Facial Reanimation with the VII–XII Anastomosis: Analysis of the Functional and Psychologic Results

1986 ◽  
Vol 94 (3) ◽  
pp. 305-310 ◽  
Author(s):  
Myles L. Pensak ◽  
C. Gary Jackson ◽  
Michael E. Glasscock ◽  
Aina Julianna Gulya
Keyword(s):  
Skull Base ◽  
Retrospective Review ◽  
Patient Population ◽  
Cerebellopontine Angle ◽  
Functional Results ◽  
Technical Performance ◽  
Photographic Documentation ◽  
Facial Reanimation ◽  
Psychosocial Perspective ◽  
Detailed Questionnaire

The VII-XII anastomosis has been employed for more than a decade by The Otology Group, P.C., In the facial reanimation of patients undergoing extirpation of tumors involving the cerebellopontine angle and the skull base. A retrospective review based upon a detailed questionnaire and submitted photographic documentation from 61 patients forms the basis for this review. Details and analysis of the functional results include (1) onset of function, (2) synkinetic activity, (3) corneal irritation and associated ophthalmologic problems, (4) facial tone and symmetry, and (5) volitional mimetic function. From a psychosocial perspective, evaluation was made regarding (1) workplace and home acceptance, (2) self consciousness, (3) adaption, and (4) overall satisfaction. Because of the nature of its technical performance and reliability, the VII-XII anastomosis is an important technique for the otolaryngologist to be familiar with. Cognizance of the functional and psychologic results with this procedure will ensure optimal (yet realistic) rehabilitation for this patient population.

Retrospective Review of 24 Cases of Head and Neck Cancer with Skull Base Invasion

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
Federico Ampil ◽  
Cherie Nathan ◽  
Gloria Caldito ◽  
Anil Nanda ◽  
Timothy Lian
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Skull Base ◽  
Neck Cancer ◽  
Retrospective Review

scholarly journals Developmentally anomalous cerebellar encephalocele arising within the cerebellopontine angle and extending into the adjacent skull base in a pediatric patient

2021 ◽  
Author(s):  
Forrest A. Hamrick ◽  
Michael Karsy ◽  
Carol S. Bruggers ◽  
Angelica R. Putnam ◽  
Gary L. Hedlund ◽  
...  
Keyword(s):  
Skull Base ◽  
Pediatric Patient ◽  
Cerebellopontine Angle ◽  
Resonance Imaging ◽  
Middle Cerebellar Peduncle ◽  
Cerebellar Tissue ◽  
Cerebellar Peduncle ◽  
Histopathologic Analysis ◽  
The Right ◽  
Internal Acoustic Canal

AbstractLesions of the cerebellopontine angle (CPA) in young children are rare, with the most common being arachnoid cysts and epidermoid inclusion cysts. The authors report a case of an encephalocele containing heterotopic cerebellar tissue arising from the right middle cerebellar peduncle and filling the right internal acoustic canal in a 2-year-old female patient. Her initial presentation included a focal left 6th nerve palsy. Magnetic resonance imaging was suggestive of a high-grade tumor of the right CPA. The lesion was removed via a retrosigmoid approach, and histopathologic analysis revealed heterotopic atrophic cerebellar tissue. This report is the first description of a heterotopic cerebellar encephalocele within the CPA and temporal skull base of a pediatric patient.

Imaging of the Postoperative Skull Base and Cerebellopontine Angle

2022 ◽  
Vol 32 (1) ◽  
pp. 159-174
Author(s):  
Jeffrey Xi Yang ◽  
Nafi Aygun ◽  
Rohini Narahari Nadgir
Keyword(s):  
Skull Base ◽  
Cerebellopontine Angle

Surgical Approaches to Cerebellopontine Angle: A 17-Year Experience of Our Skull Base Team

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P228-P228
Author(s):  
Isabel A. Correia ◽  
Vítor Sousa ◽  
Luis Marques-Pinto ◽  
Victor Gonçalves ◽  
Ezequiel Barros
Keyword(s):  
Skull Base ◽  
Cerebellopontine Angle ◽  
Surgical Approaches

The Extracorporeal Membrane Oxygenation Debate

PEDIATRICS ◽  
1990 ◽  
Vol 85 (3) ◽  
pp. 381-382
Author(s):  
WILLIAM D. RHINE ◽  
ALLEN F. FISCHER ◽  
DAVID K. STEVENSON
Keyword(s):  
Pulmonary Hypertension ◽  
Extracorporeal Membrane Oxygenation ◽  
Retrospective Review ◽  
Patient Population ◽  
Recent Article ◽  
Neonatal Care ◽  
Persistent Pulmonary Hypertension ◽  
Historical Comparison ◽  
Membrane Oxygenation ◽  
Statistical Inferences

To the Editor.— We are concerned about the statistical inferences, assumptions for comparisons, and arguments of logic implicit in the recent article on survival of infants with persistent pulmonary hypertension with ECMO (extracorporeal membrane oxygenation).1 The authors did acknowledge the difficulties of retrospective review, especially over 8 years when obstetrical and neonatal care should be improving. However, other details not reported on their patient population and classification might yield important information for this historical comparison.

