scholarly journals The Use of the Temporoparietal Fascial Flap in Preventing CSF Leak after Lateral Skull Base Surgery

2013 ◽  
Vol 74 (05) ◽  
pp. 311-316 ◽  
Author(s):  
Luke Buchmann ◽  
Jason Hunt ◽  
Rusha Patel
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Csf Leak ◽  
Fascial Flap ◽  
Lateral Skull Base

Primary Dural Repair Using Titanium Microclips Following Lateral Skull Base Surgery

2021 ◽  
Author(s):  
Camille K. Milton ◽  
Alexander G. Bien ◽  
Greg A. Krempl ◽  
Jose A. Sanclement ◽  
Rachad Mhawej ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Case Series ◽  
Jugular Foramen ◽  
Csf Leak ◽  
Skull Base Tumor ◽  
Chordoid Meningioma ◽  
Dural Repair ◽  
Lateral Skull Base ◽  
Standard Techniques

Abstract Objective Standard techniques for primary dural repair following lateral skull base surgery are both technically challenging and time consuming without the potential for primary dural repair. Inadequate closure may result in postoperative cerebrospinal fluid (CSF) leak infectious sequalae. Traditional methods of dural repair rely on secondary obliteration of the CSF fistula. We hypothesized that the use of nonpenetrating titanium microclips may serve as a useful adjunct in primary dural repair or the establishment of an immobile repair layer following lateral skull base surgery. Methods Here, we report a novel technique for primary dural repair using nonpenetrating titanium microclips as an adjunct to standard techniques in a series of six patients with lateral skull base pathologies. Results A total of six consecutive lateral skull base tumor patients with titanium microclip dural reconstruction were included in our case series. Lateral skull base pathologies represented in this group included two jugular foramen schwannomas, one vestibular schwannoma, one petroclival meningioma, one glomus jugulare paraganglioma, and one jugular foramen chordoid meningioma. Conclusion To our knowledge, this is the first report on the use of microclips in repairing dural defects following lateral skull base surgery. Surgical outcomes for this small case series suggest that dural repair of the later skull base with nonpenetrating titanium microclips is a useful adjunct in dural repair following lateral skull base surgery.

Prophylaxis and Treatment of CSF Leak in Endonasal Skull Base Surgery

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
B. Pashaev ◽  
D. Bochcarev ◽  
V. Krasnazhen ◽  
V. Danilov ◽  
A. Alekseev ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Csf Leak

Increasing Safety in Lateral Skull Base Surgery by Navigation

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Rainer Schmelzeisen ◽  
Marc Metzger
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Lateral Skull Base

Lateral skull base surgery: a complicated pursuit?

2007 ◽  
Vol 122 (3) ◽  
pp. 221-229
Author(s):  
V C Cousins
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Treatment Modalities ◽  
Published Data ◽  
Know How ◽  
Team Assessment ◽  
Pathological Conditions ◽  
Lateral Skull Base ◽  
Wide Range ◽  
Multi Disciplinary Team

AbstractThe management of lesions of the lateral skull base is a highly sophisticated branch of surgery generally performed by otolaryngology–head and neck surgeons as part of a multi-disciplinary team. Assessment of patients with diseases affecting the lateral skull base can be complex, as can the application of the various treatment modalities and the management of the expected and unexpected side effects of that treatment.A wide range of pathological conditions occur in the lateral skull base. Many operations and procedures have been described for dealing with them. There is not necessarily one correct solution to the management of any particular problem in the skull base, with multiple factors to be considered in planning and intervention.As surgeons, we need to know how our own results and outcomes compare with pooled, published data concerning the implications and complications occurring as a result of intervention, in order to better advise our patients on their management.

Anatomical study of occipital triangles: the ‘inferior’ suboccipital triangle, a useful vertebral artery landmark for safe postero-lateral skull base surgery

2017 ◽  
Vol 159 (10) ◽  
pp. 1887-1891 ◽  
Author(s):  
Giuseppe La Rocca ◽  
Roberto Altieri ◽  
Luca Ricciardi ◽  
Alessandro Olivi ◽  
Giuseppe Maria Della Pepa
Keyword(s):  
Vertebral Artery ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anatomical Study ◽  
Lateral Skull Base

scholarly journals Postoperative Continuous Positive Airway Pressure Use and Nasal Saline Rinses After Endonasal Endoscopic Skull Base Surgery in Patients With Obstructive Sleep Apnea: A Practice Pattern Survey

2018 ◽  
Vol 33 (1) ◽  
pp. 51-55 ◽  
Author(s):  
David L. Choi ◽  
Kesava Reddy ◽  
Erik K. Weitzel ◽  
Brian W. Rotenberg ◽  
Allan Vescan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Standard Deviation ◽  
Skull Base ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Skull Base Surgery ◽  
Csf Leak ◽  
Cpap Therapy ◽  
Endoscopic Skull Base Surgery ◽  
Obstructive Sleep

Background Endoscopic skull base surgery continues to evolve in its indications, techniques, instrumentation, and postoperative care. As surgery of the skull base will often violate dura, intraoperative and postoperative cerebrospinal fluid (CSF) leak is not uncommon and represents a potential conduit for air and bacterial contamination. Patients with obstructive sleep apnea (OSA) requiring continuous positive airway pressure (CPAP) therapy undergoing skull base surgery represent a challenging group. However, there appears to be a paucity of consensus regarding the postoperative management of this patient population. The objective of this study is to examine practice patterns and expert opinion on the use of postoperative CPAP and nasal saline in patients with OSA. Methods A 14-item survey was generated by consensus among expert authors and distributed online to members of the North American Skull Base society and other international skull base community members. Data were analyzed for median, mean, and standard deviation variables. Subgroup analysis was completed between surgeons from different geographical locations and operative experience. SPSS22 was utilized for all complex statistical analysis and figures. Results Seventy-one responses were collected from skull base surgeons. In patients with OSA, respondents would resume patients’ CPAP therapy after a mean of 10.1 days (median, 7; standard deviation [SD], 10.2), without a CSF leak. In the presence of a small CSF leak, the mean duration would increase to 14.3 days (median, 14; SD, 9.8) and to 20.7 days (median, 21; SD, 11.8) in the presence of a larger leak. A surgeon’s choice to attribute the relationship between delaying the start of nasal saline and CPAP after the endoscopic skull base surgery with progressively more challenging skull base repair was found to be statistically significant ( P < .001). Conclusion Saline and CPAP therapies are initiated after the endoscopic skull base surgical repairs by surgeons at an increasing temporal delay in relation to the degree and complexity of the skull base defect repaired.

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