Skull base chordomas presenting with abducens nerve deficits: clinical characteristics and predictive factors for deficit improvement or resolution.

Objective: Skull base chordomas (SBCs) often present with cranial nerve (CN) VI deficits. Studies have not assessed the prognosis and predictive factors for CN VI recovery among patients presenting with CN VI deficits.

Methods: The medical records of patients who underwent resection for primary chordoma from 2001 to 2020 were reviewed.

The role of induction chemotherapy for orbital invasion in sinonasal malignancies: A systematic review.

Background: Sinonasal malignancies (SNMs) frequently present with orbital invasion. Orbital exenteration (OE) can lead to significant morbidity. Induction chemotherapy (IC) is a promising treatment alternative that may allow for orbit preserving (OP) treatments without compromising patient survival.

Ophthalmology and oculoplastics for the rhinologist.

Purpose Of Review: As the management of ophthalmic and sinus disease advances, it is important to stay abreast of all current management options. This involves knowledge of adjacent anatomy and disease processes, and collaboration between multiple specialties. The authors provide a review of relevant ophthalmic and oculoplastic topics for the rhinologist.

The Transcaruncular Corridor of the Medial Transorbital Approach to the Frontal Lobe: Technical Nuances and Applications.

Background And Importance: Medial orbital access through a transcaruncular corridor has yet to be fully characterized as a potential approach to intradural lesions within the skull base. Transorbital approaches present unique potential in the management of complex neurological pathologies and require subspecialty collaboration across multiple disciplines.

Clinical Presentation: A 62-year-old man presented with progressive confusion and mild left-sided weakness.

Recovery of vision after treatment of hemodialysis related bilateral optic nerve ischemia.

Purpose: We present the case of a patient who lost light perception in both eyes after hemodialysis and subsequently recovered vision after treatment with erythropoietin and intravenous steroids.

Observations: Our patient reported loss of light perception in both eyes (NLP) 2 hours after hemodialysis. Examination confirmed NLP vision, chronic retinal vascular changes, and no acute changes in optic nerve appearance.

Reduced Tearing With Stable Quality of Life After Vidian Neurectomy: A Prospective Controlled Trial.

Objectives/hypothesis: Although vidian neurectomy (VN) is associated with decreased lacrimation, its impact on dry eye quality-of-life is not well-defined. Endoscopic endonasal transpterygoid approaches (EETA) may require vidian nerve sacrifice.

Study Design: A prospective cohort trial.

Gamma knife radiosurgery for uveal melanomas and metastases: a systematic review and meta-analysis.

Background: Gamma knife radiosurgery is regarded as the gold-standard stereotactic radiosurgery modality for the treatment of intracranial tumours, and its use has been expanded for the treatment of intraocular malignancies. The aim of this study was to systematically evaluate the efficacy, outcomes, and complications of gamma knife radiosurgery for uveal melanomas and metastases.

Methods: We did a systematic review and meta-analysis to aggregate the clinical outcomes of patients with uveal melanomas or intraocular metastases treated primarily with gamma knife radiosurgery.

Combined Surgical Approaches In and Around the Orbit.

Orbital pathology requiring surgery can be planned based on the nature of the disease and the position of this relative to the globe and optic nerve complex. Multidisciplinary treatment is now common, and this sometimes includes multiple surgical corridors employed for approach. The orbit is also now frequently used as a corridor to intracranial pathology, and these same processes may be applied.

Can Ophthalmologic Examination Predict Abducens Nerve Recovery After Endoscopic Skull Base Surgery?

Objectives: While abducens nerve palsy (ANP) is a known risk in the setting of some endoscopic endonasal skull base surgery (ESBS), frequency and prognosis of post-operative palsy remain unknown. Our goals were to determine the frequency and prognosis of ANP after high-risk ESBS, and identify factors associated with recovery.

Methods: Retrospective case series of all patients with pathology at highest risk for abducens nerve injury (pituitary adenoma, chordoma, meningioma, chondrosarcoma, cholesterol granuloma) generated a list of patients with abducens nerve palsy after ESBS performed from 2011-2016.

Long term follow up after transorbital penetrating injury: A case report.

Purpose: Traumatic brain injury is the leading cause of mortality and disability among young individuals. Unfortunately, there are few publications concerning long term follow up of patients with these types of injuries. We present a case of trans-orbital penetrating brain injury with an 18 year follow up.

Craniofacial Cleft: A Case of Tessier 10 Cleft With a Novel Method to Repair Large Bilateral Colobomas.

