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Medicina
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Advances in Skull Base Surgery
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Advances in Skull Base Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 20 November 2024 | Viewed by 3489

Special Issue Editors

Dr. Mirza Pojskic

E-Mail Website
Guest Editor
Department of Neurosurgery, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
Interests: modern technologies in neurosurgery and spine surgery; augmented reality; robotics; skull base surgery; neurooncology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Christopher Nimsky

E-Mail Website
Guest Editor
Department of Neurosurgery, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
Interests: modern technologies in neurosurgery and spine surgery; augmented reality; intraoperative imaging; neuro-oncology; skull base surgery; pituitary surgery neurovascular surgery; robotics
Special Issues, Collections and Topics in MDPI journals
Dr. Benjamin Saß

E-Mail Website
Guest Editor
Department of Neurosurgery, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
Interests: modern technologies in neurosurgery and spine surgery; intraoperative ultrasound; augmented reality; robotics; neurovascular surgery; skull base surgery; neurooncology

Special Issue Information

Dear Colleagues,

Skull base surgery is a complex and challenging interdisciplinary field where the modern approach to diagnosis, imaging and therapy includes an interdisciplinary team of neurosurgeons, otorhinolaryngologists, head and neck surgeons, neuroradiologists and radiation therapy specialists. These patients present often with mild symptoms, but following treatment in the past have had severe neurological deficits and significant reduction of overall quality of life. Emerging new technologies for improved visualization prior to surgery, during the operation and during the follow up, new and innovative operative approaches, use of augmented and virtual reality, intraoperative ultrasound, fluorescence-guided surgery, novel implants as well as advancing concepts of care which suppose interdisciplinary approach have led to the paradigm change in the treatment of oncological and non-oncological skull base lesions.

In this Special Issue of Medicina, we aim to publish articles on recent advances in skull base surgery in as broad a context as possible to provide the readers with a comprehensive overview of the latest developments. Clinical and basic science research in respect to surgically treated pathology of the skull base is welcome.

Case reports, retrospective and prospective case series and studies, technical notes, literature reviews, opinions, clinical and basic science research are welcome to this Special Issue. 

Dr. Mirza Pojskic
Prof. Dr. Christopher Nimsky
Dr. Benjamin Saß
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • skull base surgery
  • neurosurgery
  • otorhinolaryngology
  • skull base anatomy
  • skull base tumors
  • chordoma
  • chondrosarcoma
  • meningioma
  • vestibular schwannoma
  • paraganglioma
  • cholesteatoma
  • radiotherapy
  • imaging
  • tumour biology
  • pituitary tumors
  • craniopharyngeoma

Published Papers (3 papers)

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Research

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10 pages, 1118 KiB  
Article
Extended Endonasal Endoscopic (EEE) Surgery with Almost No Use of Adjuvant Radiotherapy for Juvenile Nasopharyngeal Angiofibroma (JNA)
by Shamsul Alam, Bipin Chaurasia, Mohsin Ali Farazi, Gianluca Ferini, Abu Saleh Mohammad Abu Obaida, Atiqul Islam, Abu Naim Wakil Uddin and Asifur Rahman
Medicina 2023, 59(9), 1620; https://doi.org/10.3390/medicina59091620 - 07 Sep 2023
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Abstract
Background and Objectives: Juvenile nasopharyngeal angiofibroma (JNA) is an angiomatous hamartoma of the nasal cavity. It is a benign but locally aggressive vascular tumor of the nasopharynx affecting adolescent males. Many surgical procedures are in practice, but the extended endonasal endoscopic (EEE) [...] Read more.
Background and Objectives: Juvenile nasopharyngeal angiofibroma (JNA) is an angiomatous hamartoma of the nasal cavity. It is a benign but locally aggressive vascular tumor of the nasopharynx affecting adolescent males. Many surgical procedures are in practice, but the extended endonasal endoscopic (EEE) approach for JNAs is a suitable and effective technique. Materials and Methods: Fifteen adolescent patients having JNA who underwent extended endonasal endoscopic (EEE) surgery from January 2010 to January 2022 were studied retrospectively. Patients having residual and recurrent JNAs and those who underwent surgery other than EEE were excluded. Results: The average age of the patients was 18.3 years of age. A total of six patients (40%) each had stage V and IV while three patients (20%) had stage III JNAs. Gross total removal was achieved in eight (53.3%) patients and seven (43.7%) had partial removal. There was no per or postoperative mortality. All the patients had at least 3 years of postoperative follow-up and during follow-ups, seven patients were found to have residual tumors, and two had recurrences. Discussion: During the last decades, the endoscopic approach for the resection of JNAs has gained increasing popularity due to its obvious advantages over transfacial approaches. The magnified and angled field of view “behind the corner” helping in a more complete inspection for the resection and shorter hospitalization time makes it a better choice than the other approaches. Conclusions: Endoscopy is an excellent approach for primary JNA. It allows well visualization and precise removal of the angiofibroma. An endoscopic multiangle, multicorridor skull base approach including Denker’s anteromedial maxillotomy is suitable and preferable for the resection of extensive JNAs. Full article
(This article belongs to the Special Issue Advances in Skull Base Surgery)
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Review

