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Philips R, Martin D, Eskander A, Schord J, Brown N, Zhao S, Brock G, Kumar B, Carrau R, Ozer E, Agrawal A, Kang SY, Rocco JW, Schuller D, Ali S, Blakaj D, Bhatt A, Grecula J, Teknos T, Diavolitsis V, Old M. Effect of adjuvant radiotherapy treatment center volume on overall survival. Oral Oncol 2018; 78:46-51. [PMID: 29496057 DOI: 10.1016/j.oraloncology.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/03/2018] [Accepted: 01/07/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES to examine the impact of radiotherapy center volume on overall survival in patients with oral cavity and oropharyngeal squamous cell carcinoma getting adjuvant radiation therapy after receiving surgery at a high-volume center. MATERIALS AND METHODS a retrospective study was conducted on patients with oral cavity squamous cell carcinoma or oropharyngeal squamous cell carcinoma treated surgically at a tertiary institution from 2000 to 2012 who received adjuvant radiotherapy. The outcome variable was overall survival and the independent variable was location of adjuvant radiation therapy: high-volume center (HVC) versus low-volume center (LVC). Cox proportional hazards models were used to assess associations between predictors of death. Variables that were found to be significant at the α = 0.10 were included in a multivariable model. RESULTS 336 patients met inclusion criteria. One-hundred thirty-nine patients received adjuvant radiation therapy at HVC and 197 patients received adjuvant radiation therapy at LVC. A univariate Cox proportional hazards model identified the variables location, age, marital status, subsite, T stage, extracapsular extension, and smoking status to include in a multivariable model. Age, subsite, T stage, and extracapsular extension were independent predictors of overall survival (p < .05). Location (p = .55), marital status (p = .29), and smoking status (p = .22) were not statistically significant predictors of survival. CONCLUSION After surgery at a HVC, the volume of adjuvant radiation therapy center was not significantly associated with overall survival. Significant predictors of survival included age, subsite, T stage, and extracapsular extension.
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Affiliation(s)
- Ramez Philips
- The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Daniel Martin
- The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Jeffrey Schord
- The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Nicole Brown
- Department of Biomedical Informatics Center for Biostatistics at the Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Songzhu Zhao
- Department of Biomedical Informatics Center for Biostatistics at the Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Guy Brock
- Department of Biomedical Informatics Center for Biostatistics at the Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Stephen Y Kang
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - James W Rocco
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - David Schuller
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Syed Ali
- The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Dukagjin Blakaj
- Department of Radiation Oncology at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Aashish Bhatt
- Department of Radiation Oncology at the James Cancer Hospital, Columbus, OH 43210, USA
| | - John Grecula
- Department of Radiation Oncology at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Theodoros Teknos
- Department of Otolaryngology-Head and Neck Surgery at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Virginia Diavolitsis
- Department of Radiation Oncology at the James Cancer Hospital, Columbus, OH 43210, USA
| | - Matthew Old
- Department of Radiation Oncology at the James Cancer Hospital, Columbus, OH 43210, USA.
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Eskander A, Kang SY, Tweel B, Sitapara J, Old M, Ozer E, Agrawal A, Carrau R, Rocco J, Teknos TN. Quality Indicators: Measurement and Predictors in Head and Neck Cancer Free Flap Patients. Otolaryngol Head Neck Surg 2018; 158:265-272. [DOI: 10.1177/0194599817742373] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective To determine the predictors of length of stay (LOS), readmission within 30 days, and unplanned return to the operating room (OR) within 30 days in head and neck free flap patients. Study Design Case series with chart review. Setting Tertiary academic cancer hospital. Subjects and Methods All head and neck free flap patients at The Ohio State University (OSU, 2006-2012) were assessed. Multivariable logistic regression to assess the impact of patient factors, flap and wound factors, and intraoperative factors on the aforementioned quality metric outcomes. Results In total, 515 patients were identified, of whom 66% had oral cavity cancers, 33% had recurrent tumors, and 28% underwent primary radiotherapy. Of the patients, 31.5% had a LOS greater than 9 days, predicted by longer operative time, oral cavity and pharyngeal tumor sites, blood transfusion, diabetes mellitus, and any complication. A total of 12.6% of patients were readmitted within 30 days predicted by absent OSU preoperative assessment clinic attendance and any complication, and 14.8% of patients had an unplanned OR return predicted by advanced age. Conclusions When assessing quality metrics, adjustment for the complexity involved in managing patients with head and neck cancer with a high comorbidity index, clean contaminated wounds, and a high degree of primary radiotherapy is important. Patients seen in a preoperative assessment clinic had a lower risk of readmission postoperatively, and this should be recommended for all head and neck free flap patients. Quality improvement projects should focus on predictors and prevention of complications as this was the number one predictor of both increased length of stay and readmission.
