Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Modifications to the endoscopic approach for anterior skull base lesions improve postoperative sinonasal symptoms.

ABSTRACT: Background/Objective Our institution previously showed that patients experience significant postoperative sinonasal symptoms for the first few months after endoscopic transnasal transsphenoidal skull base surgery (eTNTS). Since our initial study we have modified our technique, discontinuing routine resection of the middle turbinate, maxillary antrostomies, and nasoseptal flaps. In this study, we analyze whether these technical modifications decrease postoperative sinonasal morbidity after eTNTS. Methods A retrospective review was performed of 93 consecutive patients who underwent eTNTS at a tertiary academic medical center from August 2011 to August 2012. Main Outcome Measures Sino-Nasal Outcome Test (SNOT)-20 and SNOT-22 scores preoperatively and after surgery. Results Compared with our previous study, our new cohort experienced a significant improvement (p < 0.05) in SNOT scores for the need to blow nose, runny nose, postnasal discharge, thick nasal discharge, wake up at night, reduced concentration, and frustrated/restless/irritable. Within the new cohort, patients who did not have a nasoseptal flap or middle turbinate resection had less worsening and faster improvement of nasal symptom scores after surgery. Conclusions Preserving normal sinonasal physiology during eTNTS by limiting middle turbinate resections, avoiding unnecessary maxillary antrostomies, and reducing the use of nasoseptal flaps when feasible results in less sinonasal morbidity and more rapid recovery during the postoperative period.

SUBMITTER: Thompson CF

PROVIDER: S-EPMC3912144 | biostudies-other | 2014 Feb

REPOSITORIES: biostudies-other

ACCESS DATA

Json Xml

Similar Datasets

Machine-Learning Classifiers in Discrimination of Lesions Located in the Anterior Skull Base.

Project description:Purpose: The aim of this study was to investigate the diagnostic value of machine-learning models with radiomic features and clinical features in preoperative differentiation of common lesions located in the anterior skull base. Methods: A total of 235 patients diagnosed with pituitary adenoma, meningioma, craniopharyngioma, or Rathke cleft cyst were enrolled in the current study. The discrimination was divided into three groups: pituitary adenoma vs. craniopharyngioma, meningioma vs. craniopharyngioma, and pituitary adenoma vs. Rathke cleft cyst. In each group, five selection methods were adopted to select suitable features for the classifier, and nine machine-learning classifiers were employed to build discriminative models. The diagnostic performance of each combination was evaluated with area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity calculated for both the training group and the testing group. Results: In each group, several classifiers combined with suitable selection methods represented feasible diagnostic performance with AUC of more than 0.80. Moreover, the combination of least absolute shrinkage and selection operator as the feature-selection method and linear discriminant analysis as the classification algorithm represented the best comprehensive discriminative ability. Conclusion: Radiomics-based machine learning could potentially serve as a novel method to assist in discriminating common lesions in the anterior skull base prior to operation.

| S-EPMC7270197 | biostudies-literature

Risk of incisional recurrence after midface and anterior skull base surgery in sinonasal malignancies.

Project description:We sought to determine the risk of tumor incisional recurrence in patients receiving surgery and postoperative radiation therapy for locally advanced sinonasal malignancies. Medical records for 70 patients newly diagnosed with nonmetastatic American Joint Committee on Cancer stage II to stage IV sinonasal malignancies between 1991 and 2003 were retrospectively reviewed. Patient demographics and tumor variables were recorded. All patients underwent upfront surgical resection with postoperative three-dimensional conformal proton beam radiotherapy. Recurrence and survival-related outcomes were recorded. Two patients with squamous cell carcinoma had pathologically confirmed tumor recurrence at the incision site. The actuarial risk of incisional recurrence for the entire group at 1 year was 3%. One of the two patients had a maxillary sinus tumor and developed isolated skin recurrence along the transfacial incision. The other patient with an ethmoid sinus tumor developed isolated dural recurrence along the craniotomy incision. Both patients underwent multiple courses of salvage surgery and radiation therapy. One was successfully salvaged locally but developed distant metastases and the other died of local recurrence. Tumor seeding following transfacial and craniotomy surgery can occur, especially for squamous cell carcinoma. Sound oncological surgical technique, even when utilizing these difficult surgical approaches, is important to minimize incisional recurrence.

| S-EPMC3312592 | biostudies-other

Endoscopic anterior skull base surgery: intraoperative considerations of the crista galli.

