About Skull Base Tumors The brain originates the most crucial functions of the body - everything from muscle movement to eating, breathing, feeling pain and emotion. Skull base tumors can affect nearly every one of these functions in the brain. These tumors are rare, and cancerous skull base tumors are even less common.

Palliative RT has been the standard treatment for skull base malignancies providing excellent relief of pain and improvement of cranial nerve dysfunction in up to 78% of patients [4-9]. More recently, SRS has been employed as a less invasive option for the treatment of skull base metastases with the aim to deliver a high dose to the target with dose sparing of critical structures such as the optic nerves and chiasm. The efficacy of single-fraction SRS for skull base metastases has been reported in few studies that include either nasopharyngeal carcinomas or skull base metastases [14-17]. Iwai et al. [15] treated 21 patients with cavernous sinus cancers, including 12 patients with metastases from systemic cancer. At a median follow-up of 13 months, the 1-year and 2-year tumor control rates were 68% and 47%, respectively, with no significant differences between nasopharyngeal carcinoma and metastases. After SRS, there was a resolution or improvement of preoperative cranial nerve deficits in 47% of ...

Preservation of anatomic integrity and function of the cranial nerves during the removal of skull base tumors is one of the most challenging procedures in endoscopic endonasal surgery. It is possible to use intraoperative mapping and identification of the cranial nerves in order to facilitate their preservation. The purpose of this study was to evaluate the effectiveness of intraoperative trigger electromyography in prevention of iatrogenic damage to the cranial nerves. Twenty three patients with various skull base tumors (chordomas, neuromas, pituitary adenomas, meningiomas, cholesteatomas) underwent mapping and identification of cranial nerves during tumor removal using the endoscopic endonasal approach in Department of Neurooncology of Federal State Autonomous Institution

Dr. Stephanie is Chicagos Skull Base Tumor specialist. Endoscopic resection involves the use of telescopes and cameras through the nose the reach the tumor and remove it. This type of surgery is used to avoid disfiguring external skin incisions to remove the skull based tumor.

Penn Head and Neck Cancer provides expert evaluation, diagnosis and surgical treatment for benign and malignant skull base tumors.

Our Head and Neck Cancer team is made up of specialists across multiple disciplines who work together to accurately diagnose benign and malignant skull base tumors.

Endonasal Endoscopic Surgery of Skull Base Tumors: An Interdisciplinary Approach This book presents a complete step-by-step guide to endonasal endoscopic skull base surgery, written by prominent interdisciplinary specialists and reflecting important recent developments in the field. Combining the fundamentals of skull

TY - JOUR. T1 - Skull base tumor model. AU - Gragnaniello, Cristian. AU - Nader, Remi. AU - Van Doormaal, Tristan. AU - Kamel, Mahmoud. AU - Voormolen, Eduard H J. AU - Lasio, Giovanni. AU - Aboud, Emad. AU - Regli, Luca. AU - Tulleken, Cornelius A F. AU - Al-Mefty, Ossama. PY - 2010/11. Y1 - 2010/11. N2 - Object. Resident duty-hours restrictions have now been instituted in many countries worldwide. Shortened training times and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. The development of educational models for brain anatomy is a fascinating innovation allowing neurosurgeons to train without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period. The authors describe the use of Stratathane resin ST-504 polymer (SRSP), which is inserted at different intracranial locations to closely mimic meningiomas and other pathological entities of the skull ...

Dr. Arthur Wu is a fellowship trained Rhinologist and Los Angeles Skull Base Tumor Resection Surgeon who has extensive experience in these techniques.

Dr. Arthur Wu is a respected Los Angeles Skull Base Tumor Surgeon and provides exceptional patient care and cutting-edge ENT services. Call (310) 423-1220

See the causes of skull base tumors to determine if you are at risk for this life threatening condition. Schedule an appointment for diagnosis today.

Pelisyonkis Langone doctors may use results of imaging tests, an angiogram, and sometimes a biopsy to diagnose skull base tumors. Learn more.

TY - JOUR. T1 - Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. AU - Komotar, Ricardo J.. AU - Starke, Robert M.. AU - Raper, Daniel M.S.. AU - Anand, Vijay K.. AU - Schwartz, Theodore H.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Objective: To assess the advantages and limitations of the endoscopic endonasal approach to anterior skull base meningiomas, a minimally invasive approach that avoids extensive bone drilling, brain retraction, and manipulation of nerves and critical vessels, versus open transcranial surgery. Methods: A MEDLINE (2000-2010) search was performed to identify series for either olfactory groove meningiomas or tuberculum sellae (TS) or planum sphenoidale meningiomas. Statistical analyses of categorical variables such as extent of resection, morbidity, and visual outcome were performed using χ 2 and Fisher exact tests. Results: The literature review included 60 studies, involving 1426 patients. Open surgery achieved a higher rate ...

We report a case of an acute spontaneous epidural hematoma (EDH) due to skull base metastasis in a 46-year-old male patient with hepatocellular carcinoma (HCC). The patient presented with the acute onset of severe headache followed by unconsciousness, and computed tomography showed a large EDH in th...

Management of Recurrent Skull Base Meningiomas Keywords: anaplastic, atypical, chemotherapy, endoscopic surgery, meningioma, microsurgery, minimally-invasive, radiosurgery, recurrence, skull base Sheri K. Palejwala, Garni Barkhoudarian, Walavan Sivakumar, Daniel F. Kelly Abstract Skull base meningiomas, due to their frequent investment or encasement of critical neurovascular structures, are challenging to resect in their entirety, both with initial resection…

Object. In this study the authors sought to determine the neurological risks and potential clinical benefits of gamma knife radiosurgery for skull base meningiomas.. Methods. A consecutive series of 88 patients harboring skull base meningiomas were treated between 1990 and 1996 by using the Leksell gamma knife in a prospective clinical study that included a strict dose-volume protocol. Forty-nine patients had previously undergone surgery, and six had received external-beam radiotherapy. The median treatment volume was 10 cm3, and the median dose to the tumor margin was 16 Gy. The radiosurgical dosage to the optic nerve, the cavernous sinus, and Meckels cave was calculated and correlated with clinical outcome. The median patient follow-up time was 35 months (range 12-83 months).. Two tumors (2.3%) progressed after radiosurgery; the progression-free 5-year survival rate was 95%. At last follow-up review, 60 (68%) tumors were smaller and 26 (29.5%) remained unchanged. Clinical improvement (in ...