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Affiliation(s)
- Antoine Eskander
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, Ontario, Canada
| | - Stephen Y. Kang
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Benjamin Tweel
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jigar Sitapara
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew Old
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Enver Ozer
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Amit Agrawal
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Ricardo Carrau
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - James Rocco
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Theodoros N. Teknos
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
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Santamaría A, Langdon C, López-Chacon M, Cordero A, Enseñat J, Carrau R, Bernal-Sprekelsen M, Alobid I. Radio-anatomical analysis of the pericranial flap "money box approach" for ventral skull base reconstruction. Laryngoscope 2017; 127:2482-2489. [PMID: 28322453 DOI: 10.1002/lary.26574] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/27/2017] [Accepted: 02/09/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the versatility of the pericranial flap (PCF) to reconstruct the ventral skull base, using the frontal sinus as a gate for its passage into the sinonasal corridor "money box approach." STUDY DESIGN Anatomic-radiological study and case series. METHODS Various approaches and their respective defects (cribriform, transtuberculum, clival, and craniovertebral junction) were completed in 10 injected specimens. The PCF was introduced into the nose through the uppermost portion of the frontal sinus (money box approach). Computed tomography (CT) scans (n = 50) were used to measure the dimensions of the PCF and the skull base defects. The vertical projection of the external ear canal was used as the reference point to standardize the incisions for the PCF. RESULTS The surface area and maximum length of the PCF were 121.5 ± 19.4 cm2 and 18.3 ± 1.3 cm, respectively. Using CT scans, we determined that to reconstruct defects secondary to transcribriform, transtuberculum, clival, and craniovertebral approaches, the PCF distal incision must be placed respectively at -3.7 ± 2.0 cm (angle -17.4 ± 8.5°), -0.2 ± 2.0 cm (angle -1.0 ± 9.3°), +5.5 ± 2.3 cm (angle +24.4 ± 9.7°), +8.4 ± 2.4 cm (angle +36.6 ± 11.5°), as related to the reference point. Skull base defects in our clinical cohort (n = 6) were completely reconstructed uneventfully with the PCF. CONCLUSIONS The PCF renders enough surface area to reconstruct all possible defects in the ventral and median skull base. Using the uppermost frontal sinus as a gateway into the nose (money box approach) is feasible and simple. LEVEL OF EVIDENCE NA. Laryngoscope, 127:2482-2489, 2017.
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Affiliation(s)
- Alfonso Santamaría
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Cristóbal Langdon
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Mauricio López-Chacon
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Arturo Cordero
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Joaquim Enseñat
- Department of Neurosurgery, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Manuel Bernal-Sprekelsen
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.,Biomedical Research Networking Center on Respiratory Diseases, Madrid, Spain
| | - Isam Alobid
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.,Biomedical Research Networking Center on Respiratory Diseases, Madrid, Spain
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Somma T, Solari D, Beer-Furlan A, Guida L, Otto B, Prevedello D, Cavallo LM, Carrau R, Cappabianca P. Endoscopic Endonasal Management of Rare Sellar Lesions: Clinical and Surgical Experience of 78 Cases and Review of the Literature. World Neurosurg 2017; 100:369-380. [DOI: 10.1016/j.wneu.2016.11.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/10/2016] [Accepted: 11/12/2016] [Indexed: 12/28/2022]
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55
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Priddy BH, Nunes CF, Beer-Furlan A, Carrau R, Dallan I, Prevedello DMS. A Side Door to Meckel's Cave: Anatomic Feasibility Study for the Lateral Transorbital Approach. Oper Neurosurg (Hagerstown) 2017; 13:614-621. [DOI: 10.1093/ons/opx042] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: In the last decade, endoscopic skull base surgery has significantly developed and generated a plethora of techniques and approaches for access to the cranial ventral floor. However, the exploration for the least-aggressive, maximally efficient approach continues.
