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This article, published in the Journal of Neurological Surgery, discusses a case study of a 65-year-old man with a recurrent clival chordoma. Despite previous surgery and radiotherapy, the tumor had progressed significantly. The article presents a video demonstrating the use of an expanded endoscopic transpterygoid transcavernous approach for tumor resection. Skull base reconstruction was performed using a temporoparietal fascia flap. The article provides valuable insights for researchers and medical professionals studying chordoma treatment options. [Extracted from the article]

This article discusses the use of bedside skull X-rays and high fraction inspired oxygen (FIO2) therapy for monitoring and treating postoperative pneumocephalus in patients undergoing expanded endoscopic endonasal surgery (EEA) for skull base tumors. The study found that bedside skull X-rays were effective in monitoring pneumocephalus and identifying cases of worsening pneumocephalus due to over drainage. Additionally, high FIO2 therapy was shown to accelerate the resorption of trapped air in the intracranial cavity. The use of bedside X-rays reduced the need for CT scans, resulting in cost savings and reduced radiation exposure. [Extracted from the article]

This article discusses a surgical technique called the Otomimix technique for repairing cerebrospinal fluid (CSF) leaks after middle cranial fossa craniotomy. CSF leaks from the floor of the middle cranial fossa can cause symptoms such as ear fullness and hearing loss. The Otomimix technique involves a middle fossa craniotomy, removal of the encephalocoele, placement of Gelfoam and Otomimix to close the leak, and the use of Duragen and tenting sutures for dural repair. The article reports that this technique has been successful in closing CSF leaks with no recurrence in patients who underwent follow-up. The authors note that while other surgical techniques exist, the Otomimix technique has shown 100% efficacy in treating CSF leaks. [Extracted from the article]

This article discusses the safety of vidian neurectomy, a surgical procedure that involves removing the vidian nerve, during endoscopic endonasal skull base surgery. The objective of the study was to determine the incidence of symptomatic dry eyes (Keratoconjunctivitis Sicca or KCS) in patients who underwent vidian neurectomy. The study reviewed the cases of 13 patients who underwent the procedure and found that none of them reported symptomatic dry eyes at follow-up visits. The authors concluded that vidian neurectomy is well-tolerated and does not lead to KCS symptoms in patients. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, examines the diagnostic accuracy of beta-2 transferrin gel electrophoresis (B2Tf GE) in detecting cerebrospinal fluid (CSF) rhinorrhea. The study conducted a retrospective review of patients who presented with unilateral thin clear rhinorrhea (UTCR) and underwent B2Tf GE. The results showed that B2Tf GE had a sensitivity of 87.5%, specificity of 76.9%, positive predictive value of 77.8%, and negative predictive value of 87% in detecting CSF rhinorrhea. However, the study also highlighted the potential limitations of B2Tf GE and suggested considering other diagnostic tests in cases where B2Tf GE results deviate from clinical suspicion. [Extracted from the article]

Background  Numerous methods have been described to repair nasal cerebrospinal fluid (CSF) leaks. Most studies have focused on optimizing CSF leak repair success, leading to closure rates of 90 to 95%. Objective  This study aimed to determine if excellent reconstruction rates could be achieved without using sinonasal packing. Methods  A prospective case series of 73 consecutive patients with various CSF leak etiologies and skull base defects was conducted to evaluate reconstruction success without sinonasal packing. The primary outcome measure was postoperative CSF leak. Secondary outcome measures were postoperative epistaxis requiring intervention in operating room or emergency department, infectious sinusitis, and 22-item sinonasal outcome test (SNOT-22) changes. Results  Mean age was 54.5 years and 64% were female. Multilayered reconstructions were performed in 55.3% of cases, with collagen or bone epidural inlay grafts, and nasal mucosal grafts or nasoseptal flaps for onlay layers. Onlay-only reconstructions with mucosal grafts or nasoseptal flaps were performed in 44.7% of cases. Tissue sealants were used in all cases, and lumbar drains were used in 40.8% of cases. There were two initial failures (97.4% initial success), but both resolved with lumbar drains alone (no revision surgeries). There were no instances of postoperative epistaxis requiring intervention in the operating room or emergency department. Infectious sinusitis occurred in 2.7% of patients in the first 3 months postoperatively. SNOT-22 did not change significantly from preoperatively to first postoperative visits, then improved over time. Conclusion  Nasal CSF leaks from various etiologies and defect sites were successfully repaired without using sinonasal packing, and patients experienced minimal sinonasal morbidity. [ABSTRACT FROM AUTHOR]