Our UC Irvine Health skull base surgery team is experienced at diagnosing and treating the broad range of malignancies that can affect the skull base region. For more information or to schedule a consultation, call us at 714-456-7713 or 714-456-6966.

Our UCI Health skull base surgery team is experienced at diagnosing and treating the broad range of malignancies that can affect the skull base region. For more information or to schedule a consultation, call us at 714-456-7713 or 714-456-6966.

Drs. Chandler and Silva do agood job describing the bifrontalbiorbital sphenoethmoidalapproach to the skull base.This approach allows full access tothe anterior skull base, the paranasalsinuses between the medial thirds ofthe maxillary sinuses, and the entireclivus medial to the carotid arteriesand the hypoglossal nerves and belowthe pituitary gland. It should berecognized that the full extent of theapproach is not always necessary, anda good degree of tailoring is possible.Specifically, I have not found it necessaryto perform orbital osteotomiesfor access to the paranasal sinuses orfor cribriform plate resection. A smallmidline frontal craniotomy with aninferior extension to the level of thefrontonasal suture is usually sufficient.

Meningioma is a primary central nervous tumour (CNS) affecting mostly adults. Skull base meningiomas cause morbidity (and occasionally mortality) by compressing adjacent critical organs, and the aim of treatment is to optimise and preserve CNS function. Radiotherapy is an effective treatment for meningioma, with doses of 50-54Gy in conventional fractionation schedules resulting in long-term local control rates of 80-90%. However, local recurrence is unacceptably high in aggressive histological subtypes (WHO G2 and G3), and these patients have a poor outcome following standard dose regimens. In recent years Intensity-Modulated Radiotherapy (IMRT) has been developed, and can deliver highly conformal dose distributions with sharp dose gradients, making dose escalation a possibility for many tumours, including those located in the skull base. The aim of this thesis was to address two issues pertaining to the role of radiotherapy for skull base meningioma. Firstly the goal was to investigate the ...

Skull base is a term used to refer to the region of the head that lies beneath the brain and at the base of the skull. Conditions most commonly addressed at the skull base include tumors and abnormalities of the blood vessels leading to the brain. These abnormalities are often highly complex to manage because of the complicated anatomy at the base of the skull. Tumors and vascular abnormalities in this area often require a team approach, using the expertise of physicians from multiple specialties.. ...

Elias Michaelides, MD, is a neurotologist and skull base surgeon who provides compassionate support and advanced surgical care for patients with lateral skull base tumors and tumors of the ears and temporal bone. He received a BA for Cornell University and his MD from SUNY-Stony Brook. He completed a residency in Otolaryngology/Head and Neck Surgery at the Medical College of Virginia. After completing a Fellowship in Otology, Neurotology, and Skull Base Surgery at the Michigan Ear Institute, he stayed on as faculty there for four years. Dr. Michaelides provides comprehensive care of skull base tumors and other tumors of the ear.. ...

Elias Michaelides, MD, is a neurotologist and skull base surgeon who provides compassionate support and advanced surgical care for patients with lateral skull base tumors and tumors of the ears and temporal bone. He received a BA for Cornell University and his MD from SUNY-Stony Brook. He completed a residency in Otolaryngology/Head and Neck Surgery at the Medical College of Virginia. After completing a Fellowship in Otology, Neurotology, and Skull Base Surgery at the Michigan Ear Institute, he stayed on as faculty there for four years. Dr. Michaelides provides comprehensive care of skull base tumors and other tumors of the ear.. ...

TY - JOUR. T1 - Skull base meningiomas. AU - Couldwell, William T.. AU - Heros, Roberto. AU - Dolenc, Vinko. PY - 2011/5. Y1 - 2011/5. UR - http://www.scopus.com/inward/record.url?scp=84858619086&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84858619086&partnerID=8YFLogxK. U2 - 10.3171/2011.3.FOCUS1185. DO - 10.3171/2011.3.FOCUS1185. M3 - Editorial. C2 - 21529181. AN - SCOPUS:84858619086. VL - 30. JO - Neurosurgical Focus. JF - Neurosurgical Focus. SN - 1092-0684. IS - 5. ER - ...

The Skull Base, upon which the Brains undersurface rests, has three main regions. The Anterior (front) Cranial Fossa is the region located above the eyes and includes structures such as: the Olfactory Bulbs, the Nasal Cavity, and Cranial Nerves (1 & 2 and sections of 3, 4 & 6) that control vision, as well as movement of the eyeballs. The Middle Cranial Fossa is the region containing the dense, boney Petrous Ridge, and houses the Internal Carotid Artery, along with sections of the Cranial Nerves (5 & 7) that control chewing and facial sensation. The Middle Cranial Fossa also contains the Cavernous Sinus, an extremely difficult structure from which to remove tumors. The Posterior (back) Cranial Fossa is where the Internal Auditory Canal (IAC) and the Cranial Nerves (7 & 8) responsible for hearing, facial expression and balance are located; the Jugular Vein also passes through this region. Of the 24 highly specialized Cranial Nerves, which control many vital functions of our head and neck, 18 ...

