With the development of endoscopic technology and surgery, resection of midline skull base tumors has been achieved using endoscopic endonasal skull base (EESB) approaches. EESB approaches reportedly have a greater risk of postoperative cerebrospinal fluid (CSF) leakage. Recently, the introduction of the nasoseptal flap (NSF) decreased dramatically the incidence of CSF leakage, but the use of an NSF increases the risk of disturbing the function of the nose. Here, we report our new technique called "fascia patchwork closure" for closure after EESB surgery and its outcome. All 48 cases involved midline skull base tumors resected via EESB approaches. Of them, 32 cases were closed by the fascia patchwork technique after tumor resection, and there was no incidence of CSF leakage. Moreover, 6 of the 32 cases were closed without the use of an NSF, indicating that the fascia patchwork closure approach is effective as part of a multilayer closure for the prevention of CSF leakage. The establishment and popularization of this technique might result in the further development of EESB surgery and also an improvement of postoperative nasal function.
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http://dx.doi.org/10.1007/s10143-015-0614-6 | DOI Listing |
Neurosurg Rev
January 2025
Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA, USA.
The purpose of the current study was to determine the angulation of the dural venous sinuses in soft tissue, to evaluate differences between types of tissue, and to discuss the potential influence of these angulations on intracranial venous hemodynamics and related pathologies. Angulations formed in different segments of the transverse, sigmoid, and superior sagittal sinuses were measured in 13 adult human cadaveric heads (26 sides). After the soft tissues were removed, measurements were also taken from the underlying bone.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Service de Neurochirurgie, GHU-Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, F-75014, France.
Injury of the internal carotid artery (ICA), anterior cerebral artery (ACA), and middle cerebral artery (MCA) are rare but devastating complications during microsurgery of the anterior and middle cranial skull base. We systematically reviewed the current knowledge on ICA, ACA, and MCA injury during skull base microsurgery and performed a multicentric data collection to refine their management. A systematic review of ICA, ACA, and MCA injuries during direct microsurgical approaches to the anterior and middle cranial skull base was performed, using PRISMA-IPD guidelines and using a multicentric case collection.
View Article and Find Full Text PDFJ Neural Eng
January 2025
Department of Electrical and Computer Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, Pennsylvania, 15213-3815, UNITED STATES.
Objective: Transcranial electrical stimulation (TES) is an effective technique to modulate brain activity and treat diseases. However, TES is primarily used to stimulate superficial brain regions and is unable to reach deeper targets. The spread of injected currents in the head is affected by volume conduction and the additional spreading of currents as they move through head layers with different conductivities, as is discussed in [1].
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.
Background: The co-occurrence of Rathke cleft cysts (RCCs) and meningiomas in the sellar and parasellar regions represents an exceedingly rare clinical entity. Achieving maximal resection through a single operative approach while minimizing adverse events is challenging, often necessitating multiple surgical approaches, as suggested by previous reports.
Observations: The authors report the case of a 49-year-old female with a history of kidney transplant who presented with headaches and was diagnosed with coexisting RCC and meningioma in the sellar and planum sphenoidale regions, respectively.
Rhinology
January 2025
Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France.
Background: This study examines the management and outcomes of large paranasal sinus osteomas (PSO), especially those abutting or encasing critical structures of the skull base and orbit.
Methodology: A multicentric retrospective analysis was conducted between June 2007 and September 2023. The study included surgically treated (regardless the type of approach chosen) PSO, exceeding 3 cm in diameter and/or located in critical anatomical areas.
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