From The Lab To The OR

The main theme of the Surgical Neuroanatomy Lab is “From the Lab to the OR” as a reflection of a true translational effort to introduce novel anatomical concepts and innovative surgical technique into real surgical practice. Dr. Fernandez-Miranda and colleagues are defining the intricate skull base and white matter anatomy required to perform gentle, accurate, and safe endoscopic skull base and brain surgery, and have described novel approaches that allow more effective access to previously inaccessible or highly risky areas of the skull base and brain

Case 1
Case 1: This 52-year-old patient presented with difficulty walking and was found to have a tumor at the jugular tubercle region causing severe compression of the brainstem (medulla). The studies in the SNL provided an accurate description of the surgical access to this complex area, and the tumor was successfully removed with no neurological complications.

Case 2
Case 2: A 47-year-old patient presented with numbness and weaknes of her arms and legs. A large foramen magnum meningioma was identfied in imaging studies. An endoscopic endonasal transclival transcondylar approach was effectively applied to completely remove the tumor with full neurological recovery and no surgical complications.

Case 3
Case 3: This 21-year-old patient was diagnosed with a clival chordoma after suffering new onset of double vision. An endoscopic endonasal transclival approach with posterior clinoidectomy was used to achieved gross total resection and recovery of the sixth nerve palsy.

Case 4
Case 4: This is the case of 43-year-old patient with progressive visual loss secondary to a tubercullum sellae meningioma. An endoscopic endonasal trantuberculum approach with bilateral optic canal access was employed to remove all tumor including the intracanalicular portion. Patient's visual function returned to normal.

Case 5
Case 5: This 56-year-old patient presented with severe headaches and was diagnosed with a large non-functioning pituitary adenoma invading the cavernous sinus. An endoscopic endonasal transellar and transcavernous approach with mobilization of the internal carotid artery was performed to achieve near-total resection of this tumor. In the early postoperative period the patient presented mild cranial nerve sixth palsy that was recovered at 3 months follow up.