Master Techniques in Otolaryngology - Head and Neck Surgery: Skull Base Surgery

464 Pages·2014·34.144 MB·English

by  Carl Snyderman, Paul Gardner

(c) 2015 Wolters Kluwer. All Rights Reserved.
MASTER TECHNIQUES IN OTOLARYNGOLOGY
Head and Neck Surgery
SKULL BASE SURGERY
(c) 2015 Wolters Kluwer. All Rights Reserved.
MASTER TECHNIQUES IN OTOLARYNGOLOGY
Head and Neck Surgery
SKULL BASE SURGERY
Series Editor
Eugene N. Myers, MD, FACS, FRCS Edin (Hon)
Distinguished Professor Emeritus
Department of Otolaryngology
University of Pittsburgh School of Medicine
Professor
Department of Oral Maxillofacial Surgery
University of Pittsburgh School of Dental Medicine
Pittsburgh, Pennsylvania
Editors
Carl H. Snyderman, MD, MBA
Professor
Departments of Otolaryngology and Neurological Surgery
University of Pittsburgh School of Medicine
Co-Director
Center for Cranial Base Surgery
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Paul A. Gardner, MD
Associate Professor
Department of Neurological Surgery
University of Pittsburgh School of Medicine
Co-Director
Center for Cranial Base Surgery
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
(c) 2015 Wolters Kluwer. All Rights Reserved.
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Library of Congress Cataloging-in-Publication Data
Head and neck surgery. Skull base surgery / [edited by] Carl H. Snyderman, Paul Gardner. — First edition.
p. ; cm. — (Master techniques in otolaryngology)
Skull base surgery
Includes index.
ISBN 978-1-4511-7362-8
I. Snyderman, Carl H., editor of compilation. II. Gardner, Paul A. (Paul Andrew), 1973- editor of compilation. III. Title: Skull base
surgery. IV. Series: Master techniques in otolaryngology.
[DNLM: 1. Skull Base—surgery. 2. Craniotomy—methods. 3. Reconstructive Surgical Procedures—methods. WE 705]
RD529
617.5’14—dc23
2014004151
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors,
editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book
and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication.
Application of the information in a particular situation remains the professional responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accor-
dance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government
regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert
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0002121451.INDD 4 8/26/2014 12:10:15 PM
This volume on skull base surgery is dedicated to the visionary pioneers who had
the courage, creativity, and dedication to patients to tackle the problems of the skull base,
and to the next generation of skull base surgeons who will continue the cycle of innovation.
We are especially indebted to Dr. Eugene N. Myers (series editor) for his unflagging support
and mentorship and to Mary Jo Tutchko for her tireless efforts on our behalf. None of this
would have been possible without their selfless dedication.
(c) 2015 Wolters Kluwer. All Rights Reserved.
0002121451.INDD 5 8/26/2014 12:10:15 PM
Contributors
Vijay K. Anand, MD Franco DeMonte, MD Richard J. Harvey, MD
Clinical Professor Professor Associate Professor and Program Head
Department of Otolaryngology and Head Departments of Neurosurgery and Head Department of Rhinology and Skull Base
and Neck Surgery and Neck Surgery UNSW and Macquarie University
Weill Cornell Medical College The University of Texas M.D. Anderson Associate Professor
Attending Surgeon Cancer Center Departments of Otolaryngology/Skull
Department of Otolaryngology and Head Houston, Texas Base Surgery
and Neck Surgery St. Vincent’s Hospital
New York Presbyterian Hospital—Weill Richard G. Ellenbogen, MD, FACS Darlinghurst, New South Wales, Australia
Cornell Medical Center Professor and Chairman
Peter H. Hwang, MD
New York, New York Theodore S. Roberts Endowed Chair
Professor
Department of Neurological Surgery
Pete S. Batra, MD, FACS University of Washington School of Department of Otolaryngology-Head and
Neck Surgery
Stanton A. Friedberg, MD, Professor and Medicine
Stanford University School of Medicine
Chairman Seattle, Washington
Chief
Co-Director, Rush Center for Skull Base
and Pituitary Surgery Giorgio Frank, MD Division of Rhinology and Endoscopic
Skull Base Surgery
Department of Otorhinolaryngology—Head Department of Neurosurgery
Stanford University Medical Center
and Neck Surgery Center for Pituitary Surgery and Endoscopic
Stanford, California