OBJECTIVE: To describe in detail an anatomical study, along with the technical nuances of a novel endoscopic approach to Meckel's Cave (MC) using a lateral transorbital (LTO) route.
METHODS: Eighteen orbits of injected cadaveric specimens were operated on, using an endoscopic LTO approach to MC, middle cranial fossa, and paramedian skull base preserving the orbital rim. Surgical navigation and an after-the-fact infratemporal craniectomy were utilized to identify the limits of the approach.
RESULTS: Following a transorbital approach opening a trapezoid window at the superolateral aspect (average 166.7 mm2), a middle fossa “peeling” and full visualization of MC was accomplished with no difficulties in all specimens. The entire approach was performed extradurally without the need to expose the temporal lobe.
CONCLUSION: In a cadaveric model, the endoscopic LTO approach affords a direct route to access MC. Its main advantage is that it is minimally disruptive in nature, less brain retraction is required, and it reaches the middle fossa in an anterolateral perspective. It also requires no manipulation of the temporalis muscle, limited cosmetic incision, and rapid recovery. It seems a viable alternative to traditional approaches for lesions lateral to the cranial nerves at the cavernous sinus and MC, that is, schwannomas. Clinical utilization of this approach will challenge its efficacy and identify limitations.
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Affiliation(s)
- Blake Harrison Priddy
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Cristian Ferrareze Nunes
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Andre Beer-Furlan
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Ricardo Carrau
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Iacopo Dallan
- First Otorhinolaryngologic Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Daniel Monte-Serrat Prevedello
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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56
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Lima L, Servian D, Gomez M, Montaser A, Vasconcelos V, Furlan A, El-Khatib A, Otto B, Carrau R, Prevedello D. Minimally Invasive Approaches to the Lateral Cavernous Sinus and Meckel's Cave: Comparison of Transorbital and Subtemporal Endoscopic Techniques. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lucas Lima
- Ohio State University, Ohio, United States
| | | | | | | | | | | | | | - Brad Otto
- Ohio State University, Ohio, United States
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57
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Gomez M, Carrau R, Prevedello D, Otto B, Lima L, Servian D, Montaser A, de Vasconcelos V, Naudy C. Olfactory Grove Meningiomas: Endoscopic Endonasal Corridors Based on Anatomical Landmarks for Olfaction Revised. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Matias Gomez
- Ohio State University, Columbus, Ohio, United States
| | | | | | - Brad Otto
- Ohio State University, Columbus, Ohio, United States
| | - Lucas Lima
- Ohio State University, Columbus, Ohio, United States
| | - Diego Servian
- Ohio State University, Columbus, Ohio, United States
| | - Alaa Montaser
- Ohio State University, Columbus, Ohio, United States
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Hardesty D, Beer-Furlan A, Jamshidi A, Carrau R, Prevedello D. A Proposed Algorithm for the Management of Large Third Ventricular Craniopharyngiomas. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Andre Beer-Furlan
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Ali Jamshidi
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
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59
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Montaser A, Furlan A, Gomez M, Lima L, Servian D, Vasconcelos V, Prevedello D, Carrau R, Otto B. Retrospective Review of Complications Related to Extended Endoscopic Endonasal Skull Base Surgery. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alaa Montaser
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Andre Furlan
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Matias Gomez
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Lucas Lima
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Diego Servian
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Victor Vasconcelos
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Bradley Otto
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
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Oyama K, Ishii Y, Tahara S, Watanabe T, Hirohata T, Katsuno M, Prevedello D, Carrau R, Froelich S, Morita A, Matsuno A. Surgical Anatomy for Endoscopic Endonasal Approach to the Ventrolateral Skull Base Lesions. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kenichi Oyama
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yudo Ishii
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigeyuki Tahara
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Takehiro Watanabe
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Toshio Hirohata
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Makoto Katsuno
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Daniel Prevedello
- Department of Neurological Surgery, The Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Department of Otolaryngology The Ohio State University, Columbus, Ohio, United States
| | - Sebastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Paris VII-Diderot University, Paris, France
| | - Akio Morita
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Akira Matsuno
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
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Gomez M, Carrau R, Prevedello D, Otto B, Montaser A, Servian D, Lima L, de Vasconcelos V, Naudy C. Olfactory Anatomy and Surgical Implications for the Preservation of Its Function. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1598635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - Brad Otto
- Ohio State University, Ohio, United States
| | | | | | - Lucas Lima