To evaluate the impact of 68Ga-DOTATOC-PET on treatment planning and sparing of normal tissue in the treatment of skull base meningioma with advanced photons and protons. From the institutional database consisting of 507 skull base meningiomas 10 patients were chosen randomly for the present analysis. Target volume definition was performed based on CT and MRI only, as well as with additional 68Ga-DOTATOC-PET. Treatment plans were performed for Intensity Modulated Radiotherapy (IMRT) and proton therapy using active raster scanning on both target volumes. We calculated doses to relevant organs at risk (OAR), conformity indices as well as differences in normal tissue sparing between both radiation modalities based on CT/MRI planning as well as CT/MRI/PET planning. For photon treatment plans, PET-based treatment plans showed a reduction of brain stem Dmax and Dmedian for different levels of total dose. At the optic chiasm, use of 68Ga-DOTATOC significantly reduces Dmax; moreover, the Dmedian is reduced in

The skull base offers support from the bottom. Think of it as the floor of the skull, where the brain sits. Tumors can form at the base of the skull.

The research of Jamie J. Van Gompel, M.D., complements his clinical focus and fellowship training in the neurosurgical treatment of pituitary tumors, vestibular schwannomas, skull base tumors, as well as epilepsy. Dr. Van Gompel publishes on clinical outcome projects centered on pituitary tumors, esthesioneuroblastomas, acoustic neuromas (vestibular schwannomas), meningiomas, chordomas, chondrosarcomas, spontaneous cerebral spinal fluid leaks, as well as skull base anatomy and approaches.. Dr. Van Gompel works collaboratively with colleagues from Mayo Clinics Epilepsy and Neurophysiology Lab, participating in clinical work relative to brain stimulation as an alternative restorative therapy for epilepsy rather than ablative or resective surgery.. Dr. Van Gompels overall research goal is to develop the safest and most effective treatments for people with pituitary and skull base tumors. He is further involved in developing surgical options for patients with medically and, in some cases, ...

OVERVIEW: My clinical area of expertise is focused on managing skull base tumors that are typically considered to be benign tumors by world health organization (WHO) classification, however due to their intimate involvement and invasion of critical neurological structures pose a considerable challenge for the care and outcome of patients. Research in the area of skull base tumors is extremely limited and consequently targeted therapies have not been identified to date. This is an area of extreme unmet need and my lab is dedicated to advancing the molecular and genomic understanding of these tumors.. Schwannomas are tumors that arise from nerves in the skull base, peripheral nerves and spine. Schwannomas can result in significant debilitating morbidities. Schwannomas can occur either sporadically or in the setting of a genetic predisposing condition, such as NF2. We performed an integrated molecular analysis of schwannomas to determine the somatic landscape of sporadic schwannomas and NF2 related ...

Endoscopic endonasal transcribriform resection of anterior skull base tumors results in large skull base defects that may extend the entirety of the cribriform

I had a pituitary macro adenoma (acromegaly) removed at UPMC in 2005 with Gamma Knife follow-up in 2006. In 2008, I was diagnosed with Parkinsons Disease and in 2010, had a T12 compression fracture. ...

prolactin level 76. MRI found a 2x3mm tumor on the pituitary. My biggest problem is a weight gain of 13 lbs in a matter of months. I do athletic training with a trainer 3-4 times a week, eat a low carb...

Since 1910, Swedish has been the Seattle areas hallmark for excellence in hospitals and health care. Swedish is consistently named the Seattle areas best hospital, with the best doctors, nurses and overall care in a variety of specialty areas. Learn more. ...

The importance of quality of life (QOL) outcomes following treatments for head and neck tumors are now increasingly appreciated and measured to improve medical and surgical care for these patients. An understanding of the definitions in the setting of health care and the use of appropriate QOL instruments and measures are critical to obtain meaningful information that guides decision making in various aspects of patient health care. QOL outcomes following cranial base surgery is only recently being defined. In this article, we describe the current published data on QOL outcomes following cranial base surgery and provide preliminary prospective data on QOL outcomes and sinonasal morbidity in patients who underwent endonasal cranial base surgery for management of various skull base tumors at our institution. We used a disease-specific multidimensional instrument to measure QOL outcomes in these patients. Our results show that although sinonasal morbidity is increased, this is temporary, and the ...

Giant cell tumours (GCT) of the skull base account for approximately 1% of all GTC of the bone. Despite being considered as a benign neoplasm, they are locally aggressive with high recurrence rates after incomplete surgery. Due to the small number of cases reported in skull base, standardized treatment remains unclear. Even with new surgical techniques, a complete resection in skull base tumours is not always possible without functional compromise. Therefore, adjuvant therapy is essential to enhance local control and quality of life. We described a case treated successfully with primary surgery followed by Cyberknife stereotactic radiosurgery (SRS) and denosumab with a 48-month follow-up. To the best of our knowledge, the usage of combined therapy, SRS and denosumab, in skull base GCT has not been previously described.

MORALES, F. et al. Skull base meningiomas: a predictive system to know the extent of their surgical resection and patient outcome. Neurocirugía [online]. 2005, vol.16, n.6, pp.477-485. ISSN 1130-1473.. Objective. The aim of this study was to build a preoperative predictive system which could pro-vide reliable information about: 1° which skull base meningiomas can be total or partially removed, and 2° their surgical outcome. Method. Patient histories and imaging data were reviewed retrospectively from 85 consecutive skull base meningiomas patients who underwent surgery from 1990 and 2002. From the preoperative data, nine variables were selected for conventional statistical analysis as regards their relationship with: 1° total vs partial tumor resection and 2° with patients outcome according to the degree of tumour removal. Results. From the nine variables analysed only two had a statistical association with the type of tumour resection performed (total vs partial) and the patient outcome: 1) ...

Course Directors: Evandro de Oliveira, MD, PhD., Rabih G. Tawk, M.D. and Christina C. Smith, ARNP This course is designed as a review of surgical approaches and operative techniques pertaining to surgical treatment of skull base lesions such as skull base tumors, cerebral aneurysms, and other disorders. This course is designed for neurosurgery medical providers at various stages of their careers including residents, fellows, attendings and neurosurgery team members, including nurse practitioners and physician assistants.to provide a global approach to the skull base. It combines microscopic techniques with a simulated micro-anastomosis training session to improve microsurgical skills. The course will incoporate intensive hands-on cadaver dissection sessions, covering a broad spectrum of transcranial approaches and participants will work in teams on prepared injected fixed specimens under the guidance of a distinguished expert faculty.. *PLEASE NOTE: THIS COURSE WILL NOT OFFER CME CREDIT. ...

