Comprehensive Techniques in CSF Leak Repair and Skull Base Reconstruction

Description

Written by international leading experts in the field of skull base surgery, this publication provides a comprehensive description of both the etiology and management of defects arising in the anterior skull base. The contributions explore the cutting edge techniques in cranial base repair including free grafting, pedicled endonasal and extranasal grafts as well as free flap reconstruction. Further, this volume provides a detailed description of how to enhance success in cerebrospinal fluid leak and encephalocele repair using an evidence-based approach to the diagnosis and localization.The contributions are accompanied by high-definition online videos that enable the reader to watch endoscopic skull base repairs performed by the masters while providing a step-by-step explanation of the techniques utilized.Otolaryngologist, neurosurgeons as well as physicians interested in learning about or wishing to optimize their techniques in anterior skull base reconstruction will find this publication indispensable reading.

Informations

• Publié par: S. Karger AG
• Date de parution: 12 décembre 2012
• Nombre de lectures: 0
• EAN13: 9783805599535
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Comprehensive Techniques in CSF Leak Repair and Skull Base Reconstruction
Advances in Oto-Rhino-Laryngology
VOL. 74
Series Editors
G. Randolph Boston, Mass.
Comprehensive Techniques in CSF Leak Repair and Skull Base Reconstruction
Volume Editor
Benjamin S. Bleier Boston, Mass.
74 figures, 49 in color, and 12 tables, online supplementary material, 2013
___________________________
Benjamin S. Bleier Harvard Medical School Massachusetts Eye and Ear Infirmary Department of Otolaryngology, Head and Neck Surgery 243 Charles Street Boston, MA 02114 (USA)
Library of Congress Cataloging-in-Publication Data
Comprehensive techniques in CSF leak repair and skull base reconstruction / volume editor, Benjamin S. Bleier.
p. ; cm. -- (Advances in oto-rhino-laryngology, ISSN 0065-3071 ; vol. 74)
Includes bibliographical references and indexes.
ISBN 978-3-8055-9952-8 (hardcover: alk. paper) -- ISBN 978-3-8055-9953-5 (e-ISBN)
I. Bleier, Benjamin S. II. Series: Advances in oto-rhino-laryngology ; v. 74. 0065-3071
[DNLM: 1. Cerebrospinal Fluid Rhinorrhea--surgery. 2. Postoperative Complications--prevention & control. 3. Reconstructive Surgical Procedures--methods. 4. Skull Base--surgery. 5. Surgical Flaps. W1 AD701 v. 74 2013 / WL 354]
617.5'14--dc23
2012037119
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2013 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 97069) by Kraft Druck, Ettlingen
ISSN 0065-3071
e-ISSN 1662-2847
ISBN 978-3-8055-9952-8
e-ISBN 978-3-8055-9953-5
I would like thank both my mentors and students from whom I continue to learn how to better care for our patients. Most importantly, I dedicate this book to my wife whose love and support form the foundation upon which any of my accomplishments rest.
Contents
Preface
Bleier, B.S. (Boston, Mass.)
Skull Base Anatomy and CSF Rhinorrhea
Lam, A.; Holbrook, E. (Boston, Mass.)
Pathophysiology of Iatrogenic and Traumatic Skull Base Injury
Gray, S.T.; Wu, A.W. (Boston, Mass.)
Grafting Materials in Skull Base Reconstruction
Prickett, K.K.; Wise, S.K. (Atlanta, Ga.)
Free Graft Techniques in Skull Base Reconstruction
Ting, J.Y.; Metson, R. (Boston, Mass.)
Nasoseptal Flap
Pinheiro-Neto, C.D.; Snyderman, C.H. (Pittsburgh, Pa.)
Sphenopalatine-Derived Pedicled Flaps
Suh, J.D. (Los Angeles, Calif.); Chiu, A.G. (Tucson, Ariz.)
Anteriorly Based Pedicled Flaps for Skull Base Reconstruction
Meier, J.C.; Bleier, B.S. (Boston, Mass.)
Pedicled Extranasal Flaps in Skull Base Reconstruction
Kim, G.G.; Hang, A.X.; Mitchell, C.A.; Zanation, A.M. (Chapel Hill, N.C.)
Microvascular Free Flaps in Skull Base Reconstruction
Herr, M.W.; Lin, D.T. (Boston, Mass.)
Spontaneous Cerebrospinal Fluid Leak and Management of Intracranial Pressure
Soler, Z.M.; Schlosser, R.J. (Charleston, S.C.)
Endoscopic Reconstruction of Frontal, Cribiform and Ethmoid Skull Base Defects
Chin, D.; Harvey, R.J. (Sydney/Singapore)
Planum, Tubercular, Sellar and Clival Defects
Wei, C.C.; Palmer, J.N. (Philadelphia, Pa.)
Quality Control Approach to Cerebrospinal Fluid Leaks
Snyderman, C.H.; Gardner, P.A. (Pittsburgh, Pa.)
Postoperative Care following Skull Base Reconstruction
Ramakrishnan, V.R.; Waziri, A. (Aurora, Colo.)
Complications of Skull Base Reconstruction
Chaaban, M.R.; Woodworth, B.A. (Birmingham, Ala.)
Prevention and Management of Complications after Radiotherapy for Skull Base Tumors: A Multidisciplinary Approach
Jang, J.W.; Chan, A.W. (Boston, Mass.)
Novel Techniques and the Future of Skull Base Reconstruction
Meier, J.C.; Bleier, B.S. (Boston, Mass.)
Author Index
Subject Index


