December 1, 2007 Renata C. Di Francesco, MD, PhD, Perboyre Lacerda Sampaio, MD, PhD, and Ricardo Ferreira Bento, MD, PhD
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Abstract
We conducted a comparison study to determine if the development of otitis media in adults is correlated with craniofacial morphology. Our study population was made up of 66 adults, aged 18 to 40 years; 32 of these patients had otitis media and 34 did not. All subjects underwent a complete otolaryngologic examination, video-otoscopy, fiberoptic nasal endoscopy, and lateral cephalometry. Statistical analysis of the cephalometric measurements in the otitis media group and the control group revealed significant differences in the angle between the anterior skull base and medial skull base, upper facial height, and anterior facial height. Also, some significant differences were seen between the measurements in the otitis media group and the normal dimensions of the harmonic face as reported in the literature; these differences were seen in the length of the anterior skull base, the angle of cranial deflection, the depth of the maxilla, the angle of the mandibular plane, the angle of facial depth, the angle of the facial cone, and lower facial height. Not all of these significant differences, however, were predictive of the evolution of otitis media. Based on our analysis, we conclude that four cephalometric measurements are predictive of the evolution of otitis media: (1) the length of the anterior skull base, (2) the angle between the anterior skull base and medial skull base, (3) maxillary depth, and (4) upper facial height. No correlations were found between otitis media and nasal blockage or between otitis media and facial type.
August 31, 2007 Omar F. Husein, MD; Abraham Jacob, MD; Douglas D. Massick, MD; D. Bradley Welling, MD, PhD
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Abstract
Extramedullary plasmacytoma involving the skull base is rare. We describe what we believe is the first reported case of recurrent multiple myeloma presenting as an isolated lesion in the central skull base in a patient with no evidence of systemic involvement. We discuss the patient's presentation, clinical course, and treatment, and we review the relevant scientific literature.
May 31, 2007 Marc A. Cohen, MD; Noam A. Cohen, MD, PhD; Gul Moonis, MD; David W. Kennedy, MD
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Abstract
Arachnoid cysts are benign intracranial lesions that are typically diagnosed incidentally. We describe the case of a 56-year-old man who presented with a multiloculated arachnoid cyst of the middle cranial fossa that extended into the sphenoid sinus. The lesion was identified on computed tomography of the head, which had been obtained for an unrelated investigation. However, establishing a definitive diagnosis proved to be difficult. Because the cyst had caused extensive skull base erosion, the patient was managed conservatively with close observation. We report the radiographic progression of this lesion during more than a decade of follow-up, and we review the literature pertaining to the presentation, pathophysiology, and treatment of arachnoid cysts.
March 1, 2007 Eric P. Wilkinson, MD; Robert A. Robinson, MD, PhD; Douglas K. Trask, MD, PhD
May 31, 2005 Jason S. Hamilton, MD; Sean Jones-Quaidoo, MD; Ryan F. Osborne, MD
April 30, 2005 Amin B. Kassam, MD; Atul Patel, MD; William Welch, MD; Jeffrey Balzer, PhD; Carl Snyderman, MD; Barry Hirsch, MD; Ricardo Carrau, MD
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Abstract
We describe a unique method of accessing the ventromedial skull base and lower craniocervical junction. Our method employs a trajectory between that of the more anterior transoral or retropharyngeal approaches and the various posterior or posterolateral skull base approaches. This "extended" lateral approach allows surgeons to resect very large tumors of the skull base through a single incision. The operative field is more extensive than that achieved with other approaches; it extends from the cerebellar hemisphere to the extradural ventral upper cervical spine, and it provides access to tissue outside the spinal canal, such as the ventral strap muscles. We describe our use of this approach during a single-stage resection of a large hemangiopericytoma in a 37-year-old man.
January 1, 2005 Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