Background: The supraorbital keyhole approach has been used in anterior skull base tumor and aneurysm surgery. However, there are debates regarding the safety and limitations of this kind of approach. Objective: To determine the feasibility and potential benefits of surgical robotic technology in minimally invasive neurosurgery. Methods: Two fresh cadaver heads were studied with the…

The authors report a novel technique of balloon-assisted embolization of a skull base meningioma supplied by a branch of the cavernous segment of the internal carotid artery using liquid embolic agent. A temporarily inflated balloon distal to the meningiomas feeding vessel may improve the access to this small branch and may reduce the chances of unintended reflux during delivery of the liquid embolic agent. ...

The British Skull Base Society (BSBS) is the multidisciplinary, multiprofessional body whose membership is the clinical specialists responsible for the treatment of patients in the UK with skull base tumours and other disorders of the skull base. Location Crowne Plaza Glasgow

At Morristown Medical Centers Skull Base Surgery Program, we believe that the timely, accurate diagnosis of skull base tumors results in more effective treatments and speedier recoveries.

Dr. Fernandez-Miranda completed neurosurgery residency at La Paz University Hospital in Madrid, Spain. Upon completion of his residency, he was awarded the Sanitas Prize to the best medical postgraduate trainee in the country. From 2005 to 2007, he underwent fellowship training in microsurgical neuroanatomy at the University of Florida under legendary neurosurgeon Albert L. Rhoton, Jr. From 2007 to 2010 he continued subspecialty clinical training in cerebrovascular surgery at the University of Virginia, and endoscopic endonasal and open skull base surgery at University of Pittsburgh Medical Center (UPMC). During his 10-year tenure at UPMC, he pioneered endoscopic endonasal approaches to highly complex pituitary and skull base tumors, developed a world-class complex brain surgery program, and led a premier training and research program on surgical neuroanatomy and skull base surgery ...

Pamela Jones, MD MS MPH, is a neurosurgeon who cares for people with all types of brain tumors, including glioblastoma, low and high-grade gliomas, metastatic brain tumors, and skull base tumors such as meningiomas and pituitary tumors. Her expertise includes performing minimally-invasive endoscopic neurosurgery for treating tumors in the skull base and pituitary. She also specializes in the treatment of brain tumors affecting the language and motor areas of the brain that may require awake brain surgery, language and motor mapping, and subcortical stimulation. Dr. Jones was thrilled to return to the MGH in 2017 after being an assistant professor at UCSD with a clinical practice focused in neuro-oncology and skull base disease. Dr. Jones completed residency training in neurosurgery at the Massachusetts General Hospital. Her fellowship training in pituitary and endoscopic skull base was also performed at the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary under Dr. ...

Dr. Ahmed specializes in surgery for complex skull base tumors (meningiomas, pituitary adenomas, and acoustic neuromas), cerebrovascular disorders and neuroendovascular surgery. He also works closely with ear, nose and throat physicians for endoscopic skull base surgery. Some of Dr. Ahmeds research was directed at improving visualization for neuroendovascular procedures. The main goal of this research was to streamline stroke care and assist with clinical decision making while developing a user-friendly interface.. ...

Endoscopic skull base surgery has created a new era of skull base surgery. With the development of endoscopic skull base surgery technology and the cooperation in-depth among multiple disciplines, endoscopic skull base surgery has gradually expanded from midline skull base to paramidline skull base. In addition to pituitary tumor, meningioma, craniopharyngioma, and other benign lesions, the technology of endoscopic skull base surgery is gradually used in the treatment of malignant lesions, with olfactory neuroblastoma being the most typical. In addition, endoscopic skull base surgery in the treatment of recurrent nasopharyngeal carcinoma, adenoid cystic carcinoma, chordoma, and other malignant lesions also showed obvious advantages. The combination of interventional neuroradiology, surgical revascularization technique, and endoscopic skull base surgical technique further expands the indications of endoscopic skull base surgery, and greatly reduced the risk of internal carotid artery injury. At the same

TY - JOUR. T1 - Long and very-long-chain ceramides correlate with a more aggressive behavior in skull base chordoma patients. AU - La Corte, Emanuele. AU - Dei Cas, Michele. AU - Raggi, Alberto. AU - Patanè, Monica. AU - Broggi, Morgan. AU - Schiavolin, Silvia. AU - Calatozzolo, Chiara. AU - Pollo, Bianca. AU - Pipolo, Carlotta. AU - Bruzzone, Maria Grazia. AU - Campisi, Giuseppe. AU - Paroni, Rita. AU - Ghidoni, Riccardo. AU - Ferroli, Paolo. PY - 2019/9/2. Y1 - 2019/9/2. N2 - Background: Skull base chordomas are rare tumors arising from notochord. Sphingolipids analysis is a promising approach in molecular oncology, and it has never been applied in chordomas. Our aim is to investigate chordoma behavior and the role of ceramides. Methods: Ceramides were extracted and evaluated by liquid chromatography and mass spectrometry in a cohort of patients with a skull base chordoma. Clinical data were also collected and correlated with ceramide levels. Linear regression and correlation analyses were ...

The primary treatment for a skull base chordoma is surgery to remove as much of the tumor as possible. This is often an aggressive procedure that can lead to some side effects. But it offers the best chance for long-term survival. You and your healthcare team should weigh the risks and benefits of the procedure before the surgery. Once the surgery is done, an aggressive course of radiation therapy is used to kill the nearby tumor cells. Proton beam radiation is often used. It can focus on the needed area without exposing any critical organs and structures around it to radiation. Proton beam radiation offers the advantage of increasing the tumor dose while minimizing the dose to the nearby normal tissue. Other forms of radiation are sometimes used as well. Chemotherapy typically doesnt work well in treating a skull base chordoma. Currently, no medicines are approved for treating chordomas. But some have shown effectiveness in clinical trials. ...

