The Endoscopic L-shape Approach for Anterior Skull base Meningiomas with Olfactory Preservation: A Technical Note.

Background: The preservation of olfaction during the surgical resection of anterior skull base meningiomas presents a significant challenge. This study presents a modified endonasal endoscopic L-shaped approach designed to maximize tumor resection while preserving olfaction, a vital function that profoundly impacts the quality of life.

Methods: A cadaveric dissection was conducted to refine the surgical technique, and this approach was subsequently applied to a 34-year-old female patient presenting with a large planum sphenoidale meningioma.

Platysma Myocutaneous Flap for Skull Base Reconstruction: A Cadaveric Feasibility Study.

As skull base defects become increasingly complex, necessitating more extensive repairs, alternative strategies are needed to address challenging reconstructions and rescue cases of failed primary reconstruction. In this study, we aimed to validate the surgical technique and assess the feasibility of using the platysma myocutaneous flap for skull base reconstruction, using cadaveric specimens in a preclinical setting. This descriptive anatomical study was conducted on 2 fresh human cadavers (4 sides).

A 55-Year-Old Woman Presenting with a Second Diagnosis of Craniopharyngioma Following Diagnosis and Successful Treatment of Craniopharyngioma as a 5-Year-Old Child.

BACKGROUND Craniopharyngioma is a rare, partly cystic embryonic malformation of the sellar and parasellar region and is usually benign. This report is of a 55-year-old woman presenting with a second diagnosis of craniopharyngioma following diagnosis and successful treatment of craniopharyngioma as a 5-year-old child. CASE REPORT Our patient was diagnosed with craniopharyngioma at age 5 when she presented with headaches accompanied by nausea and vomiting, decreased visual acuity, polyurea, and polydipsia for 6 months.

Atypical meningiomas compared to other WHO Grade 2 meningiomas: Histological features and prognosis.

Objectives: To study each atypical feature in atypical meningioma versus other grade 2 meningiomas and its possible relation to recurrence.

Methods: This is a retrospective study of patients with WHO grade 2 meningioma operated in our institution between 01/2008 and 12/2020. The rate of recurrence, reoperation and readmission were recorded during the follow-up period.

A New Sarcoma Shortly after Treatment for High-Grade Glioma with Adjuvant Chemoradiation: A Case Report.

Introduction: High-grade gliomas are central nervous system tumors conventionally treated with surgery followed by adjuvant chemoradiotherapy. Secondary cancer due to radiation therapy is a rare yet established phenomenon that typically occurs years after radiation therapy.

Case Presentation: In this case, we discuss an early presentation of a second cancer adjacent to the radiation field.

Early Displacement of Reconstruction Material is a Predictor of Cerebrospinal Fluid Leak Post Endoscopic Skull Base Surgery.

Background: The reconstruction technique and materials used for endoscopic skull base surgery (ESBS) are important factors in preventing cerebrospinal fluid (CSF) leak, a notable complication following this surgery. Visualizing the status of reconstruction early in the postoperative course can help determine the risk of postoperative CSF leak. Here, we aimed to determine if the radiological status of reconstruction post endonasal endoscopic surgery can predict postoperative CSF leak.

A Prospective Comparison Between Soft Tissue Dissection Techniques in Pterional Craniotomy: Functional, Radiological, and Aesthetic Outcomes.

Background And Objectives: Given the complex anatomy of the operative region and individual surgeon preferences, some techniques for soft tissue dissection before pterional craniotomy have gained more popularity than others. This prospective study used subjective and objective measurements to compare the functional, radiological, and aesthetic outcomes of 3 such dissection techniques.

Methods: This multicenter prospective cohort study included all patients who underwent elective pterional craniotomy between 2018 and 2020 at 3 centers in Riyadh, Saudi Arabia.

Impact of Concurrent Chronic Rhinosinusitis on Complication Rates after Endonasal Endoscopic Skull Base Surgery: A Single-Center Experience.

 Preoperative planning of endoscopic skull base surgery (ESBS) is essential. The safety of performing surgery before managing sinus pathologies including concurrent chronic rhinosinusitis (CRS) in patients undergoing ESBS has been questioned. The current study aimed to evaluate and compare the complication rates between patients with and without CRS undergoing ESBS.

Suprasellar Meningioma Classification: Endoscopic Transnasal Perspective.

 Midline suprasellar meningiomas include planum sphenoidale, tuberculum sellae, and diaphragma sellae meningiomas. Multiple classifications have been previously documented; however, they come with controversies and limitations, including those with surgical implications. The aim of this study was to classify suprasellar meningiomas based on their behavior toward the underlying bone and neurovascular structures.

Outcomes and complications of microscopic transcallosal colloid cyst resection: A single institution experience.

Background: Colloid cysts have always provoked the interest of neurosurgeons due to their benign histology, wide variety of clinical presentations, and differences in reported surgical outcomes. Although recent studies have reported favorable outcomes with different surgical resection approaches, the transcallosal approach remains the most popular approach to date. In this series, we report the clinical and radiological outcomes of the transcallosal approach for the resection of third ventricle colloid cysts in 12 patients.

Classification of Endoscopic Transnasal Lateral Skull Base Approaches: Anatomical Study.

Objective: Endoscopic transnasal approaches (ETAs) to the ventrolateral skull base are commonly classified according to coronal planes or anatomical structures. Our goal is to simplify the description of the ETA to lateral skull base regions in a sequential dissection with correlation to computed tomography, helping in preoperative planning and efficient surgical exposure, and exposing the surgical anatomy limitations.