Rush University Medical Center Surgery of the Anterior Skull Base
Chicago, Illinois Hospital Bellaria Daniel F. Kelly, MD
Bologna, Italy Professor of Neurosurgery
Roy R. Casiano, MD
Director
Professor and Vice Chairman Paul A. Gardner, MD
Brain Tumor Center and Pituitary
Rhinology and Endoscopic Skull Base Associate Professor
Disorders Program
Program Department of Neurological Surgery
John Wayne Cancer Institute Providence
Department of Otolaryngology, Head and University of Pittsburgh School of Medicine
Saint John’s Health Center
Neck Surgery Co-Director
Santa Monica, California
University of Miami, Miller School of Center for Cranial Base Surgery
Medicine University of Pittsburgh Medical Center Dennis Kraus, MD
Miami, Florida Pittsburgh, Pennsylvania Director
New York Head and Neck Institute
Paolo Castelnuovo, MD Ziv Gil, MD, PhD
NSLIJ—Lenox Hill Hospital
Professor Associate Professor New York, New York
Department of Biotechnology and Life The Clinical Research Institute at Rambam
Ali F. Krisht, MD
Sciences Rappaport School of Medicine
University of Insubria, Varese The Technion Israel Institute of Director
Chief Technology Arkansas Neuroscience Institute
Department of Otorhinolaryngology Chairman St. Vincent Infirmary
Ospedale di Circolo Fondazione Macchi Department of Otolaryngology, Head and Little Rock, Arkansas
Varese, Italy Neck Surgery Kurt Laedrach, MD, DMD
Rambam Healthcare Campus Medical Director
William T. Couldwell, MD, PhD
Haifa, Israel Department for Craniomaxillofacial Surgery
Jospeh J. Yager Professor and Chairman
University Hospital of Bern
Department of Neurosurgery Atul Goel, MCh
Bern, Switzerland
University of Utah School of Medicine Professor and Head
Salt Lake City, Utah Department of Neurosurgery Edward R. Laws, Jr., MD, FACS
King Edward Memorial Hospital and Seth Professor
Johnny B. Delashaw, MD G.S. Medical College Department of Neurosurgery
The Ben and Catherine Ivy Center for Mumbai, India Harvard Medical School
Advanced Brain Tumor Treatment Professor
Department of Neurosurgery Chester F. Griffiths, MD Department of Neurosurgery
Swedish Medical Center Pacific Eye and Ear Specialists Brigham and Women’s Hospital
Seattle, Washington Los Angeles, California Boston, Massachusetts
vii
(c) 2015 Wolters Kluwer. All Rights Reserved.
John P. Leonetti, MD Theodore H. Schwartz, MD, FACS Mark A. Varvares, MD
Professor and Vice Chairman Professor Professor and Donald and Marlene
Department of Otolaryngology Departments of Neurosurgery, Endowed Chair
Loyola University School of Medicine Otolaryngology, Neurology, Department of Otolaryngology, Head and
Director, Cranial Base Tumor Surgery and Neuroscience Neck Surgery
Department of Otolaryngology Weill Cornell Medical College Director
Loyola University School of Medicine Attending Neurosurgeon Saint Louis University Cancer Center
Maywood, Illinois New York Presbyterian Hospital Saint Louis University
New York, New York Chief
Lawrence J. Marentette, MD Department of Otolaryngology, Head and
Chandranath Sen, MD
Professor Neck Surgery
Professor
Departments of Otolaryngology— Saint Louis University Hospital
Department of Neurosurgery
Head and Neck Surgery, Oral and St Louis, Missouri
New York University
Maxillofacial Surgery, and Neurosurgery
Attending Surgeon
University of Michigan Medical School Allan Vescan, MD
Department of Neurosurgery
Medical Director Assistant Professor
New York University-Langone Medical
Departments of Otolaryngology— Department of Otolaryngology—Head and
Center
Head and Neck Surgery, Oral and Neck Surgery
New York, New York
Maxillofacial Surgery, and Neurosurgery University of Toronto
University of Michigan Health System Dharambir S. Sethi, FRCSEd Toronto, Ontario, Canada
Ann Arbor, Michigan Associate Professor, Yong Loo Lin School
of Medicine Ian J. Witterick, MD, MSc
Kris S. Moe, MD National University of Singapore Professor and Chair
Professor Visiting Consultant, Department of Department of Otolaryngology—Head and
Chief, Division of Facial Plastic and Otolaryngology Neck Surgery
Reconstructive Surgery Singapore General Hospital University of Toronto School of
Departments of Otolaryngology/Head and Singapore Medicine
Neck Surgery and Neurological Surgery Chief
University of Washington School of Carl H. Snyderman, MD, MBA Department of Otolaryngology—Head and
Medicine Professor Neck Surgery
Seattle, Washington Departments of Otolaryngology and Mount Sinai Hospital
