scholarly journals CSF Rhinorrhoea After Endonasal Intervention to the Skull Base (CRANIAL). Part 1: Multicenter Pilot Study

2021 ◽  
Author(s):  
Danyal Z. Khan ◽  
Hani J. Marcus ◽  
Hugo Layard Horsfall ◽  
Soham Bandyopadhyay ◽  
Benjamin E. Schroeder ◽  
...  
Keyword(s):  
Pilot Study ◽  
Skull Base ◽  
Csf Rhinorrhoea

scholarly journals 926 CSF Rhinorrhoea After Endonasal Intervention to The Skull Base (CRANIAL): Multicentre Pilot Study

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Z Khan ◽  
H J Marcus ◽  
Keyword(s):  
Pilot Study ◽  
Skull Base ◽  
Operative Management ◽  
Qualitative Feedback ◽  
Pilot Experience ◽  
Observational Cohort ◽  
Csf Rhinorrhoea ◽  
Csf Diversion ◽  
User Friendly ◽  
Repair Techniques

Abstract Introduction CRANIAL (CSF Rhinorrhoea After Endonasal Intervention to the Skull Base) is a prospective, multicentre observational study seeking to determine: the scope of skull base repair methods used, and the corresponding rates of postoperative CSF rhinorrhoea in endonasal transsphenoidal (TSA) expanded endonasal approaches (EEA) for skull base tumours. Method A prospective, observational cohort pilot study was carried out at eleven neurosurgical units, via NANSIG and BNTRC collaboratives. Results 192 cases were included – 167 TSA (87%), 25 EEA (13%). The most common (MC) pathologies included: pituitary adenomas (n = 150/192), craniopharyngiomas (n = 7/192) and meningiomas (n = 4/192). The MC skull base repair techniques used were tissue glues (n = 135/192, MC Tisseel®), grafts (n = 94/192, MC fat or Spongostan™) and vascularised flap (52/192, MC nasoseptal). These repairs were most frequently supported by nasal packs (n = 127/192) and lumbar drains (n = 23/197). Biochemically confirmed CSF rhinorrhoea occurred in 10/167 (6%) TSA and 4/25 (16%) EEA. 5 cases required operative management for CSF rhinorrhoea (CSF diversion or direct repair). Qualitative feedback was largely positive (e.g., user-friendly data collection), demonstrating acceptability. Conclusions Our pilot experience highlights the acceptability and feasibility of CRANIAL. There is clear precedent for multicentre dissemination of this project, in order to establish a benchmark of contemporary skull base neurosurgery practice.

scholarly journals Nano-hemostats and a Pilot Study of Their Use in a Large Animal Model of Major Vessel Hemorrhage in Endoscopic Skull Base Surgery

2016 ◽  
Vol 38 (03) ◽  
pp. 215-221
Author(s):  
Jae Murphy ◽  
Sarah Vreugde ◽  
Alkis Psaltis ◽  
P. Wormald ◽  
Alistair Jukes
Keyword(s):  
Pilot Study ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Coagulation Cascade ◽  
Large Animal Model ◽  
Large Animal ◽  
Small Pilot Study ◽  
Sheep Model ◽  
Endoscopic Skull Base Surgery ◽  
Major Vessel

AbstractNano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable. We present a summary of the clinical studies to date and a small pilot study of nano-hemostat in an endoscopic sheep model of major vessel hemorrhage to determine its efficacy in stopping bleeding in this potentially catastrophic complication.

Neurophysiological Identification of Cranial Nerves During Endoscopic Endonasal Surgery of Skull Base Tumors: Pilot Study Technical Report

2017 ◽  
Vol 98 ◽  
pp. 230-238 ◽  
Author(s):  
Alexey Nikolaevich Shkarubo ◽  
Ilia Valerievich Chernov ◽  
Anna Anatolievna Ogurtsova ◽  
Dmitry Aleksandrovich Moshchev ◽  
Andrew Jurievich Lubnin ◽  
...  
Keyword(s):  
Pilot Study ◽  
Skull Base ◽  
Cranial Nerves ◽  
Skull Base Tumors ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Technical Report

Idiopathic diffuse erosion of the skull base presenting as cerebrospinal fluid rhinorrhoea

1998 ◽  
Vol 112 (7) ◽  
pp. 679-681 ◽  
Author(s):  
P. J. Conboy ◽  
I. J. M. Johnson ◽  
T. Jaspan ◽  
N. S. Jones
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
World Literature ◽  
Unusual Case ◽  
Similar Case ◽  
Bony Defect ◽  
Endoscopic Repair ◽  
The World ◽  
Csf Rhinorrhoea ◽  
The Right

AbstractWe present an unusual case of generalized erosion of the skull base. We have not found a similar case reported in the world literature. The presenting symptom was spontaneous cerebrospinal fluid (CSF) rhinorrhoea which arose from a bony defect associated with herniation of the right temporal lobe into the sphenoid sinus. We discuss the management of such a case including imaging of the skull base and the endoscopic repair of the bony defect.

