Management of Recurrent Cerebrospinal Fluid Rhinorrhea Caused by Sequential, Anatomically Separated Skull Base Defects-A Case-Based Systematic Review.

Objective: Recurrent cerebrospinal fluid (CSF) rhinorrhea caused by sequential, anatomically separated skull base defects is rarely reported in the literature. Neither management nor etiology has been sufficiently investigated. We present an illustrative case and a systematic review of the literature regarding etiology, diagnostics, and management of this rare phenomenon.

Pediatric sellar teratoma - Case report and review of the literature.

Background: Intracranial teratoma represents a rare neoplasm, occurring predominantly during childhood. Characteristic symptoms depend on the location but are mainly hydrocephalus, visual disturbances, hypopituitarism, and diabetes insipidus. Initial diagnosis can be challenging due to similar radiological features in both teratomas and other lesions such as craniopharyngiomas.

Primary Burkitt lymphoma of the thyroid associated with Hashimoto's thyroiditis.

Primary Burkitt lymphoma of the thyroid is an extremely rare entity with only a few reported cases. A female patient in her 70s with Hashimoto's thyroiditis presented with a 2-month history of progressive left-sided neck swelling. Ultrasound examination revealed a multinodular goitre and fine needle aspiration (FNA) showed no signs of malignancy.

The Role of Endonasal Endoscopic Skull Base Repair in Posttraumatic Tension Pneumocephalus.

Objectives: Information about the endonasal endoscopic approach (EEA) for the management of posttraumatic tension pneumocephalus (PTTP) remains scarce. Concomitant rhinoliquorrhea and posttraumatic hydrocephalus (PTH) can complicate the clinical course.

Methods: The authors systematically reviewed pertinent articles published between 1961 and December 2020 and identified 6 patients with PTTP treated by EEA in 5 reports.

Case Report: Petrous Apicitis and Otogenic Thrombosis of the Cavernous Sinus in a 10-Year-Old Boy.

Petrous apicitis and cavernous sinus thrombosis are exceedingly rare complications of acute otitis media with only few reported cases in the post-antibiotic era. Especially in children, the appropriate management is a subject of controversy. We report the case of a 10-year-old boy who presented to the emergency department with left-sided otalgia, otorrhea, and hearing loss, accompanied by somnolence and high spiking fevers.

Late prosthetic knee joint infection with .

Prosthethic Joint Infection (PJI) is a severe complication following joint replacement. Late PJI can occur years after implantation by hematogenous seeding of a microbial agent. is a coagulase-negative commensal of the human skin and rarely associated with opportunistic human infections.

Sodium-hydrogen exchanger 6 (NHE6) deficiency leads to hearing loss, via reduced endosomal signalling through the BDNF/Trk pathway.

Acid-base homeostasis is critical for normal growth, development, and hearing function. The sodium-hydrogen exchanger 6 (NHE6), a protein mainly expressed in early and recycling endosomes, plays an important role in regulating organellar pH. Mutations in NHE6 cause complex, slowly progressive neurodegeneration.

Paediatric oropharyngeal tularaemia requiring surgical intervention.

Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given.

Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors via Endoscopic Endonasal Approach: A Technical Case Report and Systematic Review of the Literature.

Background: Data on the endonasal endoscopic approach (EEA) to treat sellar/parasellar synchronous tumors remain sparse. This work aims to describe a minimally invasive approach with intraoperative magnetic resonance imaging (MRI) to remove a large sellar/parasellar synchronous tumor, and presents a systematic literature review.

Methods: The preoperative MRI of a 54-year-old woman revealed a sellar lesion (28 × 19 × 16 mm), presumably a pituitary macroadenoma, and a second extra-axial lesion (22 × 36 × 20 mm) expanding from the tuberculum sellae to the planum sphenoidale with encasement of the anterior communicating complex, presumably a meningioma.

Training visual attention in a naturalistic visual environment.

The efficiency of training visual attention in the central and peripheral visual field was investigated by means of a visual detection task that was performed in a naturalistic visual environment including numerous, time-varying visual distractors. We investigated the minimum number of repetitions of the training required to obtain the top performance and whether intra-day training improved performance as efficiently as inter-day training. Additionally, our research aimed to find out whether exposure to a demanding task such as a microsurgical intervention may cancel out the effects of training.

Inner ear exosomes and their potential use as biomarkers.

Exosomes are nanovesicles involved in intercellular communications. They are released by a variety of cell types; however, their presence in the inner ear has not been described in the literature. The aims of this study were to determine if exosomes are present in the inner ear and, if present, characterize the changes in their protein content in response to ototoxic stress.