TY - JOUR. T1 - Reverse rotation flap for reconstruction of donor site after vascular pedicled nasoseptal flap in skull base surgery. AU - Caicedo-Granados, Emiro. AU - Carrau, Ricardo. AU - Snyderman, Carl H.. AU - Prevedello, Daniel. AU - Fernandez-Miranda, Juan. AU - Gardner, Paul. AU - Kassam, Amin. N1 - Copyright: Copyright 2010 Elsevier B.V., All rights reserved.. PY - 2010/8. Y1 - 2010/8. N2 - Endonasal skull base surgery is growing exponentially as a subspecialty. In recent years, advances in endoscopic techniques and intraoperative navigation systems have allowed us to expand the indications of endoscopic skull base surgery. Major skull base centers worldwide are addressing larger and more complex lesions using endoscopic techniques. As a consequence, the skull base defects are more challenging to reconstruct. In this report, we present a novel technique to reconstruct the denuded septum remaining after the use of the vascular pedicled nasoseptal flap.. AB - Endonasal skull base surgery ...

The eustachian tube opens into the nasopharynx by passing along the posterior edge of the medial pterygoid plate. The lateral wing of the sphenoid sinus extends laterally below the maxillary nerve. (J) The frontal dura has been opened and the frontal lobes elevated to expose the olfactory and optic nerves and the internal carotid and anterior and middle cerebral arteries (1). , Tract. palatine bone medially and the body of the sphenoid bone above (Figs. 3, 6, 10, and 11). The fossa opens laterally through the pterygomaxillary fissure into the infratemporal fossa and medially through the sphenopalatine foramen to the nasal cavity. The inferior concha is a separate bone attached to the maxilla. The middle and superior concha are appendages of the ethmoid bone. The carotid artery courses along the lateral margin of the sphenoid sinus. The prominence within the sphenoid sinus, formed by the superior orbital fissure, is located anterior to the intracavernous carotid, and the prominence overlying the ...

Vestibular schwannomas, also previously known as acoustic neuromas, are common, histologically benign tumors of the vestibulocochlear nerve (cranial nerve VIII) found in the cerebellopontine angle (CPA). Their name comes from their more common location arising from the inferior division of the vestibular nerve of cranial nerve VIII. They comprise 8-10% of all intracranial tumors with an annual incidence around 1.5 cases per 100,000 population. Symptoms arise generally after 30 years of age. Early symptoms include hearing loss (usually high frequency), tinnitus (high-pitched), and dysequilibrium. Hearing loss is insidious and progressive. Only 10% of patients experience sudden hearing loss. Larger tumors may cause facial numbness or weakness, headache, and focal brainstem signs including weakness. Workup for all patients involves brain MRI with and without contrast and audiometrics. Most vestibular schwannomas are unilateral. Bilateral vestibular schwannomas are characteristic of ...

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TY - JOUR. T1 - Diagnosis of skull base lesions. T2 - The role of CT guided biopsy. AU - Manzione, James V.. AU - Shindo, Maisie L.. PY - 1998/12/1. Y1 - 1998/12/1. N2 - Accurate histologie diagnosis is important for treatment planning of skull base lesions. However, obtaining tissue diagnosis of lesions in or around the skull base can be difficult. Extensive surgery is often required for tissue biopsy with the potential for debilitating complications. This paper describes the usefulness of CT guided biopsy of lesions located at various sites in the skull base for establishing histologie diagnosis. CT guided biopsies of lesions in and around the skull base (pterygopalatine region, greater wing of the sphenoid, parapharyngeal space, infratemporal fossa) were performed in 5 patients who otherwise would have required complicated open surgical approaches. Biopsies were obtained using 18 to 22 gauge needles via one of two approaches - through the coronoid notch or transorally. Accurate diagnosis ...

Skull base chordomas (SBC) are characterized by persistent progression. Conventional radiation following resection increases 5- and 10-year local control (LC) to 36 and 23 %, respectively. Patients tr

BACKGROUND: Nonvestibular schwannomas of the skull base often represent a challenge owing to their anatomic location. With improved techniques in endoscopic endonasal skull base surgery, resection of various ventral skull base tumors, including schwannomas, has become possible.. OBJECTIVE: To assess the outcomes of using endoscopic endonasal approach (EEA) for nonvestibular schwannomas of the skull base.. METHODS: Seventeen patients operated on for skull base schwannomas by EEA at the University of Pittsburgh Medical Center from 2003 to 2009 were reviewed.. RESULTS: Three patients underwent combined approaches with retromastoid craniectomy (n = 2) and orbitopterional craniotomy (n = 1). Three patients underwent multistage EEA. The rest received a single EEA operation. Data on degree of resection were found for 15 patients. Gross total resection (n = 9) and near-total (,90%) resection (n = 3) were achieved in 12 patients (80%). There were no tumor recurrences or postoperative cerebrospinal fluid ...

TY - JOUR. T1 - The radical transbasal approach for resection of anterior and midline skull base lesions. AU - Feiz-Erfan, Iman. AU - Han, Patrick P.. AU - Spetzler, Robert F.. AU - Horn, Eric M.. AU - Klopfenstein, Jeffrey D.. AU - Porter, Randall W.. AU - Ferreira, Mauro A.T.. AU - Beals, Stephen P.. AU - Lettieri, Salvatore C.. AU - Joganic, Edward F.. PY - 2005/9/1. Y1 - 2005/9/1. N2 - Object. Craniofacial surgery can be performed to treat midline and anterior skull base lesions by creating a bicoronal scalp incision without the need for an additional transfacial procedure. Originally described as the transbasal approach, several modifications for further exposure of the skull base have been described. The authors present data on the application and outcomes of a modified transbasal approach. The radical transbasal approach consists of a bifrontal craniotomy and a frontoorbitonasal osteotomy. Methods. Between 1992 and 2002, 41 patients (28 male and 13 female patients with a mean age of 38.3 ...