Spontaneous CSF rhinorrhoea from separate defects of the anterior and middle cranial fossa

2002 ◽  
Vol 116 (7) ◽  
pp. 546-547 ◽  
Author(s):  
U. Raghavan ◽  
S. Majumdar ◽  
N. S. Jones
Keyword(s):  
Skull Base ◽  
Middle Ear ◽  
World Literature ◽  
Intrathecal Injection ◽  
Middle Cranial Fossa ◽  
Csf Leak ◽  
Csf Rhinorrhoea ◽  
Cranial Fossa ◽  
Skull Base Defect ◽  
Tomography Scan

Multiple congenital dehiscence of the skull base is rare and can give rise to spontaneous CSF rhinorrhoea. A search of the world literature revealed only five reports of CSF leak with more than one concomitant skull base defect. When treating a patient with spontaneous CSF rhinorrhoea the possibility of its originating from the middle ear and eustachian tube should be considered. An intrathecal injection of fluorescein is useful in establishing the site of a CSF leak especially when a computed tomography scan (CT) or magnetic resonance image (MRI) has not localized the site. We discuss a case of a 72-year-old lady presenting with CSF rhinorrhoea, who had an anterior skull base defect localized with the help of intrathecal fluorescein and repaired surgically. Subsequent to this she had a further episode of CSF rhinorrhoea that originated from a middle-ear meningocele that was then repaired.

Anatomical features of skull base and oral cavity: a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery

2015 ◽  
Vol 38 (4) ◽  
pp. 723-730 ◽  
Author(s):  
Aymeric Amelot ◽  
Stephanie Trunet ◽  
Vincent Degos ◽  
Olivier André ◽  
Aurore Dionnet ◽  
...  
Keyword(s):  
Pilot Study ◽  
Oral Cavity ◽  
Skull Base ◽  
Robotic Assisted ◽  
Anatomical Features ◽  
Robotic Assisted Surgery

Radiological study of primary spontaneous CSF rhinorrhoea

1991 ◽  
Vol 105 (4) ◽  
pp. 274-277 ◽  
Author(s):  
N. S. Tolley ◽  
G. A. S. Lloyd ◽  
H. O. L. Williams
Keyword(s):  
Skull Base ◽  
Ct Imaging ◽  
Cribriform Plate ◽  
Radiological Sign ◽  
Radiological Study ◽  
Csf Rhinorrhoea ◽  
Skull Base Anatomy ◽  
Contrast Ct ◽  
Suitable Technique ◽  
Fistula Site

AbstractA radiological study of skull base anatomy was performed in patients presenting with primary spontaneous CSF rhinorrhoea. Radiology correctly identified the fistula site in 90 per cent of cases. Contrast CT imaging was found to be the most suitable technique for identifying the presence and site of CSF fistulae. However, pre-contrast bony dehiscences were identified in all patients leaking from the cribriform plate region. More significantly, all of these patients showed deviation of their crista galli, a radiological sign hitherto unreported. These findings support the theory that congenital bony dehiscence is the aetiological basis for this condition. The importance of radiology in the management of this condition is emphasized.

scholarly journals Endoscopic excision of meningocele and meningoencephalocele: Report of two cases

2016 ◽  
Vol 7 (1) ◽  
pp. 53
Author(s):  
Sheikh Hasanur Rahman ◽  
Kamrul Hassan Tarafder ◽  
Mohammad Asaduzzaman Rasel
Keyword(s):  
Skull Base ◽  
Nasal Obstruction ◽  
Endoscopic Surgery ◽  
Endoscopic Procedure ◽  
Recurrent Meningitis ◽  
Endoscopic Excision ◽  
Direct View ◽  
Transcranial Approach ◽  
Csf Rhinorrhoea

Meningocele and meningoencephalocele are rare entities produced by herniation of cranial contents at the defective areas of the skull base, which may be congenital, spontaneous or traumatic. The condition may present as CSF rhinorrboea, nasal obstruction or even with meningitis. Managemenl of these basal encephaloceles with endoscopic surgery provides a direct view of the skull base and cause less morbidity compared with transcranial approach. Two cases have been reported here, first, a meningocele presented as a case of recurrent CSF rhinorrhoea and the second one, a meningoen­cepbalocele presented as recurrent meningitis, treated using an endoscopic procedure and reviews the literature regarding their management.

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