A Modified Endoscopic Draf <scp>III</scp> Approach in the Non‐Pneumatized Frontal Bone for Dermoid Cysts

Yang, Nathan; Feldstein, Neil A.; Gudis, David A.

doi:10.1002/lary.30091

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…In these cases, endoscopy can be very helpful at reducing the morbidity of anterior skull base surgery via either endoscopic endonasal approaches or endoscopic‐assisted open approaches. Endoscopy‐assisted endonasal and open approaches are being utilized with increasing frequency for resection of dermoids with suspected intracranial involvement and can allow for conservative, small window craniotomies of the skull base without necessitating traditional bifrontal craniotomies 18,19 . An additional advantage of endoscopic‐assisted approaches is the ability to utilize image‐guided navigation for safe and complete resection of lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopy-assisted endonasal and open approaches are being utilized with increasing frequency for resection of dermoids with suspected intracranial involvement and can allow for conservative, small window craniotomies of the skull base without necessitating traditional bifrontal craniotomies. 18,19 An additional advantage of endoscopic-assisted approaches is the ability to utilize image-guided navigation for safe and complete resection of lesions. At our institution, we have increasingly utilized endoscopy-assisted open approaches and have noted greatly enhanced visualization and surgical access with improved cosmetic outcomes (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Imaging and Surgical Findings in Pediatric Frontonasal Dermoids

Amin,

Siu,

Purcell

et al. 2023

The Laryngoscope

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ObjectiveTo review cases of congenital frontonasal dermoids to gain insight into the accuracy of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) in predicting intracranial extension.MethodsThis retrospective study included all patients who underwent primary excision of frontonasal dermoids at an academic children's hospital over a 23‐year period. Preoperative presentation, imaging, and operative findings were reviewed. Receiver operating characteristic (ROC) statistics were generated to determine CT and MRI accuracy in detecting intracranial extension.ResultsSearch queries yielded 129 patients who underwent surgical removal of frontonasal dermoids over the study period with an average age of presentation of 12 months. Preoperative imaging was performed on 122 patients, with 19 patients receiving both CT and MRI. CT and MRI were concordant in the prediction of intracranial extension in 18 out of 19 patients. Intraoperatively, intracranial extension requiring craniotomy was seen in 11 patients (8.5%). CT was 87.5% sensitive and 97.4% specific for predicting intracranial extension with an ROC of 0.925 (95% CI [0.801, 1]), whereas MRI was 60.0% sensitive and 97.8% specific with an ROC of 0.789 (95% CI [0.627, 0.950]).ConclusionThis is the largest case series in the literature describing a single institution's experience with frontonasal dermoids. Intracranial extension is rare and few patients required craniotomy in our series. CT and MRI have comparable accuracy at detecting intracranial extension. Single‐modality imaging is recommended preoperatively in the absence of other clinical indications.Level of EvidenceIV Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative Imaging and Surgical Findings in Pediatric Frontonasal Dermoids

Amin,

Siu,

Purcell

et al. 2023

The Laryngoscope

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“…While some authors have suggested that the endoscopic endonasal approach may be limited in neonates or younger infants due to narrow nasal cavities, this specific challenge may be partially overcome by using smaller instruments such as endoscopic otologic instruments which have been used successfully for complex pediatric endoscopic skull base cases. 7 Furthermore, there are several reports of basal meningoceles and encephaloceles repairs in the pediatric population using an endoscopic endonasal approach alone. [16][17][18].…”

Section: Limitationsmentioning

confidence: 99%

“…To overcome the small size of the pediatric nose, the nasal turbinates were outfractured, and otologic instruments, including a Beaver blade and a suction Rosen round knife, were used to elevate a right nasoseptal flap pedicled on the posterior septal branch of the sphenopalatine artery. 7 A subperichondrial and subperiosteal plane was developed to raise the nasoseptal flap. The flap was then tucked through the cleft palate into the oral cavity.…”

Section: Surgical Techniquementioning

confidence: 99%

Combined Endoscopic Endonasal and Transpalatal Repair of Congenital Anterior Cranial Fossa Agenesis

Yang

Feldstein

Gudis

2023

Operative Neurosurgery

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BACKGROUND:Congenital basal meningoceles and encephaloceles are rare pathologies that may present in isolation or with characteristic-associated clinical features. Rarely, children with congenital midline defects may present with massive encephaloceles secondary to anterior cranial fossa agenesis. Traditionally, transcranial approaches with frontal craniotomies were used to reduce the herniated contents and repair the skull base defect. However, high rates of morbidity and mortality associated with craniotomies have favored the development and adoption of less-invasive techniques.OBJECTIVE:To present a novel technique for combined endoscopic endonasal and transpalatal repair of a giant basal meningocele through an extensive sphenoethmoidal skull base defect.METHODS:A representative case of congenital anterior cranial fossa agenesis with a giant meningocele was selected. Clinical and radiological presentations were reviewed, and the intraoperative surgical technique was documented and recorded.RESULTS:A surgical video highlighting each surgical step was included to complement the description of the technique. The surgical outcome from the selected case is also presented.CONCLUSION:This report describes a combined endoscopic endonasal and transpalatal approach to repair an extensive anterior skull base defect with herniation of intracranial content. This technique capitalizes on the advantages of each approach to address this complex pathology.

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A Modified Endoscopic Draf III Approach in the Non‐Pneumatized Frontal Bone for Dermoid Cysts

Cited by 2 publications

References 5 publications

Preoperative Imaging and Surgical Findings in Pediatric Frontonasal Dermoids

Preoperative Imaging and Surgical Findings in Pediatric Frontonasal Dermoids

Combined Endoscopic Endonasal and Transpalatal Repair of Congenital Anterior Cranial Fossa Agenesis

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