Online supplementary material: www.karger.com/adorl074_suppl
Preface
The discipline of endoscopic skull base surgery has evolved profoundly in the past several decades fueled largely by advances in imaging, instrumentation and endoscopic techniques. The collaboration of neurosurgical and otolaryngologic surgeons has led to the elaboration of a series of endoscopic corridors that may be used to approach and resect lesions involving multiple subsites along the cranial base. As the indications for these approaches continue to expand, the ability to reconstruct the skull base in an immunocompetent and watertight fashion has emerged as a critical rate-limiting factor. Borrowing from traditional methods in open reconstruction and neurotologic surgery, early reconstructive approaches relied on multilayer free grafts. As defect size increased however, the failure rates associated with avascular tissue repairs provided the impetus for the development of a variety of intranasal and extranasal flap techniques. These methods have been remarkably successful resulting in dramatic reductions in postoperative cerebrospinal fluid leaks and overall morbidity.
This textbook represents a detailed exposition of the techniques required for successful skull base reconstruction written by many of the world experts who have played an important role in the expansion of this rapidly evolving field. Through textual descriptions, figures, and endoscopic videos, readers of all levels of endoscopic expertise will be able to use this book to improve and refine their techniques.
While this text represents the current state of the art in cerebrospinal fluid leak and skull base repair, the final chapter covers new technologies which are beginning to appear on the horizon and may continue to push the boundaries of what is possible using current approaches.
Endoscopic skull base surgery has allowed for the management of complex lesions in a minimally invasive fashion resulting in improved quality of life and decreased hospital stays. Advances in techniques of cranial base reconstruction have been crucial to the progression of this field. This textbook is written as a practical guide to enable the skull base surgeon to understand all the reconstructive options currently available and to maximize success in the management of these complex patients.
Benjamin S. Bleier , MD, Boston, Mass., USA
Bleier BS (ed): Comprehensive Techniques in CSF Leak Repair and Skull Base Reconstruction. Adv Otorhinolaryngol. Basel, Karger, 2013, vol 74, pp 1–11 (DOI: 10.1159/000342263)
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Skull Base Anatomy and CSF Rhinorrhea
Allen Lam Eric Holbrook
Massachusetts Eye and Ear Infirmary, Boston, Mass., USA
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Abstract
The skull base is an intricate interface between the cranium and face allowing the passageway of vital structures. Anatomic conceptualization forms the platform for surgical approaches and solutions to skull base pathology. Understanding embryogenesis provides further depth into the pathophysiology of congenital defects. This chapter aims to highlight skull base anatomy and embryology along with cerebrospinal fluid physiology and diagnostic evaluation of cerebrospinal fluid leaks.
Copyright © 2013 S. Karger AG, Basel
Skull Base Anatomy
The skull base defines the inferior aspect of the skull that divides the neurocranially derived cranial contents from the viscerocranial structures of the face and neck. Cranial nerves and vital vasculature travel through the skull base via foramina. Given the complexity of the skull base and the importance of these structures, in-depth anatomic knowledge is critical for operating in this space. The skull base is divided into 3 distinct fossae: anterior, middle and posterior.
Anterior Cranial Fossa
The anterior cranial fossa is formed by the frontal, sphenoid, and ethmoid bones. Anteriorly, the frontal bone separates fossa from the frontal sinus while the floor partitions the orbital contents and the nasal cavity. The midline frontal crest divides the cerebral hemispheres and attaches the falx cerebri. The cribriform plate and crista galla lie more posteriorly allowing passage of the olfactory nerves. It lies in a depr