Neurological Surgery
Toronto, Ontario, Canada
Daniel W. Nuss, MD, FACS University of Pittsburgh School of
George D. Lyons Professor and Chairman Medicine
Peter-John Wormald, MD, FRAC, FCS(SA),
Department of Otolaryngology—Head and Co-Director
FRCS I(Ed), MbChB
Neck Surgery Center for Cranial Base Surgery
Professor and Chair
Professor, Department of Neurosurgery University of Pittsburgh Medical Center
Department of Otolaryngology—Head and
and Neurosciences Center Pittsburgh, Pennsylvania
Neck Surgery
Louisiana State University Health Sciences
C. Arturo Solares, MD, FACS The University of Adelaide
Center
Associate Professor Chairman
New Orleans, Louisiana
Departments of Head and Neck Surgery Department of Otolaryngology—Head and
and Neurosurgery Neck Surgery
Ernesto Pasquini, MD
Co-Director, Center for Skull Base Surgery Queen Elizabeth Hospital
Department of Otolaryngology
Georgia Regents University Adelaide, South Australia, Australia
Center for Pituitary Surgery and Endoscopic
Augusta, Georgia
Surgery of the Anterior Skull Base
Adam M. Zanation, MD
Hospital Bellaria Aldo C. Stamm, MD
Associate Professor
Medical Director Associate Professor
Department of Otolaryngology—Head and
Otolaryngology Unit Department of ENT—Head and Surgery
Neck Surgery
Hospital S. Orsola-Malpighi Federal University of São Paulo
University of North Carolina
Bologna, Italy Head
Chapel Hill, North Carolina
Department of Otolaryngology
Guy J. Petruzzelli, MD, PhD, MBA, FACS Hospital Professor Edmundo Vasconcelos
Professor São Paulo, Brazil Lee A. Zimmer, MD, PhD
Department of Surgery Associate Professor
Head, Neck, and Endocrine Surgery Charles Teo, MBBS, FRACS Department of Otolaryngology—Head and
Mercer School of Medicine Associate Professor Neck Surgery
Physician-in-Chief Department of Neurosurgery University of Cincinnati
Curtis and Elizabeth Anderson Cancer University of New South Wales Director, Rhinology and Anterior Cranial
Institute Director Base Surgery
Vice-President for Oncology Programs Center for Minimally Invasive Neurosurgery University of Cincinnati Medical
Memorial University Medical Center Prince of Wales Private Hospital Center
Savannah, Georgia Randwick, New South Wales, Australia Cincinnati, Ohio
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Preface
Skull base surgery has witnessed several eras of major disruption and innovation. Each transition has been
characterized by a conflict between early adopters and skeptics. Eventually, the excessive enthusiasm of the
early adopters is tempered by increased experience and evidence-based analysis of outcomes. The most recent
example is the dichotomy between external (open) and endonasal (endoscopic) approaches to the skull base.
The adoption of endoscopic techniques over the last decade has been primarily driven by endoscopic surgeons
(rhinologists and pituitary surgeons) as opposed to oncologic head and neck surgeons (traditional skull base
surgeons). This results in a knowledge and skills gap that can only be addressed through greater collaboration
and integrated educational programs.
Skull base surgery is perhaps unique among the surgical specialties as a true model of interdisciplinary
collaboration. The synergy in learning that occurs through collaboration benefits our patients and drives inno-
vation across specialties. This volume on skull base surgery is unique in that it achieves equipoise between
the competitive and complementary fields of open and endoscopic skull base surgery. We have succeeded in
capturing the secrets of expert skull base surgeons from around the world. Overlap in surgical procedures is
intentional and provides an opportunity to compare the benefits and limitations of different approaches and
techniques. The format of the chapters is designed to provide the essential information in an accessible format.
Some of the chapters describe time-tested techniques that every skull base surgeon should master whereas oth-
ers are devoted to the latest endoscopic techniques, still in a period of evolution. We are indebted to the authors
for investing the time to share their invaluable experience in their own words.
We hope that this volume will be the definitive source for skull base surgeons of all types for many years
to come. We would be guilty of hubris not to realize, however, that all knowledge is fleeting, especially in a
field as dynamic as skull base surgery.
