Vascular Challenges In Skull Base Surgery

The essential multidisciplinary guide for the prevention and management of vascular injury from master skull base surgeons Vascular injury is the most significant source of morbidity or mortality during skull base surgery, regardless of the surgical approach. While skull base approaches always placed arteries and veins at risk, newer endoscopic endonasal approaches have introduced new challenges for the prevention and management of vascular injury. Greater anatomic knowledge, additional surgical options, improved instrumentation, advances in interventional neuroradiology, and enhanced training all contribute to successful outcomes. Vascular Challenges in Skull Base Surgery by renowned skull base experts Paul Gardner, Carl Snyderman, Brian Jankowitz, and distinguished contributors, fills a gap in the literature, with invaluable guidance on managing rare but potentially catastrophic surgical complications. The full range of surgical approaches to the anterior, middle, and posterior cranial fossae are covered in 22 chapters. Diverse topics encompass open and endoscopic endonasal surgical approaches, endovascular techniques including balloon test occlusion and embolization, and standard and alternative bypass procedures. The last three chapters discuss venous considerations, neurophysiologic monitoring, and the role of training and simulation in vascular injury prevention. Key learning points, illustrated discussion of relevant anatomy, and tips and tricks are targeted at helping skull base surgeons leverage practical strategies to improve patient outcomes. Key Highlights An impressive group of expert, highly-experienced surgeons share firsthand knowledge Insightful analyses of root causes and clinical pearls provide indispensable prevention tactics High-quality images and videos enhance visual understanding of surgical anatomy and techniques Trainees and practicing skull base surgeons will greatly benefit from the collective knowledge and evidence-based injury avoidance strategies shared by authors who have learned to master the art of skull base surgery.

State-of-the-art approaches and insightful discussions on challenging topics in skull base surgery Advances in endoscopic, microsurgical, radiosurgical, and pharmacotherapeutic strategies have revolutionized the treatment of skull base pathologies. Controversies in Skull Base Surgery, edited by Andrew Little and Michael Mooney and authored by esteemed multidisciplinary contributors, focuses on management strategies and treatment options for a wide range of tumors affecting the skull base, while addressing the most urgent and challenging questions facing skull base surgeons today. Throughout nine sections and 46 chapters, experts describe the treatment of neoplasms such as vestibular schwannoma, meningioma, pituitary adenoma, craniopharyngioma, chordoma, cranial nerve schwannoma, sinonasal malignancies, and others. In many chapters, authors provide instructional case studies and suggestions for future studies to help clarify areas of controversy. This textbook is unique in that it tackles problems typically minimized or ignored by other texts that impact a patient's quality of life and recovery. Key Highlights Reader-friendly tables feature concise summaries, author pearls, and levels of available evidence Pearls and insights on hotly debated issues such as the role of radiosurgery, surgery vs. medical management, radical resection vs. subtotal resection, and proton-beam vs. photon therapy for various pathologic conditions Controversies not frequently discussed in depth, including the use of lumbar drains, postoperative antibiotics, and cerebral revascularization in skull base surgery; multidisciplinary collaboration in endoscopic endonasal surgery; skull base reconstruction techniques; and the future of robotics in skull base surgery This stellar resource will benefit all residents and advanced practice providers who evaluate and treat patients with skull base pathologies, including neurosurgeons, otolaryngologists, and radiation and medical oncologists.

State-of-the-art approaches and insightful discussions on challenging topics in skull base surgery Advances in endoscopic, microsurgical, radiosurgical, and pharmacotherapeutic strategies have revolutionized the treatment of skull base pathologies. Controversies in Skull Base Surgery, edited by Andrew Little and Michael Mooney and authored by esteemed multidisciplinary contributors, focuses on management strategies and treatment options for a wide range of tumors affecting the skull base, while addressing the most urgent and challenging questions facing skull base surgeons today. Throughout nine sections and 46 chapters, experts describe the treatment of neoplasms such as vestibular schwannoma, meningioma, pituitary adenoma, craniopharyngioma, chordoma, cranial nerve schwannoma, sinonasal malignancies, and others. In many chapters, authors provide instructional case studies and suggestions for future studies to help clarify areas of controversy. This textbook is unique in that it tackles problems typically minimized or ignored by other texts that impact a patient's quality of life and recovery. Key Highlights Reader-friendly tables feature concise summaries, author pearls, and levels of available evidence Pearls and insights on hotly debated issues such as the role of radiosurgery, surgery vs. medical management, radical resection vs. subtotal resection, and proton-beam vs. photon therapy for various pathologic conditions Controversies not frequently discussed in depth, including the use of lumbar drains, postoperative antibiotics, and cerebral revascularization in skull base surgery; multidisciplinary collaboration in endoscopic endonasal surgery; skull base reconstruction techniques; and the future of robotics in skull base surgery This stellar resource will benefit all residents and advanced practice providers who evaluate and treat patients with skull base pathologies, including neurosurgeons, otolaryngologists, and radiation and medical oncologists.