Objective: To describe a reliable method utilizing large, rotation flaps to reconstruct a number 10 Tessier cleft.

Design: This is a descriptive clinical case report.

Setting: Pediatric teaching hospital affiliated with a university.

Development of the international orbital Cavernous Hemangioma Exclusively Endonasal Resection (CHEER) staging system.

Background: Orbital cavernous hemangiomas (OCH) are the most common adult orbital tumor and represent an ideal index lesion for endonasal orbital tumor surgery. In order to standardize outcomes reporting, an anatomic-based staging system was developed.

Methods: An international, multidisciplinary panel of 23 experts in orbital tumor surgery was formed.

Bilateral endoscopic optic nerve decompression in an infant with osteopetrosis.

Osteopetrosis is a rare disorder of bone remodeling characterized by defective resorption leading to excessive skeletal mass including optic canal. Compression of the optic nerve from the narrowed optic canal is the most common cause of vision loss in children with osteopetrosis. We report the case of a 6-month old girl with osteopetrosis who underwent bilateral optic canal decompression via endoscopic transcaruncular approach for progressive deterioration of visual function secondary to compressive optic neuropathy from narrowed optic canals.

Lateral Transorbital Versus Endonasal Transpterygoid Approach to the Lateral Recess of the Sphenoid Sinus-A Comparative Anatomic Study.

Background: The treatment of cerebrospinal fluid leaks of the lateral recess of the sphenoid sinus (LRSS) faces difficulties due to the deep location of the osseous defect. When treated with craniotomies, brain retraction is a concern. The endoscopic endonasal transpterygoid approach (EETA) is a direct and less invasive procedure; however, it may require transection of the vidian nerve (VN).

Minimally Invasive Approaches for Anterior Skull Base Meningiomas: Supraorbital Eyebrow, Endoscopic Endonasal, or a Combination of Both? Anatomic Study, Limitations, and Surgical Application.

Background: Minimally invasive accesses to the anterior skull base include the endoscopic endonasal approach (EEA) and the supraorbital eyebrow approach. These 2 are often seen as competing approaches, not alternative or combinatory approaches. In this study, we evaluated the anatomic limitations of each approach and the combined approach for accessing the anterior skull base.

Nonhealing orbital floor fracture in a pediatric patient: A unique presentation of pseudo-silent sinus syndrome.

Silent sinus syndrome was first described as spontaneous enophthalmos and hypoglobus associated with subclinical maxillary sinusitis without prior trauma or surgery. This clinical entity has later been described after trauma in which damage to the ostiomeatal complex leads to atelectasis of the maxillary sinus. We report a case of a 14-year-old boy who presented 4 years after sustaining a non-operative orbital floor fracture with enophthalmos and transient diplopia.

CLOSTRIDIUM PERFRINGENS PANOPHTHALMITIS AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION.

Purpose: This report describes a fulminant infection with Clostridium perfringens after an intravitreal anti-vascular endothelial growth factor injection.

Methods: This is a retrospective case review.

Results: Our patient's rapid infection eventually led to enucleation, despite broad-spectrum antibiotic therapy.

Endoscopic Endonasal Surgery for Tumors of the Cavernous Sinus: A Series of 234 Patients.

Background: Cavernous sinus (CS) tumors often are considered inoperable. We present our experience with endoscopic endonasal surgery (EES) and compare the outcomes for different tumor.

Methods: EES (medial or lateral approach) was used in 234 patients with CS tumors.

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia.

 To evaluate visual outcomes and potential complications for optic nerve decompression using an endoscopic endonasal approach (EEA) for fibrous dysplasia.  Retrospective chart review of patients with fibrous dysplasia causing extrinsic compression of the canalicular segment of the optic nerve that underwent an endoscopic endonasal optic nerve decompression at the University of Pittsburgh Medical Center from 2010 to 2013.  The primary outcome measure assessed was best-corrected visual acuity (BCVA) with secondary outcomes, including visual field testing, color vision, and complications associated with the intervention.

Lateral Orbitotomy Approach for Lesions Involving the Middle Fossa: A Retrospective Review of Thirteen Patients.

Background: Classically used for treatment of orbital lesions, the lateral orbitotomy with cantholysis can be combined with a temporal craniectomy for lesions involving the middle cranial fossa.

Objective: To present a single-center experience with the lateral orbitotomy approach for lesions involving the middle fossa.

Metuods: Twenty-five patients underwent lateral orbitotomies from April 2012 to July 2015.