scholarly journals GIANT BENIGN SCHWANNOMA OF THE ANTERIOR BASE OF THE SKULL WITH SINONASAL AND PHARYNGEAL EXTENSION

2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 32-34
Author(s):  
Foma Winga
Keyword(s):  
Peripheral Nerve ◽  
Skull Base ◽  
Schwann Cells ◽  
Present Observation ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
The Past ◽  
Benign Schwannoma ◽  
Base Of The Skull ◽  
Exact Origin

Introduction: Schwannomas are tumors developed from Schwann cells present in the peripheral nerve sheaths. Their development both extra and intracranial is extremely rare. Observation: We report the case of a 36-year-old man who consulted for sinonasal syndrome evolving over the past ten years in which explorations found a large benign schwannoma of the anterior base of the skull with sinonasal and pharyngeal extension. The excision was performed externally by Moure and Sébileau with ENT and neurosurgery collaboration. The suites were simple. Discussion: The present observation again raises the question of the exact origin of developing sinonasal and endocranial schwannomas. The origin of the lesion and our management conditions were discussed. Conclusion: as for other authors, schwannoma should be considered in the diagnosis of skull base tumors. External surgery for extensive forms and ENT and neurosurgery collaboration help to minimize the risk of complications. Keywords: schwannoma; sinonasal schwannoma; skull base tumor.

Full tractography for detecting the position of cranial nerves in preoperative planning for skull base surgery: technical note

2020 ◽  
Vol 132 (5) ◽  
pp. 1642-1652 ◽  
Author(s):  
Timothee Jacquesson ◽  
Fang-Chang Yeh ◽  
Sandip Panesar ◽  
Jessica Barrios ◽  
Arnaud Attyé ◽  
...  
Keyword(s):  
Skull Base ◽  
Preoperative Planning ◽  
Skull Base Surgery ◽  
Cranial Nerves ◽  
Patient Specific ◽  
Small Scale ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Brain White Matter ◽  
Human Connectome Project

OBJECTIVEDiffusion imaging tractography has allowed the in vivo description of brain white matter. One of its applications is preoperative planning for brain tumor resection. Due to a limited spatial and angular resolution, it is difficult for fiber tracking to delineate fiber crossing areas and small-scale structures, in particular brainstem tracts and cranial nerves. New methods are being developed but these involve extensive multistep tractography pipelines including the patient-specific design of multiple regions of interest (ROIs). The authors propose a new practical full tractography method that could be implemented in routine presurgical planning for skull base surgery.METHODSA Philips MRI machine provided diffusion-weighted and anatomical sequences for 2 healthy volunteers and 2 skull base tumor patients. Tractography of the full brainstem, the cerebellum, and cranial nerves was performed using the software DSI Studio, generalized-q-sampling reconstruction, orientation distribution function (ODF) of fibers, and a quantitative anisotropy–based generalized deterministic algorithm. No ROI or extensive manual filtering of spurious fibers was used. Tractography rendering was displayed in a tridimensional space with directional color code. This approach was also tested on diffusion data from the Human Connectome Project (HCP) database.RESULTSThe brainstem, the cerebellum, and the cisternal segments of most cranial nerves were depicted in all participants. In cases of skull base tumors, the tridimensional rendering permitted the visualization of the whole anatomical environment and cranial nerve displacement, thus helping the surgical strategy.CONCLUSIONSAs opposed to classical ROI-based methods, this novel full tractography approach could enable routine enhanced surgical planning or brain imaging for skull base tumors.

scholarly journals 3D Printing-Assisted Skull Base Tumor Surgeries: An Institutional Experience

2021 ◽  
Author(s):  
Sanjeev Chopra ◽  
Ashim Kumar Boro ◽  
Virendra Deo Sinha
Keyword(s):  
3D Printing ◽  
Skull Base ◽  
Surgical Approaches ◽  
Skull Base Tumor ◽  
Confined Space ◽  
Skull Base Tumors ◽  
Patient Counselling ◽  
Training Tool ◽  
3D Printed ◽  
Neurovascular Structures