This text is designed to function as a comprehensive guide/companion that will not only facilitate the decision-making process for the surgeon, but also help young surgeons build a successful career in skull base surgery. It is divided into six main sections: The first section details the general principles that every skull base surgeon needs to be acquainted with - skull base anatomy, developing a multidisciplinary skull base team, operating room equipment, surgical instruments, and modern imaging technologies. These are the key elements that play a major role in optimizing functional outcomes and patients’ quality of life. Following this, the compartmental anatomy chapters set the stage for understanding the technical and surgical nuances of each location. The subsequent five sections are organized as anatomical compartments or regions of the skull base. Every region is organized in the same format for uniformity and ease of use. Each section includes the available treatment choices to each compartment, and describes the relevant pathologies. The contribution of worldwide leaders including neurosurgeons and otolaryngologists provides top-level expertise in how to tackle each pathology. The surgical approaches chapters that lead each anatomical section describe operative techniques in a clear. stepwise fashion with accompanying intra-operative photos and surgical videos. In the individual pathology chapters, different pathological subtypes are described with representative radiographic images of clinical case examples. Accompanying each pathology is a treatment algorithm based on tumor morphology, pre-operative clinical status, and the goal of maximum functional preservation with a brief description of surgical approaches. This will serve as a roadmap that will help the reader to easily reach a decision of how to treat each skull base pathology. The general theme is functional and anatomical preservation of key neurovascular structures. Setting such structures as a target and planning an approach that minimizes iatrogenic damage to these structures will lead the surgeon down the road of either open, endoscopic, or a combination of both approaches. A comprehensive book that is versatile to serve as a handbook as well as a detailed reference for skull base surgery does not currently exist. In addition, combining the two main surgical schools represented by endoscopy and open surgery into one reference enhanced by treatment algorithms is another unique feature.

Unique skull-base surgical resource features strategic, technical, and philosophical pearls from master surgeons In a sense, surgeons go into battle every time they enter the OR. Like soldiers, they must be prepared to make profound sacrifices to protect innocent people (their patients), while putting egos aside and resisting the call of fame. Skull Base Surgery: Strategies by Walter Jean and distinguished contributors provides eloquent expression to the inner voices that speak to surgeons during each stage of battle. Unlike other textbooks that only emphasize the technical building blocks surgeons need, this resource focuses on state-of-the-art skull-base procedures, important thought processes, and vital strategies required to perform them. Size and shape variations, diverse biological characteristics, different anatomic locations and extensions, and specific relationships and entanglements with nerves and vessels make all skull base tumors unique and highly challenging. In addition to anatomy, two other important factors need to be considered every time a surgeon enters the OR - the particular circumstances of the patient and surgeon. Throughout this remarkable book, master neurosurgeons take readers on an insightful journey exploring the decision-making process of choosing and executing a surgical approach, with firsthand pearls from the battlefield. Key Highlights Nine sections organized by anatomy cover tumors in the anterior, anterolateral, lateral, central, postero-superior, and postero-inferior skull base regions, and clivus, petrous bone, and ventricles Thirty-two systematically organized chapters flow from clinical presentation and radiographic/anatomical findings of specific patients and tumors - to decision-making and execution of the surgical approach Real-life cases enhance understanding of all the elements that go into each operation Perspectives sections at the end of each chapter embrace the concept of diverse surgeon viewpoints on similar ideas, techniques, and approaches This exemplary book is essential reading for neurosurgery and otolaryngology residents, fellows, veteran practitioners, and allied health personnel who care for patients with skull base tumors. This book includes complimentary access to a digital copy on https://medone.thieme.com.

Handbook of Skull Base Surgery is a state-of-the-art surgical guide that provides clinicians and surgeons with step-by-step instructions on how to perform microscopic and endoscopic procedures. Encompassing the entire skull base, this handbook is designed for busy residents and clinicians seeking to hone their surgical skills. It presents a multidisciplinary approach to the pathologies, diagnosis, and management of skull base lesions. Key Features: Bulleted format with step-by-step descriptions of procedures accompanied by high-quality illustrations of key points Succinct summaries of content enable readers to quickly obtain the information they need Includes coverage of relevant basic sciences, advanced imaging, and adjunctive treatments such as radiosurgery and chemotherapy Comprehensive yet conveniently compact, this book is a must-have reference for residents, clinicians, nurses and researchers caring for patients with skull base pathologies.

This issue of the Neurosurgery Clinics, Malignant Tumors of the Skull Base, is Guest Edited by Drs. Orin Bloch and Franco DeMonte. Malignant tumors of the skull base pose significant challenges to the clinician, because of their proximity to critical neurovascular structures. This issue will explore various approaches to the removal of malignant tumors of the skull base, including open surgical approaches and minimally invasive approaches. Other articles in this issue include topics such as craniofacial reconstruction following oncologic resection, temporal bone malignancies, sinonasal carcinomas, and radiotherapy for malignant skull base tumors.

Tumors of the skull base continue to challenge surgeons; even in an era of groundbreaking technological advances there is no substitute for an in-depth knowledge of anatomy to achieve surgical success. This important new book serves two functions: it gives an exceptionally clear picture of the microsurgical anatomy of the cavernous sinus & surrounding areas, & it describes actual surgical approaches to the area.