◽

Vol 78 (01) ◽

pp. e9-e11 ◽

Cited By ~ 2

Author(s):

Malia Gresham ◽

Steven Shen ◽

Yi Zhang ◽

Kelly Gallagher

Keyword(s):

Skull Base ◽

Paranasal Sinus ◽

Complete Resolution ◽

Ethmoid Sinus ◽

Anterior Skull Base ◽

Intracranial Extension ◽

Endoscopic Endonasal Approach ◽

Oncogenic Osteomalacia ◽

Endoscopic Endonasal ◽

Mesenchymal Neoplasms

AbstractOncogenic osteomalacia (OO) is an uncommon but treatable cause of osteomalacia related to tumor production of FGF23, usually caused by benign mesenchymal neoplasms. Paranasal sinus glomangiomas are a rare cause of OO, with only one previously reported case. Here we describe a second case (first reported in English) of paranasal sinus glomangioma-induced osteomalacia in a 42-year-old man. He presented with weakness and multiple spontaneous fractures, and was found to have an ethmoid sinus glomangioma with intracranial extension. The tumor was removed via endoscopic endonasal approach to the anterior skull base, which resulted in complete resolution of symptoms and no further evidence of disease 1 year postoperatively.

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Head and Neck: Skull Base Imaging

Neurosurgery ◽

10.1093/neuros/nyx492 ◽

2017 ◽

Vol 82 (3) ◽

pp. 255-267 ◽

Cited By ~ 6

Author(s):

Patricia A Hudgins ◽

Kristen L Baugnon

Keyword(s):

Head And Neck ◽

Skull Base ◽

Intracranial Extension ◽

Resonance Imaging ◽

Head And Neck Malignancy ◽

Imaging Appearance ◽

Imaging Protocols ◽

Neck Malignancy ◽

Head And Neck Pathology ◽

Skull Base Lesions

Abstract There are a myriad of head and neck pathologies that extend from the extracranial to the intracranial compartment, traversing the skull base, and knowledge of the imaging appearance of this pathology is critical to practicing neurosurgeons. This article reviews some of the important inflammatory or acquired head and neck pathology along the skull base, neoplastic skull base lesions, and the intracranial extension of head and neck malignancy. Focus will be on the relevant anatomy, appropriate imaging protocols to evaluate these processes, as well as the differentiating imaging findings on computed tomography and magnetic resonance imaging.

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Skull base hydatid cyst with intracranial extension presenting as vocal cord palsy: a case report

British Journal of Radiology ◽

10.1259/bjr/21853098 ◽

2010 ◽

Vol 83 (987) ◽

pp. e67-e69 ◽

Cited By ~ 4

Author(s):

J Sureka ◽

R Sarawagi ◽

A Eapen ◽

S N Keshava ◽

R Vedantam

Keyword(s):

Case Report ◽

Hydatid Cyst ◽

Skull Base ◽

Vocal Cord ◽

Vocal Cord Palsy ◽

Intracranial Extension

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Imaging and Outcomes for a New Entity: Low-Grade Sinonasal Sarcoma with Neural and Myogenic Features

Journal of Neurological Surgery Reports ◽

10.1055/s-0037-1598198 ◽

2017 ◽

Vol 78 (01) ◽

pp. e15-e19 ◽

Cited By ~ 5

Author(s):

Richard Cannon ◽

Richard Wiggins ◽

Benjamin Witt ◽

Yusuf Dundar ◽

Tawni Johnston ◽

...

Keyword(s):