Induction of mitophagy in the HEI-OC1 auditory cell line and activation of the Atg12/LC3 pathway in the organ of Corti.

Autophagy is a highly evolutionary conserved quality control defense mechanism within cells, which has also been implicated in cell death processes. In the mammalian inner ear, autophagy has been shown to play a role during early morphogenesis as well as in adult cochlear hair cells exposed to ototoxic insults. Mitophagy, a selective autophagic cell process targeting mitochondria, hasn't been studied in the inner ear so far.

Effects of peroxisome proliferator activated receptors (PPAR)-γ and -α agonists on cochlear protection from oxidative stress.

Various insults cause ototoxicity in mammals by increasing oxidative stress leading to apoptosis of auditory hair cells (HCs). The thiazolidinediones (TZDs; e.g.

Renal cell carcinoma metastases to the maxillary sinus.

Metastasis of renal cell carcinoma (RCC) to the head and neck region is rare. We report the case of a 65-year-old man with history of RCC, presented 7 years after nephrectomy, adrenalectomy and lung metastasectomy for his primary tumour, with symptoms of nasal obstruction, postnasal drip, productive cough and pressure sensation in the left maxillary sinus. CT revealed a unilateral, irregular opacification in the left maxillary sinus with bony erosion of the infraorbital canal wall.

Lung adenocarcinoma metastastic lesion in the internal auditory meatus.

Metastasis to the cerebellopontine angle (CPA) or internal auditory meatus (IAM) is rare.We report a rare case of a 69-year-old woman with metastatic lung adenocarcinoma, who presented with 2 weeks history of left-sided hearing loss and progressively worsening vertigo. Examination revealed a left-sided facial nerve palsy while pure tone audiometry (PTA) showed a new left-sided deafness.

[Conservative and surgical rehabilitation of hearing loss].

According to WHO 360 million people are hard of hearing. Hearing disorders are not only seen in elderly but also in children. Clinically we differentiate between hearing disorders concerning the transmission of sound from the outer ear to the cochlea (conductive hearing loss) and disorders with reduced sound perception concerning the inner ear an related structures (sensorineural hearing loss).

Simvastatin Results in a Dose-Dependent Toxic Effect on Spiral Ganglion Neurons in an In Vitro Organotypic Culture Assay.

Statins are inhibitors of the 3-hydroxy-3-methylglutaryl-coenzyme A reductase, an enzyme necessary for the production of mevalonate. They are widely used as cholesterol-lowering drugs. However, conflicting data about the effect of statins on neuronal cells has been published.

A Cost-Effective Delivery System for FloSeal During Endoscopic and Microscopic Brain Surgery.

Objective: To share our experience with a new delivery system for the flowable hemostatic matrix, FloSeal, in endoscopic and microscopic skull base surgery.

Methods: We prospectively analyzed the use of FloSeal with a hemostatic delivery system in transnasal endoscopic and microscopic skull base procedures performed at the authors' institution from January 1, 2015, to June 30, 2015. In all cases the number of aliquots was noted for the entire operation, and the total number of FloSeal ampules of 5 mL was also recorded.

Evaluation and treatment of isolated sphenoid sinus diseases.

Purpose Of Review: To review cause, clinical evaluation, medical and surgical management of isolated sphenoid sinus diseases.

Recent Findings: Early diagnosis of isolated sphenoid sinus diseases requires a high index of clinical suspicion and appropriate radiological imaging. Sphenoid sinus can be approached endoscopically via a few different surgical techniques.

Endoscopic transnasal approach to anterior and middle cranial base lesions.

We present our experience in managing pathologies involving the anterior and middle cranial base using an endoscopic transnasal approach, highlighting the surgical technique, indications, and complications. The different types of endoscopic approaches used include the transtuberculum/transplanum, transcribiform, transsellar, and cavernous sinus approaches. The common indications include repair of cerebrospinal fluid leaks (both spontaneous and post traumatic) and excision of pituitary adenomas, meningiomas, craniopharyngiomas, esthesioneuroblastomas, and other malignancies of the anterior cranial base.

Metformin Protects Auditory Hair Cells from Gentamicin-Induced Toxicity in vitro.

Metformin is a commonly used antidiabetic drug. It has been shown that this drug activates the AMP-activated protein kinase, which inhibits downstream the mammalian target of rapamycin. In addition, several studies indicate that metformin reduces intracellular reactive oxygen species.

Integrated Anterior, Central, and Posterior Skull Base Unit - A New Perspective.

The skull base is one of the most complex anatomical regions and forms the floor of the cranial cavity. Skull base surgery involves open, microscopic, and endoscopic approaches to the anterior, middle, or posterior cranial fossa. A multispecialty team approach is essential in treating patients with skull base lesions.