Project description:We sought to measure the anatomic dimensions of the crista galli in a consecutive series of patients undergoing the endoscopic transcribriform approach for anterior skull base tumors at a tertiary academic university hospital. We performed a retrospective chart review of patients undergoing purely endoscopic transcribriform surgery for sinonasal and skull base lesions. Main outcome measures included radiological dimensions of the crista galli. A total of 12 patients were identified and treated by the senior authors at the University of Pennsylvania. The average crista galli dimensions were 12.7 ± 2.4 mm (anterior-posterior) and 12.9 ± 2.5 mm (cranial-caudal dimension). Knowledge of the dimensions of the crista galli is important in preoperative planning for both instrumentation and access.

| S-EPMC3312591 | biostudies-other

Perioperative Considerations in Endoscopic Skull Base Surgery.

Project description:Purpose of the Review:Present an overview of perioperative considerations specific to endoscopic skull base surgery necessary to maximize successful outcomes. Recent Findings:The majority of perioperative considerations for endoscopic skull base surgery lack strong supporting evidence and frequently have varied use or implementation amongst institutions. A notable exception comes from a recent randomized controlled trial demonstrating the benefit of lumbar drainage in high-risk cerebrospinal fluid leaks. Summary:Skull base surgeons must consider a multitude of perioperative factors. While many components of perioperative management are extrapolated from related fields such as endoscopic sinus surgery or open cranial base surgery, additional high-quality studies are needed to delineate best practices specific to endoscopic skull base surgery.

| S-EPMC7223122 | biostudies-literature

Morphometric measurements of the anterior skull base for endoscopic transoral and transnasal approaches.

Project description:The objective of this study is to determine the bony limits of the transnasal and transoral approaches to the anterior skull base. The data we present are meant to assist surgeons in preoperative planning for lesions of the sella, clivus, foramen magnum, and odontoid. Using precise measurements undertaken on 41 high-resolution computed tomography scans from patients at the University of Pennsylvania without any history of sinus or sellar pathology, we sought to define the bony limits of transoral and transnasal approaches. Direct measurements and calculated angles were used to assess the dimensions of the anterior skull base. Using our measurements, a transnasal approach can reach an average of 22.5 mm below the plane of the hard palate to the body of C2, and a transoral route can reach 38 mm above the basion along the length of the clivus. Analysis of variance demonstrated no significant differences when subjects were grouped based on race or gender. The measurements outlined within this article help to define the relative dimensions necessary for adapted transoral and transnasal skull base surgeries.

| S-EPMC3312413 | biostudies-other

A new radiological classification for the risk assessment of anterior skull base injury in endoscopic sinus surgery.

Project description:Keros and Gera classifications are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifications are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classification (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital floor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classification was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classified as TMS type 1, Keros type 2 and Gera class II, followed by patients classified as TMS type 3, Keros type 1 and Gera class 1. TMS has significant correlation with Keros classification (p?<?0.05). There was no significant correlation between Keros and Gera classifications (p?=?0.33) and between TMS and Gera classifications (p?=?0.80). The TMS classification has potential to be used for risk assessment of skull base injury among patients undergoing ESS. It serves as an additional assessment besides the Keros and Gera classifications.