- Ohio State University, Ohio, United States
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62
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Montaser A, Lima L, Gomez M, Servian D, Vasconcelos V, Furlan A, Prevedello D, Carrau R, Otto B. Extended Endoscopic Endonasal Clipping of Intracranial Aneurysms: An Anatomical Feasibility Study. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alaa Montaser
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Lucas Lima
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Matias Gomez
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Diego Servian
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Victor Vasconcelos
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Andre Furlan
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Bradley Otto
- Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
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63
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Hollingsworth B, Senter L, Zhang X, Brock GN, Jarjour W, Nagy R, Brock P, Coombes KR, Kloos RT, Ringel MD, Sipos J, Lattimer I, Carrau R, Jhiang SM. Risk Factors of 131I-Induced Salivary Gland Damage in Thyroid Cancer Patients. J Clin Endocrinol Metab 2016; 101:4085-4093. [PMID: 27533304 PMCID: PMC5095242 DOI: 10.1210/jc.2016-1605] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Sialadenitis and xerostomia are major adverse effects of 131I therapy in thyroid cancer patients. The risk factors for these adverse effects, other than administered activity of 131I, have not been investigated. OBJECTIVE The aim of this study is to identify risk factors for 131I-induced salivary gland damage among follicular cell-derived thyroid cancer patients. DESIGN We enrolled 216 thyroid cancer patients who visited The Ohio State University Wexner Medical Center between April 2013 and April 2014. Symptoms of xerostomia and sialadenitis were identified via questionnaire and medical record search. To validate the findings in a large cohort, we retrospectively searched for ICD-9/10 codes for sialadenitis, xerostomia, and autoimmune disease associated with Sjögren's syndrome (AID-SS) in our existing database (n = 1507). Demographic and clinical information was extracted from medical records. Multivariate analyses were performed to identify independent predictors for salivary gland damage. RESULTS 131I treatment associated with higher incidence of xerostomia and sialadenitis. Patients with xerostomia had 46 mCi higher mean cumulative 131I activity and 21 mCi higher mean first-administered 131I activity than patients without xerostomia. Increased age associated with higher incidence of xerostomia, and females had a higher incidence of sialadenitis. Patients who experienced sialadenitis before 131I therapy had higher sialadenitis incidence after 131I therapy. 131I-treated patients diagnosed with AID-SS, whether before or after 131I treatment, had a higher incidence of xerostomia and sialadenitis among 131I-treated patients. CONCLUSION Risk factors for 131I-induced salivary gland damage include administered 131I activity, age, gender, history of sialadenitis before 131I treatment, and AID-SS diagnosis.
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Affiliation(s)
- Brynn Hollingsworth
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Leigha Senter
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Xiaoli Zhang
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Guy N Brock
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Wael Jarjour
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Rebecca Nagy
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Pamela Brock
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Kevin R Coombes
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Richard T Kloos
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Matthew D Ringel
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Jennifer Sipos
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Ilene Lattimer
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Ricardo Carrau
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
| | - Sissy M Jhiang
- Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210
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Hachem RA, Beer-Furlan A, Elkhatib A, Rangarajan S, Prevedello D, Blakaj D, Bhatt A, Carrau R. Modern Treatment Outcomes in Sinonasal Malignancies. Curr Otorhinolaryngol Rep 2016. [DOI: 10.1007/s40136-016-0133-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Arrese LC, Carrau R, Plowman EK. Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer. Dysphagia 2016. [PMID: 27538876 DOI: 10.1007/s00455-016-9741-7.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration-aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1-5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson's and Spearman's Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = -2.36, p < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.
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Affiliation(s)
- Loni C Arrese
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 W. 10th Ave, Columbus, OH, 43210, USA.
| | - Ricardo Carrau
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 W. 10th Ave, Columbus, OH, 43210, USA
| | - Emily K Plowman
- Department of Speech, Language and Hearing Sciences, Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, 1225 Center Drive, Room 2141, Gainesville, FL, 32610, USA
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Arrese LC, Carrau R, Plowman EK. Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer. Dysphagia 2016; 32:83-89. [PMID: 27538876 DOI: 10.1007/s00455-016-9741-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/05/2016] [Indexed: 12/12/2022]
Abstract
The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration-aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1-5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson's and Spearman's Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = -2.36, p < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.