Skull Base ◽

Surgical Outcomes ◽

Medical Center ◽

Academic Medical Center ◽

Case Series ◽

Intracranial Extension ◽

Low Grade ◽

Skull Base Tumor ◽

Imaging Characteristics ◽

Sinonasal Mass

Objectives Low-grade sinonasal sarcoma with neural and myogenic features (LGSSNMF) is a new, rare tumor. Our goal is to describe the imaging characteristics and surgical outcomes of this unique skull base malignancy. Design Retrospective case series. Setting Academic medical center. Participants There were three patients who met inclusion criteria with a confirmed LGSSNMF. Main Outcome Measures Imaging and histopathological characteristics, treatments, survival and recurrence outcomes, complications, morbidity, and mortality. Results Patients presented with diplopia, facial discomfort, a supraorbital mass, and nasal obstruction. Magnetic resonance imaging and computed tomography imaging in all cases showed an enhancing sinonasal mass with associated hyperostotic bone formation that involved the frontal sinus, invaded the lamina papyracea and anterior skull base, and had intracranial extension. One patient underwent a purely endoscopic surgical resection and the second underwent a craniofacial resection, while the last is pending treatment. All patients recovered well, without morbidity or long-term complications, and are currently without evidence of disease (mean follow-up of 2.1 years). One patient recurred after 17 months and underwent a repeat endoscopic skull base and dural resection. Conclusions The surgical outcomes and imaging of this unique, locally aggressive skull base tumor are characterized.

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Pneumosinus Dilatans Helping Subcranial Resection in a Patient with Advanced Ethmoid Malignancy

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0034-1393736 ◽

2015 ◽

Vol 8 (3) ◽

pp. 218-220

Author(s):

Shawn T. Joseph ◽

Krishnakumar Thankappan ◽

Rahul Buggaveeti ◽

Subramania Iyer

Keyword(s):

Skull Base ◽

Surgical Approach ◽

Frontal Sinus ◽

Anterior Skull Base ◽

Intracranial Extension ◽

Skull Base Tumors ◽

Invasive Approach ◽

Pneumosinus Dilatans ◽

Less Invasive Approach ◽

Malignant Lesions

Subcranial approach is a useful procedure in the management of limited anterior skull base tumors. But the posterior and superior visualization may be limited, in ethmoid malignancies with a large intracranial extension. A 55-year-old male patient, a case of an ethmoid malignancy, with a large intracranial component was resected with adequate margins by a subcranial approach. The coincident pneumosinus dilatans helped the surgical resection. This case demonstrates that assessment of pneumatization of the frontal sinus is as important as the size and extent of the tumor, while deciding an anterior skull base surgical approach. Even large malignant lesions may be approached subcranially if the frontal sinus is proportionately large. Pneumosinus dilatans, though rare, can be used to the benefit of the patient in selecting a less invasive approach.

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Vascularized Omentum Graft for the Reconstruction of the Skull Base after Removal of a Nasoethmoidal Tumor with Intracranial Extension: Case Report

Neurosurgery ◽

10.1227/00006123-199106000-00015 ◽

1991 ◽

Vol 28 (6) ◽

pp. 877-880 ◽

Cited By ~ 11

Author(s):

Toshiaki Yamaki ◽

Teiji Uede ◽

Atsushi Tano-oka ◽

Kohji Asakura ◽

Sumiyoshi Tanabe ◽

...

Keyword(s):

Nasal Cavity ◽

Skull Base ◽

Subcutaneous Fat ◽

Anterior Skull Base ◽

Intracranial Extension ◽

Dural Defect ◽

Nasal Cavities ◽

Intradural Tumor ◽

Omental Transfer ◽

Omental Graft

Abstract A 16-year-old boy with rhabdomyosarcoma occupying the nasal cavities and the ethmoid sinus with intracranial extension underwent transcranial surgery. The intradural tumor was resected first with the affected dura of the anterior skull base, and the dural defect was repaired with fascia harvested from the sheath of the rectus abdominis muscle. The remaining tumor contiguous to the nasal cavities was completely extirpated. The cranial cavity was then exposed to the opened nasal cavities, where a revascularized omental graft was used to separate these compartments. Lyophilized dura was placed beforehand beneath the omental graft, as a roof to the nasal cavity, and was removed 3 weeks later through the nostril. A bony skull base repair was performed over the omentum using the inner table of the bone flap. Subcutaneous fat from the abdomen was placed on the bone graft for fixation and as an additional seal for the dural defect. Reconstruction of the anterior skull base with a vascularized omental transfer provides an efficient barrier to the nasal cavity. It also serves as an excellent supporting structure for regeneration of the mucosal epithelium of the nasal cavities.

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