Carl H. Snyderman, MD, MBA
Paul A. Gardner, MD
ix
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Contents
Contributors vii 10 Pterional/Orbital–Pterional Craniotomy 103
Preface ix
Ali F. Krisht
PART I: SPHENOID AND PARASELLAR 11 Endonasal Transfrontal Approach to the Anterior
Cranial Base 115
REGIONS 1
Peter-John Wormald
1 Optic Nerve Decompression 1
12 Endonasal Transcribriform Approach to the
Pete S. Batra Anterior Cranial Fossa 123
Paul A. Gardner and Carl H. Snyderman
2 Endonasal Approach to the Sella 7
Dharambir S. Sethi 13 Endonasal Transplanum Approach to the Anterior
Cranial Fossa 131
3 Endoscopic Endonasal Approach to the Sella Theodore H. Schwartz and Vijay K. Anand
for Pituitary Adenomas and Rathke’s Cleft
Cysts 23
14 Endonasal Transorbital Approach to the Anterior
Daniel F. Kelly and Chester F. Griffiths Cranial Fossa 143
Lee A. Zimmer
4 Transcranial Approaches to the Sella, Suprasellar,
and Parasellar Area 37
15 Transorbital Endoscopic Approaches to the
Atul Goel Anterior Cranial Fossa 151
Richard G. Ellenbogen and Kris S. Moe
5 Endoscopic Endonasal Approach to the Medial
Cavernous Sinus 59
16 Supraorbital Keyhole Approach to the Anterior
Charles Teo Cranial Fossa 165
Charles Teo
6 Endonasal Suprasellar Approach 67
Edward R. Laws, Jr. 17 Endonasal Resection of the Anterior Cranial
Base 173
7 Transpterygoid Approach to the Lateral Recess Roy R. Casiano
of the Sphenoid Sinus 73
Paolo Castelnuovo 18 Transcranial Approach for Anterior Craniofacial
Resection 185
8 Transsphenoidal Approach to the Medial Petrous Franco DeMonte
Apex 83
Ian J. Witterick 19 Anterior Craniofacial Resection: Endoscopic
Assisted 197
PART II: ANTERIOR CRANIAL FOSSA 93 Richard J. Harvey and Charles Teo
20 Facial Translocation Approach to the Central
9 Craniotomy for Suprasellar Tumor 93 Cranial Base 209
William T. Couldwell Daniel W. Nuss
xi
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xii Contents
21 Anterior Craniofacial Resection: Midfacial 33 Postauricular Approach to the Infratemporal
Degloving 225 Skull Base 335
Lawrence J. Marentette John P. Leonetti
22 Anterior Craniofacial Resection: Lateral 34 Transorbital Endoscopic Approaches to the
Rhinotomy 231 Middle Cranial Fossa 343
Guy J. Petruzzelli Kris S. Moe and Richard G. Ellenbogen
23 Anterior Craniofacial Resection: Raveh
PART IV: POSTERIOR CRANIAL FOSSA 357
Technique 239
Kurt Laedrach
35 Endoscopic Endonasal Pituitary Transposition
24 Cranialization of the Frontal Sinus 251 Approach to the Superior Clivus 357
Dennis Kraus Paul A. Gardner and Carl H. Snyderman
25 Frontal Sinus Osteoplastic Flap with and without 36 Transclival Approach to the Middle and Lower
Obliteration 259 Clivus 365
Peter H. Hwang Paul A. Gardner and Carl H. Snyderman
37 Endoscopic Endonasal Approach to the
PART III: MIDDLE CRANIAL FOSSA 267
Craniocervical Junction and Odontoid 373
Carl H. Snyderman and Paul A. Gardner
26 Suprapetrous Approach to the Lateral Cavernous
Sinus 267 38 Combined Supra- and Infratentorial Presigmoid
Retrolabyrinthine Transpetrosal Approach 381
Giorgio Frank and Ernesto Pasquini
Chandranath Sen
27 Suprapetrous Approach to Meckel’s Cave and
the Middle Cranial Fossa 277 39 Far Lateral Transcervical Approach to the Lower
Clivus and Upper Cervical Spine 391
Paul A. Gardner and Carl H. Snyderman
William T. Couldwell
28 Infrapetrous Approach to the Jugular
Foramen 285
PART V: RECONSTRUCTION 401
Paul A. Gardner and Carl H. Snyderman
29 Surgery for Angiofibroma 293 40 Nonvascularized Repair of Small Dural
Defects 401
Aldo C. Stamm
Vijay K. Anand and Theodore H. Schwartz
30 Modified Orbitozygomatic Craniotomy 303
41 Nonvascularized Repair of Large Dural
Johnny B. Delashaw
Defects 407
Paolo Castelnuovo
31 Preauricular Approach to the Infratemporal Skull
Base 309
42 Nasoseptal Flap 417
Ziv Gil
Allan Vescan
32 Anterior Transpetrosal Approach to the Middle
Cranial Fossa and Posterior Cranial Fossa 325 43 Middle Turbinate Flap 423
Chandranath Sen C. Arturo Solares
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