Expertise, Disease and Conditions: Cerebrospinal Fluid (CSF) Leaks, Cholesterol Granuloma, Chordomas, Chrondrosarcoma, Chronic Sinonasal Infection and Ear Disease, Chronic Sinusitis with Polyps, Clival Tumors, Endocrine Diseases, Endoscopic Frontal Sinus Surgery, Endoscopic Orbital Decompression for Graves Disease, Endoscopic Repair of Nasal Cerebrospinal Fluid Leaks, Endoscopic Resection of Nasal Tumors, Endoscopic Skull Base Surgery, Endoscopic Tear Duct Surgery, Esthesioneuroblastoma, Head and Neck Surgery, Meningiomas, Nasal Obstruction, Nasal Polyps, Otolaryngology, Otolaryngology (ENT), Paranasal Sinus Tumors, Parasellar Tumors, Pituitary Tumors, Salivary Gland Tumors, Sellar Tumors, Sinus Problems, Sinusitis, Sinusitis and Nasal Polyposis, Skull Base Surgery, Skull Base Tumors, Suprasellar Tumors, Thyroid Cancer, Thyroid Diseases, Thyroid ...

Expertise, Disease and Conditions: Cerebrospinal Fluid (CSF) Leaks, Cholesterol Granuloma, Chordomas, Chrondrosarcoma, Chronic Sinonasal Infection and Ear Disease, Chronic Sinusitis with Polyps, Clival Tumors, Endocrine Diseases, Endoscopic Frontal Sinus Surgery, Endoscopic Orbital Decompression for Graves Disease, Endoscopic Repair of Nasal Cerebrospinal Fluid Leaks, Endoscopic Resection of Nasal Tumors, Endoscopic Skull Base Surgery, Endoscopic Tear Duct Surgery, Esthesioneuroblastoma, Head and Neck Surgery, Meningiomas, Nasal Obstruction, Nasal Polyps, Otolaryngology, Otolaryngology (ENT), Paranasal Sinus Tumors, Parasellar Tumors, Pituitary Tumors, Salivary Gland Tumors, Sellar Tumors, Sinus Problems, Sinusitis, Sinusitis and Nasal Polyposis, Skull Base Surgery, Skull Base Tumors, Suprasellar Tumors, Thyroid Cancer, Thyroid Diseases, Thyroid ...

TY - JOUR. T1 - The pericranial flap for reconstruction of anterior skull base defects. AU - Price, John C.. AU - Loury, Mark. AU - Carson, Benjamin. AU - Johns, Michael E.. PY - 1988/11. Y1 - 1988/11. N2 - In 1981, the senior author first reported the use of the pericranial flap for support of the brain following resection of the anterior skull base. Since the initial report, considerable experience has been gained with this flap. It is currently deployed via a bifrontal craniotomy and is placed primarily as a support beneath the frontal lobes. The pericranial flap may also be used to repair dural laceration and defects. The sinonasal surface is routinely grafted with split-thickness skin or dermis. This technique provides an excellent barrier between the sinonasal cavity and the cerebrospinal fluid, establishing a tough, fibrous platform. Herniation of intracranial contents has not occurred. One major complication has been reported in which radiation necrosis occurred during postoperative ...

TY - JOUR. T1 - Microsurgery in skull base meningiomas-mainly focusing on clinoidal meningioma. AU - Sasaki, Tomio. AU - Akagi, Yojiro. AU - Nagata, Shinji. AU - Yoshimoto, Koji. N1 - Copyright: Copyright 2018 Elsevier B.V., All rights reserved.. PY - 2011. Y1 - 2011. N2 - Clinoidal meningioma is one of the most challenging skull base tumors for neurosurgeons. When the tumor encases the internal carotid artery, middle cerebral artery, or the anterior cerebral artery and their perforators, total removal of the tumor is particularly difficult. Nevertheless, the achievement of total removal at the first operation is especially important, because adhesion of the tumor to important vessels and nerves becomes more severe when it recurs. In this article, the authors describe some surgical techniques to achieve total removal with preservation of the encased arteries. At the initial stage of the surgery, devascularization of the tumor is performed to reduce the blood loss. Thereafter, we start debulking ...

TY - JOUR. T1 - Indications and limitations of endoscopic endonasal surgery. AU - Yoshimoto, Koji. AU - Mukae, Nobutaka. AU - Kuga, Daisuke. AU - Iihara, Koji. PY - 2017/1/1. Y1 - 2017/1/1. N2 - The introduction of endoscopy, in conjunction with the technical development of endoscopy such as high definition and 3D, has had a significant impact on the field of endonasal transsphenoidal surgery. Cur-rently, endoscopic surgery is applied for the resection of not only sellar tumors but also parasellar tumors such as anterior skull base tumors, intraorbital tumors, cavernous sinus tumors, infratemporal fossa tumors, clival tumors, and others. Endoscopic endonasal surgery is expected to be used more frequently in the near future. In this paper, based on our own experiences and after reviewing the recent publications, we summarize the indications for endoscopic surgery, focusing on pituitary tumors, craniopharyngiomas, and tuberculum sellae meningiomas. In pituitary tumor surgery, operative results by ...

Endoscopic Endonasal Approach to the Anterior Skull Base and Parasellar Region James K. Liu M.D. Director, Center for Skull Base and Pituitary Surgery Neurological Institute of New Jersey Rutgers University-New Jersey Medical School Newark, New Jersey 2nd Annual Lateral Skull Base Anatomy & Surgical Approaches for the Neurosurgeon September 19 - 20, 2015

Free tissue transfer has been the gold standard of extensive skull base reconstruction, but the onlay of free flaps onto skull base defects carries the risk of cerebrospinal fluid (CSF) leakage. The purpose of this study was the evaluation of a novel technique of a combined sub- and onlay concept with a partially intracranially positioned folded free fasciocutaneous flap in terms of flap applicability, versatility and complication rate. Within 5 years, 7 patients with anterior (n=4), middle (n=2) or posterior (n=1) skull base defects were reconstructed with free extended lateral arm (n=3) or anterolateral thigh (n=4) flaps. The flaps were partially intracranially positioned and fixed with osteo-dermal sutures. Both flaps proved to be applicable in terms of sealing efficiency, minimizing intracranial flap volume and folding. No flap loss was observed. Specific complications consisted of one pneumocranium via an accessory frontal sinus and one cerebellar herniation due to lumbar CSF loss. No flap ...

