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Endoscopy-assisted iliotibial tract harvesting for skull base reconstruction: feasibility on a cadaveric model.

ABSTRACT: During the last years, multiple methods and a wide set of materials for skull base reconstruction have been described. In our experience, the ideal graft for duraplasty is the iliotibial tract due to its favorable characteristics in terms of thickness, pliability, and strength. In this report, we show the iliotibial tract-harvesting technique under endoscopic guidance with a minimally invasive approach using a cadaveric model. Two longitudinal incisions of 1 cm each were made at 4 cm down a line drawn between the anterior-superior iliac spine and the lateral margin of patella at the extremities of the middle third of the thigh. By using a set of instruments for endoscopic face-lifting, the graft was easily set up and harvested. The endoscopic approach is associated with less visible scars, but longer operative time in comparison with open traditional procedure. The pros and cons in terms of morbidity need to be evaluated by further studies on actual cases.

SUBMITTER: Villaret AB

PROVIDER: S-EPMC3312104 | biostudies-other | 2011 May

REPOSITORIES: biostudies-other

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Endoscopy-assisted muscle-sparing Latissimus Dorsi muscle flap harvesting for partial breast reconstruction.

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Endoscopy-assisted periacetabular osteotomy: a preliminary cadaveric study.

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A Perfusion-based Human Cadaveric Model for Management of Carotid Artery Injury during Endoscopic Endonasal Skull Base Surgery.

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Project description:The role of robotic surgery in the skull base is evolving and represents the natural progression toward maximizing surgical resections in confined spaces without compromising oncological principles. In this study, we describe the novel application of robotic surgery to the repair of dural defects in the skull base. A transmaxillary-transantral approach to the nasal cavity was performed bilaterally in a cadaveric model. Repair of the skull base defect was undertaken robotically. In this technical report, we demonstrate the feasibility of a suture-based technique for surgical reconstruction of the skull base with robotic assistance in a cadaveric model. In all cases, suture repair of dural defects was successfully performed with robotic-assisted technique. Although preliminary in nature, this study suggests that traditional suture techniques can be implemented in a confined surgical site with the use of robotic technology.

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Human skull base chordoma LC-MSMS

Project description:The prognostic factors of skull base chordoma associated with outcomes of patients after surgical resection remain poorly defined. This project aimed to identify a novel prognostic factor for patients with skull base chordoma. Using a proteomics approach, we screened tumor biomarkersthat upregulated in the rapid-recurrence group of chordoma, narrowed down by bioinformatics analysis, and finally potential biomarker was chosen for validation by immunohistochemistry using tissue microarray.

2021-11-03 | PXD025894 | Pride

A new segment of the trochlear nerve: cadaveric study with application to skull base surgery.

Project description:Objectives The trochlear nerve is important to preserve during approaches to the skull base. Traditionally, this nerve has been divided into cisternal, cavernous, and orbital segments. However, the authors anecdotally observed an additional segment during routine cadaveric dissections. Therefore, they performed this study to better elucidate this anatomy. Design Twenty latex-injected cadaveric sides (10 adult cadavers) were dissected with the aid of an operating microscope. Standard microdissection techniques were used to examine the course of the distal cisternal and precavernous segments of the trochlear nerve. Setting Cadaver laboratory. Main Outcome Measures Measurements were made using a microcaliper. Digital images were made of the dissections. Results The authors identified a previously undescribed segment of the trochlear nerve in all specimens. This part of the nerve coursed between the entrance of the trochlear nerve into the posterior corner of the oculomotor trigone to the posterior wall of the cavernous sinus. This segment of trochlear nerve was, on average, 4 mm in length. Conclusions The authors have identified a new segment of the trochlear nerve not previously described. They propose that this be referred to as the trigonal segment. Knowledge of the microanatomy of the trochlear nerve is useful to skull base surgeons.

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Use of titanium mesh for middle cranial fossa skull base reconstruction.

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Project description:Objective When the use of the nasoseptal flap for endoscopic skull base reconstruction has been precluded, the posterior pedicle inferior turbinate flap is a viable option for small midclival defects. Limitations of the inferior turbinate flap include its small surface area and limited arc of rotation. We describe a novel extended inferior turbinate flap that expands the reconstructive applications of this flap. Design Cadaveric anatomical study. Participants Cadaveric specimens. Main Outcome Measures Flap size, arc of rotation, and reconstructive applications were assessed. Results The average width of the flap was 5.46 ± 0.58 cm (7.32 ± 0.59 cm with septal mucosa). The average length of the flap was 5.01 ± 0.58 cm (5.28 ± 0.37 cm with septal mucosa). The average surface area of the flap was ∼ 27.26 ± 3.65 cm(2) (40.53 ± 6.45 cm(2) with septal mucosa). The extended inferior turbinate flap was sufficient to cover clival defects extending between the paraclival internal carotid arteries. The use of the flap in 22 cadavers and 5 clinical patients is described. Conclusion The extended inferior turbinate flap presents an additional option for reconstruction of skull base defects when the nasoseptal flap is unavailable.

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