Molecular and genetic nature of skull base tumours drives management

This article reviews the molecular basis and paradigm shift in the diagnosis and management of skull base tumours. It is now known that the phenotype of meningiomas is influenced by their genotype. Endolymphatic sac tumours are observed in up to...

QoL post-endoscopic hypophysectomy

This prospective study conducted over four years surveyed more than 300 patients after endoscopic pituitary adenoma resection. The authors used the Anterior Skull Base Questionnaire-35 and the Sinonasal Outcome Test-22, and the scores were analysed for quality of life (QoL)...

Are there any benefits of postoperative antibiotics after endoscopic transsphenoidal surgery for pituitary tumours?

This prospective randomised double-blind multicentre study evaluated whether postoperative antibiotics resulted in improvement in sinonasal quality of life (QoL) compared to placebo in patients undergoing endoscopic endonasal transsphenoidal pituitary surgery. A total of 461 patients were screened for the study...

Which factors affect the postoperative CSF leak following endoscopic skull base surgery?

Endoscopic skull base surgery is being increasingly performed worldwide for skull base tumours. Common indications include pituitary tumours, rathke cleft cysts, chordomas, craniopharyngiomas and olfactory neuroblastomas. The most common and important complication following endoscopic skull base surgery is postoperative CSF...

Treatment of internal carotid artery blowout with embolisation and bypass grafting (nasopharyngeal carcinoma)

Carotid artery blowout syndrome (CBS) occurs when there is rupture of the carotid artery causing massive epistaxis and bleeding through the oral cavity caused by tumour invasion, surgery, radiotherapy, or infection. This article proposes a revascularisation strategy for internal carotid...

Does Koos classification predict facial nerve dysfunction?

The Koos classification is a grading system used often for preoperative evaluation of acoustic tumours on imaging studies. It indirectly correlates to the size of the tumour. Size of the vestibular schwannoma is often considered the main determinant for hearing...

Canal wall up mastoid defects - can they be usefully reconstructed with hydroxyapatite cranioplastic cement?

Standard canal wall up (CWU) mastoid surgery leaves a mastoid defect of varying size, commonly covered by soft tissue. Rarely, this bony defect can cause discomfort, cosmetic issues or other problems. To mitigate these, the defect can be filled either...

Long-term curative effects of microvascular decompression for hemifacial spasm

This article describes results of a multicentre prospective trial performed to evaluate long- and short-term outcomes and complications of patients who underwent microvascular decompression (MVD) for hemifacial spasm (HFS). The surgeries were performed by surgeons with more than 15 years...

Lateral skull base surgery using the endoscope

Endoscopic lateral skull base surgery could be performed via less invasive techniques due to wide panoramic visualisation of the operative field. With less invasive techniques, patients have been shown to require shorter recovery time and reduced postoperative pain. In this...

Review of pituitary tumour pathology

This is an excellent review article covering the pathology of pituitary adenomas (PA) as well as rare sellar lesions like lymphocytic hypophysitis that require aggressive treatment. The authors have preserved the 2017 World Health Organization (WHO) classification of PA and...

The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

Predictors of diabetes insipidus post-hypophysectomy

Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...