Skull base approach to glomus jugulare

Introduction: Skull base chordomas present with headache, commonly VI cranial nerve palsy or sometimes with lower cranial nerve involvement.Sometimes in neglected case it presents with complete blindness and facial nerve palsy. Case presentation: A 60-year old man presented with headache,visual disturbance progressing to blindness and facial nerve palsy. At first, radiological imaging showed large tumor which eroded his clivus, sella floor and involved both cavernous carotid more on left side,both ethmoid sinus,middle cranial fossa entension with transdural extension posteriorly. Conclusion: Patients who present with complete blindness and facial nerve palsy, endoscopic excision in a single skull base approach of a skull base chordoma type III is challenging and who developed visual improvement following surgery, has been highlighted in this report. Bang. J Neurosurgery 2019; 9(1): 57-63

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Low-Profile 1-Piece Bifrontal Craniotomy for Anterior Skull Base Approach and Reconstruction

Journal of Craniofacial Surgery ◽

10.1097/scs.0b013e3181c5a217 ◽

2010 ◽

Vol 21 (1) ◽

pp. 233-238 ◽

Cited By ~ 5

Author(s):

Fatma Ozlen ◽

Bashar Abuzayed ◽

Reza Dashti ◽

Cihan Isler ◽

Necmettin Tanriover ◽

...

Keyword(s):

Skull Base ◽

Anterior Skull Base ◽

Base Approach ◽

Low Profile ◽

Skull Base Approach

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Modified one-piece extended transbasal approach for translamina terminalis resection of retrochiasmatic third ventricular craniopharyngioma

Neurosurgical FOCUS ◽

10.3171/2013.v1.focus12354 ◽

2013 ◽

Vol 34 (v1supplement) ◽

pp. 1 ◽

Cited By ~ 4

Author(s):

James K. Liu

Keyword(s):

Skull Base ◽

Third Ventricle ◽

Blind Spot ◽

Anterior Wall ◽

Anterolateral Approach ◽

Lamina Terminalis ◽

Base Approach ◽

The Third ◽

Skull Base Approach ◽

Midline Approach

Retrochiasmatic third ventricular craniopharyngiomas are formidable tumors to remove surgically. Access to the third ventricle can be achieved through the lamina terminalis corridor. A skull base approach to the lamina terminalis can be performed using either an anterolateral approach (orbitozygomatic, pterional, supraorbital) or a midline approach (extended transbasal, subfrontal). The major disadvantage of an anterolateral approach is the lack of visualization of the ipsilateral wall of the third ventricle and hypothalamus. However, a midline transbasal approach eliminates this blind spot thereby providing direct visualization of both ependymal walls for safe dissection of the tumor. In this operative video manuscript, the author demonstrates an illustrative step-by-step technique for translamina terminalis resection of a retrochiasmatic retroinfundibular craniopharyngioma within the third ventricle via a modified one-piece extended transbasal approach. This approach uses the standard bifrontal craniotomy and incorporates the anterior wall of the frontal sinus as a one-piece flap. The inferior limit of the osteotomy is based along the coronal contour of the anterior skull base which eliminates any bony overhang that can obstruct the line of sight to the lamina terminalis. Additional removal of the supraorbital bar is not necessary. The operative technique for this skull base approach and surgical nuances for craniopharyngioma resection are illustrated in this video atlas.The video can be found here: http://youtu.be/E3Bsp6dUdAE.

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