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Affiliation(s)
- Loni C Arrese
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 W. 10th Ave, Columbus, OH, 43210, USA.
| | - Ricardo Carrau
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 W. 10th Ave, Columbus, OH, 43210, USA
| | - Emily K Plowman
- Department of Speech, Language and Hearing Sciences, Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, 1225 Center Drive, Room 2141, Gainesville, FL, 32610, USA
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Teknos TN, Old MO, Grecula JC, Agrawal A, Ozer E, Carrau R, Kang S, Rocco JW, Blakaj D, Diavolitsis V, Baiocchi RA, Kumar B, Savvides P. A phase 1 trial of vorinostat in combination with concurrent chemoradiation therapy in the treatment of advanced stage head and neck squamous cell carcinoma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.6036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Matthew Owen Old
- The Ohio State University - Arthur James Cancer Hospital, Columbus, OH
| | | | - Amit Agrawal
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - Enver Ozer
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
| | - Ricardo Carrau
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
| | - Stephan Kang
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
| | | | - Dukagjin Blakaj
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
| | | | | | - Bhavna Kumar
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
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Beer-Furlan A, Jamshidi A, Abi-Hachem R, Otto B, Carrau R, Prevedello D. Endoscopic Endonasal Management for Ventral Skull Base Metastatic Tumors. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vivas A, Díaz J, Slijepcevic A, Wuesthoff C, Prevedello D, Otto B, Carrau R. Anatomic Guidelines for the Repair of CSF Leaks in the Lateral Recess of the Sphenoid Sinus. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tanjararak K, Upadhyay S, Thiensri T, Rianmanee S, Muto J, Prevedello D, Otto B, Carrau R. Parapharyngeal Internal Carotid Artery: A Comparative Analysis of Surgical Exposure and Vascular Control via Endoscopic Endonasal, Transoral and Transcervical Approaches. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Soldatova L, Campbell R, Carrau R, Prevedello D, Ditzel Filho L, Otto B. Sinonasal Neuroendocrine Neoplasms: Histopathologic Differentiation and Treatment Outcomes. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Oyama K, Prevedello D, S. L, Filho D, Muto J, Gun R, Kerr E, Otto B, Carrau R. Anatomic Comparison of the Endonasal and Transpetrosal Approaches for Interpeduncular Fossa Access. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Soldatova L, Campbell R, Schmidt T, Pinto J, Prevedello D, ElKhatib A, Filho L, Otto B, Carrau R. Role of Leukocyte Platelet Rich Fibrin in Endoscopic Endonasal Skull Base Surgery Defect Reconstruction. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1580038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Goulart C, Upadhyay S, Ditzel L, Otto B, Carrau R, Prevedello L, Prevedello D. Newly Diagnosed Sellar Tumors in Patients with Cancer. Advantages of Surgical Intervention Over Empiric Radiotherapy. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Upadhyay S, Buohliqah L, Otto B, Prevedello D, Carrau R. Olfactory Assessment in Patients Undergoing Endoscopic Skull Base Surgery- Lessons Learnt. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Upadhyay S, Buohliqah L, Junior G, Otto B, Prevedello D, Carrau R. First Olfactory Fiber as an Anatomical Landmark for Frontal Sinus Surgery. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Alobid I, Mason E, Solares CA, Prevedello D, Enseñat J, De Notaris M, Prats-Galino A, Bernal-Sprekelsen M, Carrau R. Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology 2015; 53:235-41. [PMID: 25923031 DOI: 10.4193/rhino14.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The aim of this radio-anatomical study is to ensure that the potential donor area of the pedicled lateral nasal wall flap (PLNW) is adequate to reconstruct nasal perforation. MATERIAL AND METHODS Analysis was conducted on 40 de-identified CT angiographies. The area and length of the PLNW, the septum, and the nasal floor were measured. In a cadaver study, 20 hemi-cranial sagittal sections were also analyzed. The anterior-posterior length of the PLNW flap and the distance between the sphenopalatine foramen and piriform aperture were measured. A clinical study with endoscopic closure of a large perforation was conducted in three patients. RESULTS The CT angiographies demonstrated an average PLNW area of 10.80±1.13 cm2 and a nasal floor area of 3.78±0.58 cm2. The septal area (22.54±21.32 cm2) was significantly larger than the total PLNW flap area (14.59±1.21 cm2). The average length of the flap was 5.58±0.39 cm, while the septum was 6.66±0.42 cm; therefore the PLNW flap is insufficient to reconstruct the entire septum. The cadaver study showed that the length of the PLNW flap was 5.28±0.40 cm. These results demonstrate that measurements obtained from CT scans are reliable data and similar to those found in the radiological study. Complete closure was achieved in all three patients. CONCLUSION The PLNW flap does not render enough tissue to reconstruct a total septal perforation; however, up to 84% of the septum could be repaired with a PLNW. The potential donor area obtained by CT scan and clinical practice support the approachability of PLNW to repair large septal perforation.