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0 pages, 1596 KiB  
Review
Sphenoid Sinus Mucosal Flap after Transsphenoidal Surgery—A Systematic Review
by Piotr Sumislawski, Martyna Piotrowska, Jan Regelsberger, Jörg Flitsch and Roman Rotermund
Medicina 2024, 60(2), 282; https://doi.org/10.3390/medicina60020282 - 06 Feb 2024
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Abstract
Background and Objectives: Skull base reconstruction is a crucial step during transsphenoidal surgery. Sphenoid mucosa is a mucosal membrane located in the sphenoid sinus. Preservation and lateral shifting of sphenoid mucosa as sphenoid mucosal flap (SMF) during the transsphenoidal exposure of the sella [...] Read more.
Background and Objectives: Skull base reconstruction is a crucial step during transsphenoidal surgery. Sphenoid mucosa is a mucosal membrane located in the sphenoid sinus. Preservation and lateral shifting of sphenoid mucosa as sphenoid mucosal flap (SMF) during the transsphenoidal exposure of the sella may be important for later closure. This is the first systematic review to evaluate the utility of sphenoid mucosal flap for sellar reconstruction after transsphenoidal surgery. Materials and Methods: A systematic literature search was performed in January 2023: Cochrane, EMBASE, PubMed, Scopus, and Web of Science. The following keywords and their combinations were used: “sphenoid mucosa”, “sphenoid sinus mucosa”, “sphenoid mucosal flap”, “sphenoid sinus mucosal flap”. From a total number of 749 records, 10 articles involving 1671 patients were included in our systematic review. Results: Sphenoid sinus mucosa used to be applied for sellar reconstruction as either a vascularized pedicled flap or as a free flap. Three different types of mucosal flaps, an intersinus septal flap, a superiorly based flap and an inferiorly based flap, were described in the literature. Total SMF covering compared to partial or no SMF covering in sellar floor reconstruction resulted in fewer postoperative CSF leaks (p = 0.008) and a shorter duration of the postoperative lumbar drain (p = 0.003), if applied. Total or partial SMF resulted in fewer local complications (p = 0.012), such as fat graft necrosis, bone graft necrosis, sinusitis or fungal infection, in contrast to no SMF implementation. Conclusions: SMF seems to be an effective technique for skull base reconstruction after transsphenoidal surgery, as it can reduce the usage of avascular grafts such as fat along with the incidence of local complications, such as fat graft necrosis, bone graft necrosis, sinusitis and fungal infection, or it may improve the sinonasal quality of life by maintaining favorable wound healing through vascular flap and promote the normalization of the sphenoid sinus posterior wall. Further clinical studies evaluating sphenoid mucosal flap preservation and application in combination with other techniques, particularly for higher-grade CSF leaks, are required. Full article
(This article belongs to the Special Issue Advances in Skull Base Surgery)
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Other

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17 pages, 683 KiB  
Systematic Review
Augmented Reality Integration in Skull Base Neurosurgery: A Systematic Review
by Emir Begagić, Hakija Bečulić, Ragib Pugonja, Zlatan Memić, Simon Balogun, Amina Džidić-Krivić, Elma Milanović, Naida Salković, Adem Nuhović, Rasim Skomorac, Haso Sefo and Mirza Pojskić
Medicina 2024, 60(2), 335; https://doi.org/10.3390/medicina60020335 - 16 Feb 2024
Cited by 2 | Viewed by 854
Abstract
Background and Objectives: To investigate the role of augmented reality (AR) in skull base (SB) neurosurgery. Materials and Methods: Utilizing PRISMA methodology, PubMed and Scopus databases were explored to extract data related to AR integration in SB surgery. Results: The majority of 19 [...] Read more.
Background and Objectives: To investigate the role of augmented reality (AR) in skull base (SB) neurosurgery. Materials and Methods: Utilizing PRISMA methodology, PubMed and Scopus databases were explored to extract data related to AR integration in SB surgery. Results: The majority of 19 included studies (42.1%) were conducted in the United States, with a focus on the last five years (77.8%). Categorization included phantom skull models (31.2%, n = 6), human cadavers (15.8%, n = 3), or human patients (52.6%, n = 10). Microscopic surgery was the predominant modality in 10 studies (52.6%). Of the 19 studies, surgical modality was specified in 18, with microscopic surgery being predominant (52.6%). Most studies used only CT as the data source (n = 9; 47.4%), and optical tracking was the prevalent tracking modality (n = 9; 47.3%). The Target Registration Error (TRE) spanned from 0.55 to 10.62 mm. Conclusion: Despite variations in Target Registration Error (TRE) values, the studies highlighted successful outcomes and minimal complications. Challenges, such as device practicality and data security, were acknowledged, but the application of low-cost AR devices suggests broader feasibility. Full article
(This article belongs to the Special Issue Advances in Skull Base Surgery)
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