Closure of Skull Base Defects after Endonasal Endoscopic Resection of Planum Sphenoidale and Tuberculum Sellae Meningiomas.

Background: The expanded endoscopic endonasal transplanum transtuberculum approach allows tumor removal by minimally invasive procedures. A large dural and bone defect is created during the surgical procedure, increasing the risk of postoperative cerebrospinal fluid (CSF) leakage.

Objective: The aim of this study is to describe a surgical technique and complications observed in patients undergoing endonasal resection of planum sphenoidale and/or tuberculum sellae meningiomas.

Quality-of-life evaluation for patients submitted to nasal endoscopic surgery for resection of pituitary tumours.

Purpose: This study aimed to evaluate the pre- and post-operative quality-of-life of patients submitted to the resection of pituitary adenoma via endoscopic transsphenoidal.

Methods: This was a prospective study on patients submitted to endoscopic transsphenoidal pituitary surgery with the harvest of a nasoseptal flap who responded to the questionnaires FV-36 and SNOT-22 in the pre-operative and in months 1, 3 and 6 following the surgical procedure.

Results: A total of 42 patients submitted to pituitary adenoma resection surgery via endoscopic transsphenoidal with a nasoseptal flap were recruited.

Design of a temporoparietal fascial flap after a spontaneous nasal fistula unresolved by conventional approaches.

We report the surgical management of a spontaneous and recurrent nasal fistula using a temporoparietal fascial flap for definitive treatment after several failed attempts to close the fistula by conventional approaches. Two formalin-fixed cadaveric human heads were also dissected to study the anatomy and surgical technique involved in the design of the temporoparietal fascial flap.

Relationship Between the Bilateral Removal of the Middle Nasal Turbinate and the Olfactory Function in Endoscopic Skull Base Surgery.

Objective: To determine the impact of endonasal endoscopic access to the skull base on the olfaction sense, involving the harvest of a nasoseptal flap, with the removal of the middle nasal turbinate.

Methods: A study was performed on a prospective cohort of 50 patients who underwent transnasal endoscopic surgery of the anterior skull base, with the harvest of a nasoseptal and reverse flap. The patients were divided into 2 groups: partial unilateral removal of the middle nasal turbinate and bilateral removal.

Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap.

Introduction: Endoscopic transnasal access to the skull base, both for treatment and reconstruction, can cause olfactory morbidity. Knowing the main consequences of this intervention is essential to have objective criteria for decision-making regarding the appropriate surgical technique.

Objectives: The aim of this study is to determine the impact on olfactory function of the endonasal endoscopic access to the skull base with the creation of the nasoseptal flap.

Development of an Experimental Model for Studying the Nasosinusal and Skull Base Arterial and Venous Systems Using Iodinated Contrast and Latex in Cadavers.

Background: Cadaver dissection remains one of the most reliable and safest ways to study anatomy, whereas computed tomography angiography (CTA) is an essential technology for enabling students to become familiar with human anatomy and surgical planning. Thus, the convergence of both radiologic and anatomic information is important for surgical success, especially in regions of complex anatomy such as the nasosinusal and skull base regions. Here we propose an experimental model in formalinized cadaver heads consisting of intravascular injection of colored latex and iodinated contrast mixture, followed by CTA scans of the nasosinusal and skull base arterial and venous systems before dissection.

Long Term Follow-up after Endoscopic Endonasal Approach for the Treatment of Cushing's Disease.

 Surgery has been the standard treatment for Cushing's disease. Currently, the endoscopic endonasal approach (EEA) is the most widely used technique. However, among some endocrinologists and neurosurgeons used to the microscope assisted technique, there are still questions about the effectiveness and safety of transitioning to the EEA.

Technique for Latex Injection and Reuse of Human Heads Preserved in Formaldehyde.

 Understanding the anatomy of the skull base is paramount for every skull base surgeon, particularly in light of the expanded endoscopic endonasal approaches, and of the refined surgical technique used in both medial and lateral approaches. A comprehensive knowledge of anatomy is the cornerstone for a safe surgery, maximizing resection and minimizing complications. The best study method is the careful dissection of fresh human cadaveric heads in a well-equipped anatomy laboratory.

Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note.

Introduction: One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base.

Objective: Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy.

Long term follow-up of growth hormone-secreting pituitary adenomas submitted to endoscopic endonasal surgery.

Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas.

Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.

Postoperative otorhinolaryngologic complications in transnasal endoscopic surgery to access the skull base.

Introduction: The large increase in the number of transnasal endoscopic skull base surgeries is a consequence of greater knowledge of the anatomic region, the development of specific materials and instruments, and especially the use of the nasoseptal flap as a barrier between the sinus tract (contaminated cavity) and the subarachnoid space (sterile area), reducing the high risk of contamination.

Objective: To assess the otorhinolaryngologic complications in patients undergoing endoscopic surgery of the skull base, in which a nasoseptal flap was used.

Methods: This was a retrospective study that included patients who underwent endoscopic skull base surgery with creation of a nasoseptal flap, assessing for the presence of the following post-surgical complications: cerebrospinal fluid leak, meningitis, mucocele formation, nasal synechia, septal perforation (prior to posterior septectomy), internal nasal valve failure, epistaxis, and olfactory alterations.

[Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing's syndrome].

Objective: To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found.

Subjects And Methods: Fourteen patients with suspected Cushing's syndrome underwent bilateral inferior petrosal sinuses (IPS) catheterization between 2009 and 2012. The technique for catheterization and for hormone analysis were described.

A rare association of tension pneumocephalus and a large frontoethmoidal osteoma: imaging features and surgical treatment.

Osteomas are the most common benign paranasal sinus tumors and are often found in the frontal and ethmoidal sinus. Intracranial complications such as pneumocephalus have occasionally been reported in association with osteomas. We describe a 33-year-old man with a large frontoethmoidal osteoma complicated by tension pneumocephalus and neurological disturbances, and we discuss the clinical and imaging resolutions after surgical management.

Endoscopic endonasal transsphenoidal approach for pituitary adenomas: technical aspects and report of casuistic.

Objective: Analyse technical aspects, effectiveness and morbidity of the endoscopic endonasal transphenoidal approach for pituitary adenomas.

Method: From January 2005 to September 2008, 30 consecutive patients underwent endoscopic endonasal resection of pituitary adenomas with a follow up from 3 to 36 months. Their medical charts were retrospectively analysed.