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Jamshidi A, Chan J, Ditzel Filho L, Kerr E, Mohyeldin A, Carrau R, Prevedello D. The Use of Intraoperative Ultrasound during Endoscopic, Endonasal Approach to the Anterior Skull Base for Resection of a Tuberculum Sella Meningioma: A Technical Note. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Upadhyay S, Dolci R, Buohliqah L, Ditzel L, Prevedello D, Otto B, Carrau R. Sublabial Anterior Maxillectomy or Endoscopic Denker Approach: Comparative Analysis of Two Minimally Invasive Approaches to the Infratemporal Fossa. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tailor AR, Buohliquah L, Ammirati M, Carrau R, Lamki T, Lubow M. Cranial-Base Surgery for Drug Delivery via Mastoid Cavity: A Novel Procedure for Vestibular/Auditory Syndromes. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mesquita Filho P, Prevedello D, Ditzel Filho L, Kerr E, Martinez C, Fiore M, Dolci R, Otto B, Carrau R. Optic Canal Decompression: Comparing the Endonasal Endoscopic and Transcranial Approaches. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Little A, Kelly D, Prevedello D, Carrau R, Griffiths C, Rosseau G, Garni B, Jahnke H, Jelinek K, Milligan J, White W. Comparison of Sinonasal Quality of Life between Patients undergoing Microscopic and Endoscopic Transsphenoidal Surgery for Pituitary Lesions: A Prospective Cohort Study. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Patwa H, Prevedello D, Carrau R. Far Medial Transoral Approach to the Infratemporal Fossa: An Anatomic Feasibility Study for a Multiportal Approach to the Infratemporal Fossa. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Upadhyay S, Buohliqah L, Dolci R, Fiore M, Prevedello D, Otto B, Carrau R. Effect of Incremental Maxillectomy on Exposure of the Pterygopalatine and Infratemporal Fossa: A Cadaveric Study with Comparative Analysis of Radial Access, Area of Exposure, and Surgical Freedom. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jamshidi A, Mohyeldin A, Chan J, Ditzel Filho L, Kerr E, Otto B, Carrau R, Prevedello D. The Use of Intraoperative Ultrasound in Endoscopic Endonasal Surgery of the Craniovertebral Junction: A Technical Note. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dolci R, Carrau R, Buohliqah L, Filho L, Zoli M, Filho P, Martinez C, Lazarini P, Otto B, Prevedello D. Endoscopic Endonasal Anatomical Study of the Cavernous Sinus Segment of the Ophthalmic Nerve. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Patwa H, Upadhyay S, Prevedello D, Carrau R. Analysis of the Expanded Endonasal and Far Medial Transoral Endoscopic Approaches to the Infratemporal Fossa: Feasibility Study for a Multi-Portal Minimally Invasive Approach. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dolci R, Carrau R, Upadhyay S, Ditzel L, Fiore M, Buohliqah L, Junior G, Lazarini P, Otto B, Prevedello D. Endoscopic Endonasal Study of the Cavernous Sinus and Quadrangular Space: Anatomical Relationships. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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90
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Griffiths C, Barkhoudarian G, Cutler A, Duong H, Lobo B, Karimi K, Doyle O, Carrau R, Kelly D. Bilateral Nasoseptal Rescue Flap with Olfactory Epithelium Preservation: A Prospective Study Analyzing Postoperative Olfaction and Epistaxis. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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91
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buohLIQAH L, Upadhyay S, Dolci R, Pravedelo D, Carrau R. Can Esthesioneuroblastoma Metastasize to the Paranasal Sinuses?: Clinical Report and Literature Review. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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92
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Oyama K, Prevedello D, Ditzel Filho L, Muto J, Gun R, Kerr E, Otto B, Carrau R. Anatomic Comparison of the Endonasal and Transpetrosal Approach for Interpeduncular Fossa Access. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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93
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Fiore M, Kerr E, Filho P, Dolci R, Upadhyay S, Buohliqah L, Vieira G, Filho L, Otto B, Carrau R, Prevedello D. Extending the Inferior Limit of Endoscopic Endonasal Surgery to the Cervical Spine Utilizing an Endoscopic Endonasal Posterior Palatectomy. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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94