AbstractThree-dimensional (3D) printing technology in neurosurgery has gained popularity nowadays. Skull base contains many major neurovascular structures in a confined space, along with anatomical variations making surgical approaches to this region challenging. 3D-printed model of skull base tumors consists of the patient's bony skull base, actual tumor dimensions, and surrounding major neurovascular structures. We included a total number of five patients with skull base tumors (one case of planum sphenoidale meningioma, two cases of sellar tumor with suprasellar extension, and two cases of cerebellopontine angle tumor) and 3D-printed tumor model of each of them. These models were used for preoperative simulation and served as very true to life training tool. These help in increasing the efficacy of the surgeon, improves surgical safety and ergonomics. They were also used for patient counselling, educating about the disease, the surgical procedure, and associated risks.

scholarly journals Bone Conduction Implants for Hearing Rehabilitation in Skull Base Tumor Patients

2019 ◽  
Vol 80 (02) ◽  
pp. 139-148
Author(s):  
Lauren Placke ◽  
Eric Appelbaum ◽  
Akash Patel ◽  
Alex Sweeney
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Bone Conduction ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Tumor Patients ◽  
Hearing Rehabilitation ◽  
Bone Conduction Hearing ◽  
Direct Vibration ◽  
Over Time

AbstractBone conduction implants transfer sound to the inner ear through direct vibration of the skull. In patients with skull base tumors and infections, these devices can bypass a dysfunctional ear canal and/or middle ear. Though not all skull base surgery patients opt for bone conduction hearing rehabilitation, a variety of these devices have been developed and marketed over time. This article reviews the evolution and existing state of bone conduction technology.

Slower growth of skull base meningiomas compared with non–skull base meningiomas based on volumetric and biological studies

2012 ◽  
Vol 116 (3) ◽  
pp. 574-580 ◽  
Author(s):  
Naoya Hashimoto ◽  
Carter S. Rabo ◽  
Yoshiko Okita ◽  
Manabu Kinoshita ◽  
Naoki Kagawa ◽  
...  
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Biological Behavior ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Biological Studies ◽  
History Of ◽  
Skull Base Meningiomas ◽  
Mib 1

Object The precise natural history of incidentally discovered meningiomas (IDMs) remains unknown. It has been reported that for symptomatic meningiomas, tumor location can be used to predict growth. As to whether the same is true for IDMs has not been reported. This study aims to answer this question and provide biological evidence for this assumption by extending the study to involve symptomatic cases. Methods A total of 113 IDMs were analyzed by fine volumetry. A comparison of growth rates and patterns between skull base and non–skull base IDMs was made. Subsequently, materials obtained from 210 patients with symptomatic meningiomas who were treated in the authors' hospital during the same period were included for a biological comparison between skull base and non–skull base tumors using the MIB-1 index. Results The 110 patients with IDMs included 93 females and 17 males, with a mean follow-up period of 46.9 months. There were 38 skull base (34%) and 75 non–skull base (66%) meningiomas. Forty-two (37%) did not exhibit growth of more than 15% of the volume, whereas 71 (63%) showed growth. Only 15 (39.5%) of 38 skull base meningiomas showed growth, whereas 56 (74.7%) of 75 non–skull base meningiomas showed growth (p = 0.0004). In the 71 IDMs (15 skull base and 56 non–skull base), there was no statistical difference between the 2 groups in terms of mean age, sex, follow-up period, or initial tumor volume. However, the percentage of growth (p = 0.002) was significantly lower and the doubling time (p = 0.008) was significantly higher in the skull base than in the non–skull base tumor group. In subsequently analyzed materials from 94 skull base and 116 non–skull base symptomatic meningiomas, the mean MIB-1 index for skull base tumors was markedly low (2.09%), compared with that for non–skull base tumors (2.74%; p = 0.013). Conclusions Skull base IDMs tend not to grow, which is different from non–skull base tumors. Even when IDMs grow, the rate of growth is significantly lower than that of non–skull base tumors. The same conclusion with regard to biological behavior was confirmed in symptomatic cases based on MIB-1 index analyses. The authors' findings may impact the understanding of the natural history of IDMs, as well as strategies for management and treatment of IDMs and symptomatic meningiomas.