Surgical management of cerebellopontine angle and petrous lesions

2019 ◽  
pp. 281-296
Author(s):  
Nicholas Hall ◽  
Yuval Sufaro ◽  
Andrew Kaye
Keyword(s):  
Skull Base ◽  
Cerebellopontine Angle ◽  
Surgical Techniques ◽  
Operating Microscope ◽  
Critical Function ◽  
Anatomical Structures ◽  
Nerve Monitoring ◽  
Mortality And Morbidity ◽  
Harvey Cushing ◽  
The Brain

At the turn of the twentieth century Harvey Cushing, the father of neurosurgery, described the cerebellopontine angle (CPA) region of the brain as ‘the gloomy corner of neurosurgery’, famously comparing this anatomical region with the bloody fence corner of the Gettysburg. With limited magnification and illumination, a modern skull base subspecialist neurosurgeon can understand the huge technical challenges that pioneers such as Cushing would have faced treating large tumours with major pre-existing morbidity in this location. At that stage Cushing advocated subtotal tumour debulking as the only rational strategy, however, shortly after that Dandy began to advocate safe total removal of cerebellopontine angle tumours. Since these early days introduction of more sophisticated anaesthesia, perioperative antibiotic prophylaxis, the operating microscope, and cranial nerve monitoring techniques have all resulted in significant advances in cerebellopontine angle surgery. The concentration of cases in subspecialty centres and the recognition of the importance of experience and meticulous technique has transformed skull base surgery into a subspecialty field with consequent reductions in mortality and morbidity. Although fragile and tenuous anatomical structures, supplying critical function, will always make treatment of pathology in this region a high-risk challenge, frequently, curative outcomes are now achieved with minimal morbidity for patients. This chapter aims to outline the anatomy and pathology of the cerebellopontine angle. The chapter describes the presentation of patients and investigations needed to make diagnoses for the different pathologies in this region, and the surgical techniques, approaches, and outcomes that we use to treat these lesions.

scholarly journals Endoscopic endonasal surgical management of chondrosarcomas with cerebellopontine angle extension

2014 ◽  
Vol 37 (4) ◽  
pp. E13 ◽  
Author(s):  
Paulo M. Mesquita Filho ◽  
Leo F. S. Ditzel Filho ◽  
Daniel M. Prevedello ◽  
Cristian A. N. Martinez ◽  
Mariano E. Fiore ◽  
...  
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Tumor Resection ◽  
Petrous Bone ◽  
Petrous Apex ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Female Ratio ◽  
Male Female Ratio

Object Skull base chondrosarcomas are slow-growing, locally invasive tumors that arise from the petroclival synchondrosis. These characteristics allow them to erode the clivus and petrous bone and slowly compress the contents of the posterior fossa progressively until the patient becomes symptomatic, typically from cranial neuropathies. Given the site of their genesis, surrounded by the petrous apex and the clival recess, these tumors can project to the middle fossa, cervical area, and posteriorly, toward the cerebellopontine angle (CPA). Expanded endoscopic endonasal approaches are versatile techniques that grant access to the petroclival synchondrosis, the core of these lesions. The ability to access multiple compartments, remove infiltrated bone, and achieve tumor resection without the need for neural retraction makes these techniques particularly appealing in the management of these complex lesions. Methods Analysis of the authors’ database yielded 19 cases of skull base chondrosarcomas; among these were 5 cases with predominant CPA involvement. The electronic medical records of the 5 patients were retrospectively reviewed for age, sex, presentation, pre- and postoperative imaging, surgical technique, pathology, and follow-up. These cases were used to illustrate the surgical nuances involved in the endonasal resection of CPA chondrosarcomas. Results The male/female ratio was 1:4, and the patients’ mean age was 55.2 ±11.2 years. All cases involved petrous bone and apex, with variable extensions to the posterior fossa and parapharyngeal space. The main clinical scenario was cranial nerve (CN) palsy, evidenced by diplopia (20%), ptosis (20%), CN VI palsy (20%), dysphagia (40%), impaired phonation (40%), hearing loss (20%), tinnitus (20%), and vertigo/dizziness (40%). Gross-total resection of the CPA component of the tumor was achieved in 4 cases (80%); near-total resection of the CPA component was performed in 1 case (20%). Two patients (40%) harbored high-grade chondrosarcomas. No patient experienced worsening neurological symptoms postoperatively. In 2 cases (40%), the symptoms were completely normalized after surgery. Conclusions Expanded endoscopic endonasal approaches appear to be safe and effective in the resection of select skull base chondrosarcomas; those with predominant CPA involvement seem particularly amenable to resection through this technique. Further studies with larger cohorts are necessary to test these preliminary impressions and to compare their effectiveness with the results obtained with open approaches.

Temporal bone and skull base

2018 ◽  
Author(s):  
Arangasamy Anbarasu ◽  
Jack I. Lane
Keyword(s):  
Skull Base ◽  
Temporal Bone ◽  
External Auditory Canal ◽  
Cerebellopontine Angle

In this section the temporal base is covered in detail. The skull, Cerebellopontine angle, External Auditory Canal, and areas of the ear are all discussed. Various issues and problems are detailed with imagining techniques for each area.

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