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Jamshidi A, Mohyeldin A, Muto J, Ditzel Filho L, Kerr E, Prevedello D, Otto B, Carrau R. The Use of a Bipolar Sealer System in Endoscopic Endonasal Surgery of the Skull Base: A Technical Note. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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95
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Little A, Kelly D, Milligan J, Griffiths C, Carrau R, Prevedello D, Rosseau G, Barkhoudarian G, White W. Predictors of Sinonasal Quality of Life and Nasal Morbidity after Endoscopic Transsphenoidal Surgery: A Multicenter Study. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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96
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Mesqita Filho P, Prevedello D, Ditzel Filho L, Kerr E, Martinez C, Fiore M, Dolci R, Otto B, Carrau R. Cerebellopontine Angle Chondrosarcomas: Endoscopic Endonasal Management. Skull Base Surg 2015. [DOI: 10.1055/s-0035-1546598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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97
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Alobid I, Solares C, Ensenat J, De Notaris M, Prats-Galino A, Bernal-Sprekelsen M, Carrau R. Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology 2015. [DOI: 10.4193/rhin14.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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98
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Reyes C, Mason E, Solares CA, Bush C, Carrau R. To preserve or not to preserve the orbit in paranasal sinus neoplasms: a meta-analysis. J Neurol Surg B Skull Base 2014; 76:122-8. [PMID: 25844298 DOI: 10.1055/s-0034-1390403] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022] Open
Abstract
Context The effect on survival of orbital evisceration on patients with paranasal sinus neoplasms has not been well established. Objective To review systematically the available literature concerning survival in patients who undergo surgery for paranasal sinus neoplasm with and without preservation of the eye. Data Source A retrospective meta-analysis of English and non-English articles using Medline and the Cochrane database. Eligibility Criteria Studies analyzing 5-year survival rates in patients who had orbital evisceration compared with orbital preservation for the treatment of paranasal sinus neoplasms were included in the final analysis. Data Extraction Independent review by two authors using predefined data fields. Data Synthesis A meta-analysis of four articles involving 443 patients was performed using the DerSimonian-Laird random-effects method. Results Our analysis revealed a total effect size of 0.964 in favor of preservation of the eye; however, these results are not robust, having a true effect size anywhere from 0.785 to 1.142 with a 95% confidence interval. Limitations Only retrospective observational studies were included because a prospective randomized study cannot be performed in this population. Conclusion Our study supports the notion that in select patients preservation of the eye may yield a different outcome when compared with orbital evisceration.
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Affiliation(s)
- Camilo Reyes
- Department of Otolaryngology, Universidad del Rosario, Bogota, Colombia
| | - Eric Mason
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States ; Center for Skull Base Surgery, Georgia Regents University, Augusta, Georgia, United States
| | - C Arturo Solares
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States ; Center for Skull Base Surgery, Georgia Regents University, Augusta, Georgia, United States
| | - Carrie Bush
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States
| | - Ricardo Carrau
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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99
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Labib MA, Prevedello DM, Carrau R, Kerr EE, Naudy C, Abou Al-Shaar H, Corsten M, Kassam A. A Road Map to the Internal Carotid Artery in Expanded Endoscopic Endonasal Approaches to the Ventral Cranial Base. Oper Neurosurg (Hagerstown) 2014; 10 Suppl 3:448-71; discussion 471. [DOI: 10.1227/neu.0000000000000362] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Injuring the internal carotid artery (ICA) is a feared complication of endoscopic endonasal approaches.
