Giant Cell Granuloma of the Anterior Skull Base: Need for Early, Maximal Surgical Excision: A Short Series of 3 Cases with Review of Literature.

Giant Cell Granuloma of the Anterior Skull Base: Need for Early, Maximal Surgical Excision: A Short Series of 3 Cases with Review of Literature.

Indian J Otolaryngol Head Neck Surg. 2015 Dec;67(4):347-52

Authors: Shah SR, Keshri A, Behari S, Patadia S, Kumari N

Abstract
Giant cell granuloma is a rare benign granulomatous lesion of the bone. The local aggressiveness, potentiation with trauma and complex anatomy of the skull base makes the surgical management in this location challenging. We report a series of three cases along with the clinical presentation, radiological and histopathological findings and the management issues while dealing with this lesion. A review of literature reveals the rarity of the lesion, alternate management modalities and the outcomes for such lesion involving the jaw bones and the skull base. For best outcomes differential diagnosis from giant cell tumor and brown tumor of hyperparathyroidism is essential. Further it may be concluded that there is a need for maximal surgical excision to avoid recurrence as the second line management options are not as effective.

PMID: 26693450 [PubMed]

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Pneumocephalus Following Thoracic Surgery with Posterior Chest Wall Resection.

Pneumocephalus Following Thoracic Surgery with Posterior Chest Wall Resection.

Thorac Cardiovasc Surg Rep. 2015 Dec;4(1):5-7

Authors: Müller I, Tönnies M, Pfannschmidt J, Kaiser D

Abstract
Pneumocephalus can be seen after head injury with fracture of the skull-base or in cerebral neoplasm, infection, or after intracranial or spinal surgery. We report on a 69-year-old male patient with pneumocephalus after right-sided lobectomy and en bloc resection of the chest wall for non-small-cell lung cancer. Postoperatively, the patient showed a reduced vigilance level with no response to pain stimuli and anisocoria. The CCT scan revealed an extensive pneumocephalus; following which, the patient underwent neurosurgery with laminectomy and ligature of the transected nerve roots. After operation the patient returned to his baseline mental status.

PMID: 26693117 [PubMed]

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Endoscopic Endonasal Repair of Sphenoid Sinus Cerebrospinal Fluid Leaks: Our Experience.

Endoscopic Endonasal Repair of Sphenoid Sinus Cerebrospinal Fluid Leaks: Our Experience.

Indian J Otolaryngol Head Neck Surg. 2015 Dec;67(4):412-6

Authors: Janakiram TN, Subramaniam V, Parekh P

Abstract
Endoscopic endonasal approaches are becoming increasingly popular over transcranial approaches for repair of cerebrospinal leak defects. Sphenoid sinus CSF leaks pose a significant challenge and carry the risk of life-threatening intracranial complications. Their management depends upon identifying the leak using imaging techniques followed by intraoperative endoscopic localization. Our experience in the endoscopic endonasal management of sphenoid sinus CSF leaks is reported in this paper.

PMID: 26693461 [PubMed]

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Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain.

Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain.

J Craniovertebr Junction Spine. 2015 Oct-Dec;6(4):183-9

Authors: Deukmedjian AJ, Cianciabella AJ, Cutright J, Deukmedjian A

Abstract
BACKGROUND: Lumbar fusion is a proven treatment for chronic lower back pain (LBP) in the setting of symptomatic spondylolisthesis and degenerative scoliosis; however, fusion is controversial when the primary diagnosis is degenerative disc disease (DDD). Our objective was to evaluate the safety and effectiveness of lumbar fusion in the treatment of LBP due to DDD.
MATERIALS AND METHODS: Two-hundred and five consecutive patients with single or multi-level DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic LBP between the years of 2008 and 2011. The primary outcome measures in this study were back and leg pain visual analogue scale (VAS), patient reported % resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay (LOS).
RESULTS: The average resolution of preoperative back pain per patient was 84% (n = 205) while the average resolution of preoperative leg pain was 90% (n = 190) while a mean follow-up period of 528 days (1.5 years). Average VAS for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1 (P ≤ 0.0001), a change of 7.9 points for the cohort. The average number of lumbar disc levels fused per patient was 2.3 (range 1-4). Median postoperative LOS in the hospital was 1.2 days. Average blood loss was 108 ml perfused level. Complications occurred in 5% of patients (n = 11) and the rate of reoperation for symptomatic adjacent segment disease was 2% (n = 4). Complications included reoperation at index level for symptomatic pseudoarthrosis with hardware failure (n = 3); surgical site infection (n = 7); repair of cerebrospinal fluid leak (n = 1), and one patient death at home 3 days after discharge.
CONCLUSION: Lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory LBP with or without leg pain.

PMID: 26692696 [PubMed]

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Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis.

Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis.

Eur Arch Otorhinolaryngol. 2015 Dec 21;

Authors: Pitiot V, Hermann R, Tringali S, Dubreuil C, Truy E

Abstract
The objective of the study was to report audiological results in revision stapes surgery, comparing hydroxyapatite (HAP) bone cement, malleovestibular (MV) prosthesis, and total ossicular replacement prosthesis (TORP). The study is a retrospective case review conducted in a tertiary referral center. Patients treated for revision stapes surgery from 2010 to 2014, where a lysis of the long process of the incus (LPI) was observed with the use of HAP bone cement, MV prosthesis, or a TORP were included in the study. The main outcomes measured were pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz), including high frequencies BC (HFBC) (1, 2, 3, 4 kHz) and air-bone gap (ABG). 107 revision stapes surgery were performed in 96 ears. Main cause of failure was LPI lysis in 38 cases (39.6 %). 31 patients were analyzed: HAP bone cement was used in 11 patients (Group I), MV prosthesis in ten patients (Group II), and TORP in ten patients (Group III). The mean post-operative ABG was 10.7 dB (±7.4) (p = 0.003), 10.7 dB (±8.8) (p = 0.001), and 16.9 dB (±9.8) (p = 0.001), respectively. There were no significant differences between groups. In Group I, the mean change in HFBC revealed an improvement of 5.6 dB (±7.9) (p = 0.03), while in Group III there was a significant deterioration of the thresholds of 5.8 dB (±7.6) (p = 0.04). There were no cases of post-operative anacusis. In revision stapes surgery when LPI is eroded, we recommend to perform a cement ossiculoplasty for stabilizing a standard Teflon piston when LPI is still usable, the LPI lengthening with cement being not recommended. When LPI is too eroded, we prefer performing a malleovestibulopexy, and reserve TORP for cases with a bad anatomical presentation.

PMID: 26690574 [PubMed - as supplied by publisher]

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