scholarly journals Endoscopic-assisted Craniofacial Resection

2011 ◽  
Vol 3 (3) ◽  
pp. 156-160
Author(s):  
Aliasgar Moiyadi ◽  
Deepa Nair ◽  
Prathamesh S Pai
Keyword(s):  
Skull Base ◽  
Tumor Resection ◽  
Additional Treatment ◽  
Anterior Skull Base ◽  
Skull Base Tumors ◽  
Craniofacial Resection ◽  
Endoscopic Endonasal ◽  
The Past ◽  
Select Group ◽  
Sinonasal Tumor

ABSTRACT Management of anterior skull base tumors has progressed steadily since AS Ketcham popularized the craniofacial surgical technique in the seventies with good results. In the past two decades, endoscopic sinonasal tumor resection has been established as an additional treatment option. For tumors that cross the anterior skull base, a cranial access is vital to encompass the tumor all around. For a select group of these transcranial lesions, the sinonasal component is suitable for an endoscopic endonasal oncologically safe resection along with a traditional transcranial access to complete the resection. This article endeavors to describe the endoscopicassisted craniofacial combining the advantages of a transnasal minimal access to reduce facial morbidity and the transcranial access for superior control of tumors with adequate margins.

scholarly journals Trends in Neurosurgical Fellowship Training in North America Over Two Decades 1997 to 2016

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Ankush Chandra ◽  
Michael G Brandel ◽  
John K Yue ◽  
Lauro Avalos ◽  
Michael William McDermott ◽  
...  
Keyword(s):  
North America ◽  
Peripheral Nerve ◽  
Skull Base ◽  
North American ◽  
Fellowship Training ◽  
Neurosurgical Training ◽  
Factors Associated ◽  
The Past ◽  
Top 40 ◽  
Nih Funding

Abstract INTRODUCTION Neurosurgical training programs serve to create a combination of generalists and subspecialists. To better understand trends in training neurosurgical subspecialists, we investigated trends in neurosurgical fellowship enrollment in North America. METHODS Retrospective review of North American neurosurgery residents enrolled in training 1997 to 2016, using AANS membership data. RESULTS We followed 3619 North American neurosurgical residency graduates over 20 yr, of which 40.7% (n = 1472) completed a fellowship and 4.8% (n = 175) completed 2 or more different fellowships. Of completed fellowships, 27.2% (n = 456) were in spine, 14.6% (n = 245) were endovascular, 14.0% (n = 235) were pediatric, 9.6% (n = 161) were functional, 8.7% (n = 146) were skull base, 8.7% (n = 146) were open cerebrovascular, 7.2% (n = 122) were neuro-oncology, 6.2% (n = 104) other, 1.6% (n = 26) neurotrauma, 1.4% (n = 24) peripheral nerve, and 0.7% (n = 11) combined endovascular/open cerebrovascular fellowships. The overall proportion of residents pursuing fellowships increased from 1997–2006 to 2007–2016 (29.1 vs 49.6%, P < .001). The proportion of spine, cerebrovascular, and trauma fellowships decreased by 0.5% (P = .037), 0.3% (P = .029), and 0.3% (P < .001) per year, respectively, while the proportion of skull base, peripheral nerve, and combined endovascular/cerebrovascular fellowships increased by 0.5% (P = .002), 0.2% (P = .016), and 0.2% (P = .001) per year, respectively. Residents from top 40 NIH-funded institutions were more likely to complete fellowships (OR = 1.5, P = .004), whereas residents in low-population cities were less likely to complete fellowships during 2007 to 2016 (OR = 0.7, P = .030). CONCLUSION Over the past two decades, the proportion of neurosurgical residents pursuing fellowships has significantly increased, to nearly half of all neurosurgical residents in 2016. Skull base, peripheral nerve and combined endovascular/cerebrovascular fellowship enrollments have increased, while spine, cerebrovascular, and trauma fellowship enrollments have decreased. Academic interest, as assessed by departmental NIH funding, increased the likelihood of fellowship enrollment. Factors associated with academic centers in densely populated cities continue to be positive predictors for pursuit of advanced neurosurgical training.