Treatment Planning for Photon Radiotherapy will be performed using the Planning Systems available at the Department of Radiation Oncology in Heidelberg, Germany (including Masterplan/Nucletron, Virtuos-Konrad/Siemens, or Precisis/STP/Stryker-Leibinger, or the Tomotherapy Software). Carbon ion and proton RT planning is performed using the treatment planning software PT-Planning (Siemens, Erlangen, Germany) including biologic plan optimization. Biologically effective dose distributions will be calculated using the a/ß ratio for meningioma as well as for the endpoint late toxicity to the brain. Patient positioning prior to radiotherapy will be evaluated by comparison of x-rays to the DRRs. Set up deviations ,3mm are corrected prior to radiotherapy.. To the target volume defined for photon treatment, a total dose of 52.2 Gy E - 57.6 Gy E is applied in single fractions of 1.8Gy E. In the 3Gy E Photon arm, photon radiotherapy will be delivered to a total dose of 45 Gy E in 15 fractions. ...

Video Atlas of Neurosurgery: Contemporary Tumor and Skull Base Surgery, 1e By Alfredo Quinones-Hinojosa MD FAANS FACS List Price: $299.99 ADD TO SHOPPING CART Video Atlas of Neurosurgery: Contemporary Tumor and Skull Base Surgery is a unique resource that consists of 40 procedural videos and a concise companion book to

Current standard of care for complex head, neck and skull base surgery require navigation systems that allow instruments to be tracked optically or electromagnetically while registered to a patients pre-operative X-ray computed tomography (CT) or magnetic resonance image (MRI). However, conventionally, the CT/MRI data is not registered with video endoscopy. Augmentation of endoscopic video by preoperative data can facilitate navigation around critical structures and robust target resection. The work presented here describes evaluation of a high definition (HD) video-overlay system for endonasal endoscopic skull base surgery. We adopt a modular design that can be extended for other video augmentation applications. The system supports fast automatic camera calibration, comparable in re-projection errors to standard camera calibration tools, while performing within appropriate run time for clinical use. Phantom studies have shown the registration accuracy of the system to be equivalent to that of ...

The skull base includes the frontal bone, the sphenoid bone, the temporal bone, and the occipital bone. Tumors of the temporal bone and skull base tend to arise in one of three locations: (1) the mastoid or middle ear, (2) the jugular foramen, or (3) the petroclival junction or petrous apex. Tumors of the cerebellopontine angle and Meckel cave are not considered in this chapter (see Chapter 61, Nonacoustic Lesions of the Cerebellopontine Angle). Tumors arising within the skull base are rare and usually cause few symptoms until they grow to a size in which they begin to affect cranial nerves. Table 65-1 lists the various skull base neoplasms and their imaging characteristics. ...

Phillip Pirgousis, M.D., D.M.D., is a head and neck surgeon who specializes in head and neck oncology and skull base tumor surgery in the Department of Otorhinolaryngology at Mayo Clinic hospital in Jacksonville, Florida. He performs microvascular reconstructive surgeries for defects in the head and neck and skull base regions, which treat various deformities and cancers.. Dr. Pirgousis earned his Doctor of Medicine in Dentistry at the University of Adelaide in Adelaide, South Australia, where he also earned his Doctor of Medicine. He went on to become chief resident of general surgery and a fellow at institutions in Australia and England and completed his residency in maxillofacial surgery. Afterwards, he completed a reconstructive surgery fellowship at the University of Florida College of Medicine, where he was chair of Otolaryngology.. Dr. Pirgousis speaks English and Greek, has contributed to numerous medical journals and book chapters, and is a member of multiple societies and associations ...

Radiosurgery is defined as the use of high-dose ionizing radiation for precise and total destruction of a chosen target, avoiding concomitant or delayed harm to adjacent tissues. The three types of radiations include gamma rays (GammaKnife) by Cobalt-60, X8 rays using linear accelerator (LINAC) system, and charged-particles generated from synchocyclotron. Recommendations: Based on current evidence, radiosurgery has proven benefits as the treatment of certain brain metastases, vestibular schwannomas, meningiomas, and some skull base tumors. Conclusion: This review describes the current recommendations for use of radiosurgery for intracranial pathologies. Radiosurgery is a relatively newer modality in the developing country of Pakistan. Much work is needed to increase awareness and promote its use as and when indicated.

Ameloblastic fibrosarcoma is a malignant odontogenic tumor that rarely affects the skull base and surrounding regions. We present a case of a 48-year-old man with histologically confirmed malignant transformation of a benign ameloblastic fibroma 10 years after initial presentation of a localized facial mass. The ameloblastic fibrosarcoma extended from the facial region to the orbit, anterior and middle fossa skull base, the infratemporal fossa, and the cavernous sinus. Progressive proptosis with complete monocular vision loss was the presenting symptom. To our review, our case represents the first report of intradural extension of ameloblastic fibrosarcoma. Using a multidisciplinary skull base approach, resection of all tumors except that in the cavernous sinus was achieved with the resulting defect reconstructed with an anterolateral thigh free flap. The patient had no new neurologic deficits after surgery and underwent adjuvant fractionated radiation therapy. Malignant transformation of ...