| S-EPMC7067776 | biostudies-literature

Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Project description:Simple Summary Sinonasal cancers are rare and heterogeneous tumors, mainly carcinomas, with essentially local evolution and a severe vital and functional prognosis. These tumors are more and more being treated in first intent by a mini-morbid endoscopic approach rather than open surgery as the cornerstone of curative treatment. Adjuvant radiotherapy remains necessary owing to non-optimal local control. This article describes the requirements of radiotherapy to ensure adequate delays, the potential of postoperative radiotherapy to increase local and distant disease control and to decrease morbidity further after mini morbid surgery and dose painting techniques, and reviews the criteria that lead to the choice of one technique over another. Abstract Radiotherapy plays an important role in the treatment of sinonasal cancer, mainly in the adjuvant setting after surgical resection. Many technological approaches have been described, including intensity-modulated radiotherapy, concomitant chemoradiotherapy, charged particle therapy or combined approaches. The choice is based on general criteria related to the oncological results and morbidity of each technique and their availability, as well as specific criteria related to the tumor (tumor extensions, pathology and quality of margins). The aims of this review are: (i) to provide an overview of the radiotherapy techniques available for the management of sinonasal malignant tumors and (ii) to describe the constraints and opportunities of radiotherapy owing to the recent developments of endonasal endoscopic surgery. The indication and morbidity of the different techniques will be discussed based on a critical literature review.

| S-EPMC8508309 | biostudies-literature

Postoperative acute sialadenitis after skull base surgery.

Project description:During retrosigmoid and far-lateral skull base surgical approaches, the head may be positioned at the extreme limits of rotation and flexion. In rare instances, patients may develop acute sialadenitis after surgery as a result of this positioning technique. Over a 4-year period, five patients developed postoperative sialadenitis after undergoing either a retrosigmoid craniotomy in the supine position (n = 4) or a far-lateral craniotomy in the park-bench position. Based on all the retrosigmoid and far-lateral approaches performed by the senior author (RFS), the incidence of sialadenitis was 0.84%. In all five patients, the acute sialadenitis was not clinically apparent at the conclusion of the operation. However, the diagnosis was evident within 4 hours of surgery. In each case, the neck swelling in the vicinity of the submandibular gland was contralateral to the craniotomy site. All patients were treated with intravenous hydration and antibiotic therapy. One patient was extubated immediately after surgery with no obvious evidence of sialadenitis. However, she required emergent reintubation due to airway compromise. The mechanism of acute sialadenitis in these patients was obstruction of the salivary duct caused by surgical positioning. This previously unreported observation in patients undergoing skull base surgery deserves consideration during perioperative and postoperative management.

| S-EPMC2435476 | biostudies-other

Mental Health Disorders Associated with Sinonasal and Skull Base Malignancies: A Large Cohort Study.

Project description:Objective The main purpose of this article is to examine the prevalence, incidence, sociodemographic, and clinical characteristics of mental health disorders (MHDs) among patients with skull base malignancies. Design Retrospective cohort study. Settings/Participants Six-thousand seven-hundred sixty sinonasal/skull base cancer patients in the MarketScan database between 2005 and 2014. Main Outcome Measures Frequency of MHDs pre- and post-diagnosis in patients harboring sinonasal/skull base malignancies. Results A significant increase in MHDs was noted from pre- to post-cancer diagnosis (22 vs 31%, p < 0.0001). Despite an increase in the prevalence rate, the demographic profile of patients with MHDs post-diagnosis remained similar to pre-diagnosis. Those patients harboring MHDs were, however, more likely to be women (62.7 vs 47.4%), and carry a history of smoking (40.9 vs 26.3%) than those without MHDs. These comparisons were statistically significant ( p < 0.0001). Conclusion The prevalence of MHDs increases following a diagnosis of a sinonasal/skull base malignancy. Patients with MHDs were more likely to be women and smokers.

| S-EPMC7082165 | biostudies-literature

Toward Video-Based Navigation for Endoscopic Endonasal Skull Base Surgery.

Project description:Endoscopic endonasal skull base surgery (ESBS) requires high accuracy to ensure safe navigation of the critical anatomy at the anterior skull base. Current navigation systems provide approximately 2mm accuracy. This level of registration error is due in part from the indirect nature of tracking used. We propose a method to directly track the position of the endoscope using video data. Our method first reconstructs image feature points from video in 3D, and then registers the reconstructed point cloud to pre-operative data (e.g. CT/MRI). After the initial registration, the system tracks image features and maintains the 2D-3D correspondence of image features and 3D locations. These data are then used to update the current camera pose. We present registration results within 1mm, which matches the accuracy of our validation framework.

| S-EPMC2850286 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data