Advanced reconstructive techniques following orbital exenteration: The role of LCFA free flaps.

Background: Orbital exenteration is a severe and disabling surgical procedure that involves the removal of all orbital contents. Effective reconstruction is crucial to managing the resulting defects. This study aims to propose a reconstructive algorithm utilizing free flaps derived from the lateral circumflex femoral artery (LCFA) system for orbital exenteration defects, based on our clinical experience.

Lateral optico-carotid recess as an anatomical landmark for optimal endoscopic optic nerve decompression.

Background: Transnasal endoscopic decompression of the optic nerve is increasingly gaining acceptance among ear, nose, and throat (ENT) surgeons, however neither strict indications for the procedure nor the precise extent of effective decompression have been firmly established to date. This study aimed to determine the distance between endoscopically visible, anatomical structures within the sphenoid sinus and the posterior (i.e.

Anterior Skull Base Reconstruction in Multiportal Approaches: Insight into Vascularized Flap Techniques.

: To evaluate the outcomes of anterior skull base (ASB) reconstruction using single versus double vascularized flap techniques following multiportal cranio-endoscopic approaches (CEA), based on a 12-year experience. : A retrospective analysis was conducted on 46 patients who underwent ASB reconstruction after a CEA at our department between 2010 and 2022. Patients were divided into two groups: Group 1 received a pericranial flap (PF) reinforced with a fascia graft, while Group 2 underwent multiple flap reconstruction with PF, fascia graft, and nasoseptal flap (NSF).

Temporoparietal Fascia Flap (TPFF) in Extended Endoscopic Transnasal Skull Base Surgery: Clinical Experience and Systematic Literature Review.

The temporoparietal fascia flap (TPFF) has recently emerged as an option for skull base reconstruction in endoscopic transnasal surgery when vascularized nasal flaps are not available. This study provides a systematic literature review of its use in skull base surgery and describes a novel cohort of patients. PRISMA guidelines were used for the review.

A novel multilayered membrane repair technique for high-flow cerebrospinal fluid leaks during expanded endoscopic endonasal tumor resection.

Background: Postoperative cerebrospinal fluid (CSF) leak is a life-threatening complication following endoscopic skull base surgery. This study describes a multilayered membrane reconstruction strategy for treating high-flow intraoperative CSF leaks during expanded endoscopic endonasal tumor resection (EEA) and presents the associated outcomes, supplemented by surgical video documentation.

Methods: A retrospective review was performed on patients who underwent multilayered membrane reconstruction for high-flow CSF leaks during EEA.

Parasellar region meningiomas with optic canal (OC) invasion: Correlation between the degree of decompression of the OC and the improvement of visual acuity.

Purpose: To evaluate the correlation between the degrees of circumferential decompression of the optic canal (OC) and the improvement of visual acuity in patients with parasellar meningiomas (PMs) with optic canal invasion.

Methods: This is a monocentric retrospective study conducted at author's institution. The visual acuity was evaluated preoperative and at 3-months after surgery with Snellen acuity test.

Massive pneumocephalus after Valsalva maneuver in sphenoidal meningocele.

Pneumocephalus, defined as the presence of gas within the intracranial space, typically results from head trauma, surgery, or diagnostic/therapeutic procedures that disrupt the dura. However, spontaneous or non-traumatic pneumocephalus is rare. This video article presents a case report of a 64-year-old woman referred to the Department of Otolaryngology with a severe frontal headache and clear nasal discharge (rhinorrhea) after performing the Valsalva maneuver to relieve ear fullness.

Ethmoid Sinus Mucocele Penetrating the Anterior Skull Base: A Case Report.

Sinus mucoceles are nonmalignant cystic tumors lined by non-neoplastic epithelium, typically involving the frontal and ethmoid sinuses. Although it is common for these mucoceles to cause destruction of surrounding bone tissue due to their growth, cerebrospinal fluid leaks resulting from skull base penetration by an ethmoid sinus mucocele have rarely been reported. A 24-year-old male patient presented with right proptosis and right periorbital pain, who underwent bilateral endoscopic sinus surgery 12 years ago.

Preoperative Quality of Life in Patients with Small Vestibular Schwannomas.

Background: Vestibular schwannomas (VS) are benign tumors arising from the eighth cranial nerve. They often cause no symptoms for a long period of time. Due to the improved availability and quality of magnetic resonance imaging diagnostics, even small tumors can be diagnosed at an early stage.

Risk factors for complications following titanium mesh cranioplasty.

Background: Studies on complications following titanium mesh cranioplasty have predominantly focused on patients with cranial defects after decompressive craniectomy. This study investigates possible risk factors for complications using titanium mesh for smaller cranial defects.

Methods: All patients treated with titanium mesh cranioplasty over a 5-year period at Copenhagen University Hospital were identified.

Burden of disease scenarios by state in the USA, 2022-50: a forecasting analysis for the Global Burden of Disease Study 2021.

Background: The capacity to anticipate future health issues is important for both policy makers and practitioners in the USA, as such insights can facilitate effective planning, investment, and implementation strategies. Forecasting trends in disease and injury burden is not only crucial for policy makers but also garners substantial interest from the general populace and leads to a better-informed public. Through the integration of new data sources, the refinement of methodologies, and the inclusion of additional causes, we have improved our previous forecasting efforts within the scope of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to produce forecasts at the state and national levels for the USA under various possible scenarios.

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).

Endoscopic nasal multilevel skull base reconstruction combined with lumbar cistern drainage in the treatment of infection caused by cerebrospinal fluid leakage: A case report.

Rationale: Traumatic cerebrospinal fluid leakage can cause complications such as meningitis, ventriculitis and brain abscess. It is necessary to formulate individualized treatment strategies, such as the use of antibiotics and skull base reconstruction methods. The application of nasal septum mucosal flap can significantly reduce the incidence of cerebrospinal fluid leakage.

Janus radial nanofiber patch with leak-proof, antimicrobial, and osteogenic integration for skull base reconstruction.

During transsphenoidal surgery to remove pituitary adenomas, the structures of the skull base consisting of the dura mater and skull base bones are destroyed, making it crucial to restore the natural structure of the skull base. We crafted a dual-layer Janus fiber membrane utilizing the layer-by-layer electrospinning technique, comprising an osteoblast layer and a leak-proof antimicrobial layer. Specifically, RPG-1%PCPP radially aligned nanofibrous membranes (osteoblasts) can promote directional cell migration and facilitate cellular osteogenic differentiation.

[Repair protocol of intraoperative CSF leak after endoscopic endonasal clival malignancy resection].

To evaluate the repair protocols for intraoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal clival malignancy resection (EECR) and to analyze the risk factors of surgical complication. The clinical data of patients who underwent EECR and had intraoperative CSF leaks in XuanWu Hospital, Capital Medical University between January 2012 and January 2024 were reviewed. The pathological results, imaging data, location of the dural defect, degree of intraoperative CSF leaks, repair materials, complications such as postoperative central nervous system (CNS) infections, types of antibiotics used, bacterial culture and drug sensitivity results, secondary repair, and follow-up results were collected.