OBJECTIVE:
To introduce a comprehensive ICA classification scheme pertinent to safe endoscopic endonasal cranial base surgery.
METHODS:
Anatomic dissections were performed in 33 cadaveric specimens (bilateral). Anatomic correlations were analyzed.
RESULTS:
Based on anatomic correlations, the ICA may be described as 6 distinct segments: (1) parapharyngeal (common carotid bifurcation to ICA foramen); (2) petrous (carotid canal to posterolateral aspect of foramen lacerum); (3) paraclival (posterolateral foramen lacerum to the superomedial aspect of the petrous apex); (4) parasellar (superomedial petrous apex to the proximal dural ring); (5) paraclinoid (from the proximal to the distal dural rings); and (6) intradural (distal ring to ICA bifurcation). Corresponding surgical landmarks included the Eustachian tube, the fossa of Rosenmüller, and levator veli palatini for the parapharyngeal segment; the vidian canal and V3 for the petrous segment; the fibrocartilage of foramen lacerum, foramen rotundum, maxillary strut, lingular process of the sphenoid bone, and paraclival protuberance for the paraclival segment; the sellar floor and petrous apex for the parasellar segment; and the medial and lateral opticocarotid and lateral tubercular recesses, as well as the distal osseous arch of the carotid sulcus for the paraclinoid segment.
CONCLUSION:
The proposed endoscopic classification outlines key anatomic reference points independent of the vessel's geometry or the sinonasal pneumatization, thus serving as (1) a practical guide to navigate the ventral cranial base while avoiding injury to the ICA and (2) further foundation for a modular access system.
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Affiliation(s)
- Mohamed A. Labib
- Division of Neurosurgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Ricardo Carrau
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, Ohio
| | | | | | - Hussam Abou Al-Shaar
- Division of Neurosurgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Martin Corsten
- Department of Otolaryngology, University of Ottawa, Ottawa, Ontario, Canada
| | - Amin Kassam
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
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100
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Griffiths CF, Cutler AR, Duong HT, Bardo G, Karimi K, Barkhoudarian G, Carrau R, Kelly DF. Avoidance of postoperative epistaxis and anosmia in endonasal endoscopic skull base surgery: a technical note. Acta Neurochir (Wien) 2014; 156:1393-401. [PMID: 24809531 DOI: 10.1007/s00701-014-2107-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/19/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most endoscopic transsphenoidal approaches jeopardize the sphenopalatine artery and septal olfactory strip (SOS), increasing the risk of postoperative anosmia and epistaxis while precluding the ability to raise pedicled nasoseptal flaps (NSF). We describe a bilateral "rescue flap" technique that preserves the mucosa containing the nasal-septal vascular pedicles and the SOS. This approach can reduce the risk of postoperative complications, including epistaxis and anosmia. METHODS A retrospective analysis was conducted of all patients who underwent endoscopic transsphenoidal surgery with preservation of both sphenopalatine vascular pedicles and SOS. In a recent subset of patients, olfactory assessment was performed. RESULTS Of 174 consecutive operations performed in 161 patients, bilateral preservation of the sphenopalatine vascular pedicle and SOS was achieved in 139 (80 %) operations, including 31 (22 %) with prior transsphenoidal surgery. Of the remaining 35 operations, 18 had a planned formal NSF and 17 had prior surgery or extensive lesions precluding use of this technique. Of pituitary adenomas, RCCs or sellar arachnoid cysts, 118 (94 %) underwent this approach, including 91 % of patients who had prior surgery. Preoperative olfaction function was maintained in 97 % of patients that were tested. None of the patients had postoperative arterial epistaxis. CONCLUSION Preservation of bilateral sphenopalatine vascular pedicles and the SOS is feasible in over 90 % of patients undergoing endonasal endoscopic surgery for pituitary adenomas and RCCs. This approach, while not hindering exposure or limiting instrument maneuverability, preserves the nasoseptal vasculature for future NSF use if needed and appears to minimize the risks of postoperative arterial epistaxis and anosmia.
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Affiliation(s)
- Chester F Griffiths
- Saint Johns Medical Center, John Wayne Cancer Institute, 2200 Santa Monica Blvd, Santa Monica, CA, 90404, USA
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