Methods: Five freshly injected cadaver heads were dissected using an extended ETA to the lateral skull base.

Early Postoperative Computed Tomography Scan Air Distribution Predicts Postoperative CSF Leak in Endoscopic Skull Base Surgery.

Background: Cerebrospinal fluid (CSF) leak remains the primary concern of endoscopic skull base surgery (ESBS). Pneumocephalus seen in postoperative images has been linked to CSF leak in some reports; however, few studies have looked at the extent to which it is indicative of CSF leak. In the current study, we aim to examine the size and location of post-ESBS pneumocephalus in the early postoperative period and determine their association with postoperative CSF leak.

The 100 Most Cited Articles in Endoscopic Endonasal Skull Base Surgery: A Bibliometric Analysis.

Background: The accelerated growth of endoscopic endonasal skull base surgery has led to an abundance of highly cited works that have helped shape the field into its current state. Highlighting these works can serve as a guide for trainees and facilitate evidence-based clinical decision making and operative techniques.

Methods: Elsevier's Scopus database was used to generate a list of the 100 most cited articles on endoscopic endonasal skull base surgery in September 2022.

Graft-Extended Nasoseptal Flap for Endoscopic Anterior Skull Base Reconstruction: A Novel Technique.

Reconstruction of the anterior part of the anterior skull base with a nasoseptal flap (NSF) is technically demanding. This challenge is mainly related to the real possible length of the flap. Herein, we describe a new technique for extending the NSF such that it can sufficiently cover the far anterior part of the anterior skull base.

Ultrasound Elastography in Neurosurgery: Current Applications and Future Perspectives.

Background: Similar to clinical palpation, Ultrasound elastography (USE) helps distinguish between tissues by providing information on their elasticity. While it has been widely explored and has been applied to many body organs, USE has not been studied as extensively for application in neurosurgery. The current systematic review was performed to identify articles related to the use of interoperative USE in neurosurgery.

Modified retrosigmoid extended approach to jugular tubercle meningioma: A video abstract.

Background: Primary jugular fossa meningiomas are one of the rarest subgroups of meningioma, with an estimated incidence of 0.7-4.3% of all skull base meningiomas.

Nasoseptal flap and rigid reconstruction in endoscopic endonasal skull base surgeries: The longitudinal experience of a single center.

Background: Recently, endoscopic endonasal approaches (EEA) have been used for skull base defect reconstruction surgeries. The nasoseptal flap (NSF), a vascular pedicled flap, was introduced to decrease postoperative cerebrospinal fluid (CSF) leakage.

Purposes: This study aimed to outline the authors' institutional experience using NSF and rigid implants in anterior skull base defect reconstruction surgeries following EEA.

Extent of Nasal Irrigation in Non-operated Sinuses: A Cadaveric Trial.

Background: Nasal irrigation is among the most widely used treatment modalities for sinonasal diseases. The extent of irrigation is well studied in operated sinuses but not for non-operated sinuses. Moreover, the preferred head positioning during irrigation is not known.

Persistence of communicating hydrocephalus post choroid plexus tumor resection: Case reports and review of literature.

Background: Hydrocephalus is the most common presentation of choroid plexus tumors; it is thought to be caused either by mass effect obstructing the cerebrospinal fluid pathways or secretory properties of the tumor. In these case reports, we present two cases of choroid plexus tumors with persistence of communicating hydrocephalus postoperatively and review similar reports in the literature.

Case Description: Case 1: a 2-month-old baby girl presented with bulging fontanelle, sunsetting eyes.

Endoscopic Transnasal Resection of Midline Skull Base Meningiomas: Tumor Consistency and Surgical Outcomes.

 The endoscopic transnasal approach (ETA) has proven to be of great value in the resection of midline skull base meningiomas when compared with traditional approaches. Our objective was to assess tumor consistency in relation to surgical outcomes for midline meningiomas (MMs) resected using ETA.  Radiological preoperative features, including the tumor to cerebellar peduncle T2-weighted magnetic resonance imaging (MRI) ratio (TCTI), were evaluated.

Effects of compressive lesions on intraoperative human spinal cord elasticity.

Objective: Although evaluating tissue elasticity has various clinical applications, spinal cord elasticity (SCE) in humans has never been well documented. In this study, the authors aimed to evaluate the impact of compression on human SCE in vivo.

Methods: The authors prospectively assessed SCE using intraoperative shear wave elastography (SWE).

Impact of COVID-19 on Saudi Neurosurgery Residency: Trainers' and Trainees' Perspectives.

Introduction: After the official announcement of the coronavirus disease-19 pandemic on March 11, 2020, the disease impacted most aspects of health care delivery, especially postgraduate education and training.

Method: A cross-sectional, online questionnaire-based assessment was performed. The study participants involved neurosurgery residents and program directors (PDs) across the country between May 16 and May 27, 2020.

Shear wave elastography for intracranial epidermoid tumors.

Background: Ultrasound elastography (USE) is a novel technique that assesses the mechanical properties of body tissues in real time. Based on elasticity measurements, USE enables the differentiation of tumor tissue from surrounding normal tissue.

Objectives: We aimed to evaluate an intraoperative SWE technique for differentiating tumor tissue (epidermoid cyst) from the surrounding normal brain tissue based on elastic properties.

Arteriovenous Malformation of the Upper Eyelid: A Case Report.

Arteriovenous malformations (AVMs) are rare lesions formed by direct connection of arteries and veins bypassing capillary beds. AVM locations can vary; however, extracranial AVMs remain the least common. The vast majority of these malformations are congenital and can be triggered by hormonal changes.