Skull base approaches and gamma knife radiosurgery for multimodality treatment of skull base tumors

2002 ◽  
Vol 97 ◽  
pp. 674-676 ◽  
Author(s):  
Paul C. Francel ◽  
Sumon Bhattacharjee ◽  
Paul Tompkins
Keyword(s):  
Radiation Dose ◽  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Multimodality Treatment ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Content Type ◽  
Fine Print

Object. The purpose of this study was to evaluate descriptive data obtained in patients who had received multimodality treatment with resection and gamma knife radiosurgery (GKS) for skull base tumors. Retrospective data were collected from 71 patients with skull base tumors who were treated from November 1996 to December 2000, all of whom underwent follow-up evaluation at 1 year or more. Methods. Data were collected from hospital charts and office records, including patient age, tumor type and location, number of tumors, maximum radiation dose, estimated radiation dose to the periphery, tumor volume, and percentage of patients with tumors smaller or the same size at follow-up evaluation. Conclusions. Of the 71 patients with 1 year or more of follow up, 93% had tumor either the same size or smaller and 34% of these patients had a smaller tumor size. It is concluded that: 1) GKS with multimodality treatment is effective for control of skull base tumors; 2) the radiosurgical team should consider the benefits of GKS for treatment of any skull base tumor to afford optimum patient management; and 3) neurosurgeons involved with the management of skull base tumors should either be trained and proficient in GKS or work closely with a colleague trained in the technique. This will ensure proper consideration of both options, resulting in overall improved patient treatment.

scholarly journals Complications in Skull Base Surgery and Subsequent Repair

2020 ◽  
Vol 34 (04) ◽  
pp. 286-292
Author(s):  
Weitao Wang ◽  
Tom Shokri ◽  
Spiros Manolidis ◽  
Yadranko Ducic
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Skull Base Tumors ◽  
Viable Option ◽  
The Past ◽  
Tissue Transfer

AbstractOver the past several decades, endoscopic sinus surgery has revolutionized the approach to skull base surgery. Open skull base approaches remain a viable option for advanced skull base tumors. Complications have gone down with increased reliability of vascularized tissue transfer. In this article, the authors explore the various complications that can present following skull base surgery and review the approaches for repair when such issues are encountered.

scholarly journals Treatment of Radiation-Induced Brain Necrosis

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Xiaojing Yang ◽  
Hanru Ren ◽  
Jie Fu
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Effective Treatment ◽  
Skull Base ◽  
Skull Base Tumors ◽  
Treatment Methods ◽  
The Past ◽  
Brain Necrosis ◽  
Radiation Induced ◽  
New Treatment

Radiation-induced brain necrosis (RBN) is a serious complication of intracranial as well as skull base tumors after radiotherapy. In the past, due to the lack of effective treatment, radiation brain necrosis was considered to be progressive and irreversible. With better understanding in histopathology and neuroimaging, the occurrence and development of RBN have been gradually clarified, and new treatment methods are constantly emerging. In recent years, some scholars have tried to treat RBN with bevacizumab, nerve growth factor, and gangliosides and have achieved similar results. Some cases of brain necrosis can be repairable and reversible. We aimed to summarize the incidence, pathogenesis, and treatment of RBN.

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