Consultant Clinical Oncologist in UHBristol since 2007, caring for paediatric cancer patients and adults with brain tumours.. Lead Clinician for Bristol Gamma Knife Centre, providing intracranial stereotactic radiosurgery for brain tumours, particularly skull base tumours.. Provide paediatric radiotherapy to all patients who require this in the south west UK.. Member of the EpSSG radiotherapy committee, helping with the development of trials in soft tissue sarcoma.. Set up the teenager and young adult with cancer service in UHBristol in 2009, and lead clinician for this service 2009-2014.. South West representative for teenager and young adult with cancer NHS England clinical reference group (CRG).. Member National Cancer Intelligence Network (NCIN) committee for children and young adults with cancer.. ...

University of Pittsburgh Center for Cranial Base Surgery co-directors author Skull Base Surgery offering step-by-step expert instruction on more than 45 procedures, covering both open and minimally invasive approaches to the skull base.

R Loch Macdonald, MD, PhD, FRCSC, FACS, is board certified in Neurosurgery.. He earned his medical degree from University of British Columbia, Vancouver and completed his fellowship in Cerebrovascular Neurosurgery at University or Toronto, Toronto. His professional interests include intracranial neurosurgery including neurovascular surgery, cerebral revascularization and neurovascular bypass surgery, carotid artery disease, cerebral aneurysms and subarachnoid hemorrhage, brain vascular malformations and brain tumors including meningiomas, gliomas, pituitary tumors and skull base tumors.. Dr. Macdonald is currently faculty of UCSF in the UCSF Fresno Department of Neurosurgery. He previously had faculty appointments at the University of Chicago and the University of Toronto. He was the Head of the Division of Neurosurgery at St. Michaels Hospital of University of Toronto and the Keenan endowed chair in Surgery at St. Michaels Hospital.. His hobbies include running and cycling.. ...

Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of developing cerebral ischemia. These include patients with moyamoya disease, occlusive cerebrovascular disease, skull base tumors, and complex aneurysms. Our aim in this review is to provide a comprehensive update of both surgical and anesthetic aspects of cerebral revascularization procedures. The anesthetic concerns for most patients presenting for different types of bypass procedures are similar and include the maintenance of adequate cerebral perfusion to prevent cerebral ischemia. Patients with complex aneurysms and tumors have additional considerations related to the surgical treatment of the underlying pathology.. ...

Featured physician Cameron Wick, MD is a surgeon who specializes in otolaryngology, adult and pediatric cochlear implants, head and neck surgery, skull base tumors, EN&T, otology, neurotology

We are pleased to address you to present the XIV National Congress of the Spanish Skull Base Society SEBAC, which will be held in Alicante on October 24 and 25, 2019, under the slogan Multidisciplinary work in Skull Base Surgery. The pre-congress Surgical Anatomy of the 3D Skull Base will be held on Wednesday, October 23, 2019.. It is a great satisfaction for us to invite you to participate in this meeting, oriented to the participation and interaction between professionals, in which we will be able to share new perspectives for the study and debate of the topics of greatest interest and topicality in the field of skull base surgery.. We have accepted the responsibility and commitment to organize this congress, taking care of every detail and motivated to design a scientific program of maximum interest, with national and international guests of maximum recognition, being open to the participation of all interested parties by presenting communications. We have set the goal of holding a ...

The anterior skull base from the endonasal view. The dural fold of the limbus of the sphenoid is identified and separates the planum sphenoidale...

Dr. Mathew Geltzeiler and the Oregon Sinus Center team work closely with the Departments of Neurosurgery, Endocrinology and Oculoplastic Surgery to provide comprehensive care for anterior skull base disorders.

AbeBooks.com: Surgical Reconstruction of the Face and Anterior Skull Base (9780721669939) by Anthony J. Maniglia MD; Fred J. Stucker MD; David W. Stepnick MD and a great selection of similar New, Used and Collectible Books available now at great prices.

Various different pathologies originate from or extend into the base of the skull. Treatment of lesions of the skull base may involve surgery, radiation therapy, chemotherapy or a combination of therapies. Because of their location and proximity to other vital structures, skull base lesions present unique challenges for surgeons. Recent advances in diagnostic and surgical techniques have made the area more accessible to surgery, providing new treatments for these patients. ...

Dr. Nathan Zwagerman, an assistant professor and director of pituitary and skull base surgery in MCWs department of Neurosurgery, received his neurosurgery residency and fellowship training at the University of Pittsburgh Medical Center.

Medtronic products help sinus surgeons treat a broad spectrum of patients who need sinus surgery or transnasal skull base surgery. View surgical techniques.

TY - CHAP. T1 - CBCT-based image guidance for sinus and skull base surgery. AU - Woodworth, Bradford A.. AU - Chennupati, Sri Kiran. AU - Chiu, Alexander G. PY - 2018/1/4. Y1 - 2018/1/4. UR - http://www.scopus.com/inward/record.url?scp=85045867477&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=85045867477&partnerID=8YFLogxK. U2 - 10.1007/978-3-319-62061-9_27. DO - 10.1007/978-3-319-62061-9_27. M3 - Chapter. AN - SCOPUS:85045867477. SN - 9783319620596. SP - 1057. EP - 1070. BT - Maxillofacial Cone Beam Computed Tomography. PB - Springer International Publishing. ER - ...

The Skull Base Surgery Tumor Program surgeons have extensive experience and are respected internationally for their ability to treat head and neck tumors in this delicate and complex area.

Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose-volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who ...

We are pleased to invite you to attend the 1st International Course in Skull base Surgery - Amsterdam. This unique course will showcase the expertise and knowledge of world renowned surgeons in the field of minimal invasive skull base surgery, a combined course with leading Neurosurgical and ENT surgeons.. ...

At the Yale Medicine Skull Base Program, we offer comprehensive leading-edge surgical care for the removal of both benign and cancerous growths, and abnormalities on the underside of the brain, the skull base, or the top few vertebrae of the spinal column. In caring for our patients, we harness the latest technologi

Hands-on cadaveric course.. Location: Leeds. Next dates: 26th-27th June 2017. Advert: Leeds Endoscopic Course Flyer. Contact: [email protected]. ...