Base Reconstruction Research Articles

Microsurgical reconstruction of the skull base and midface after orbitomaxillary resections for malignant tumors

Background. Orbitomaxillary resection includes exenteration of the orbital contents with resection of the inferior orbital and medial walls. The main goals are: reconstruction of soft tissue and bone structure defects, tamponade of the orbital cavity and/or its preparation for further ocular prosthetics, and reconstruction of the skull base defect. The purpose of the study to present the immediate results of orbitomaxillary resections in patients with malignant neoplasms of the skull base and midface. Material and methods. Between 2014 and 2020, 6 patients who previously underwent surgery for primary cancer (n=3) and recurrent cancer (n=3) were treated at the Head and Neck cancer department of N.N. Blokhin National medical Research center of oncology. To reconstruct defects after resection of bone structures (maxilla, frontal and nasal bones) and skin, a musculocutaneous alt-flap was used in 3 (50 %) cases and a fascial skin radial flap in 3 (50 %) cases. Results. The aesthetic result was assessed in 6 patients. In all cases, a satisfactory result was obtained. None of the patients who underwent resection of the dura mater followed by reconstruction had no symptoms of liquorrhea in the postoperative period. Conclusion. Flap selection depends on the defect size. In cases with a small defect size (up to 70 cm3), reconstruction with the radial fascial skin flap can be performed. If the defect size is more than 71 cm3, reconstruction with musculocutaneous alt flap can be the method of choice.

ESTESIONEUROBLASTOMA CON INVASIÓN INTRACRANEAL, MANEJO QUIRÚRGICO POR DOBLE ABORDAJE: CRANEOTOMÍA Y CRANEOFACIAL. REPORTE DE CASO

Introduction: Esthesioneuroblastoma, or olfactory neuroblastoma, is a rare malignant neoplasm of the sinonasal tract that originates in the olfactory neuroepithelium with neuroblastic differentiation. It occurs most frequently in the upper nasal cavity. It is a locally aggressive neoplasm and metastasizes both hematogenously and lymphatic. A multimodal approach, which can combine surgery, chemotherapy, and radiotherapy, is essential for the management of these tumors. Clinical Case: A 56-year-old female patient with an 18-month illness, characterized by loss of smell, shortness of breath, and frontal headache. Brain tomography showed an extensive tumor in the nasopharynx with intracranial involvement and destruction of the anterior skull base. She was diagnosed with Esthesioneuroblastoma by endonasal endoscopic biopsy. A combined approach was planned first by Neurosurgery, through a bifrontal craniotomy in which the resection of the intracranial portion and the reconstruction of the skull base were achieved. Then, Head and Neck Surgery perform the resection of the tumor in the nasal cavity through right lateral rhinotomy. The patient evolved favorably in the postoperative period without presenting neurological deficit, so she was discharged in the following days after the removal of the tracheostomy cannula. She subsequently received adjuvant chemotherapy and radiation therapy. Conclusion: In an Esthesioneuroblastoma, obtaining an extensive resection, total, if possible, is a very important factor in the prognosis of a patient, so it is recommended to use the combination of several surgical techniques to achieve this goal. Keywords: Esthesioneuroblastoma, Olfactory, Craniotomy, Nasal Cavity, Skull Base (source: MeSH NLM)

Sinonasal quality of life in patients after an endoscopic endonasal surgery of a sellar tumour

Endoscopic endonasal approach uses the nasal cavity and paranasal sinuses to access the cranial base and may be a source of post-surgical morbidity in many patients with a sellar tumour. The objective of the presented study was to evaluate sinonasal quality of life and assess the effect of chosen reconstruction of the cranial base on the final condition. 65 patients, 33 male and 32 female who underwent an endoscopic endonasal surgery due to sellar expansion, were included into this prospective study. Sinonasal quality of life was evaluated using the Sinonasal Outcome Test-22 (SNOT-22) questionnaire before the surgery and six months after the surgery. Sinonasal quality of life was evaluated for the total cohort of patients and for patients after reconstruction (fascia lata, muscle) and without reconstruction. The minimum follow-up period was one year. There was no significant difference between the score (SNOT-22) before the surgery (average 14.4 points) and after the surgery (average 17.5 points), p = 0.067 in the whole cohort. Statistically significant differences were found in the following items—the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. The comparison of subgroups with and without the reconstruction yielded statistically significant differences in favour of patients with reconstruction in the following items—lack of high-quality sleep and feeling exhaustion. The endoscopic endonasal approach in patients with a sellar tumour is a gentle method with minimal effects on sinonasal quality of life over a period longer than six months. The most common complaints are the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. Cranial base reconstruction using the muscle and fascia lata seems to be a potential factor positively influencing sinonasal quality of life.

Temporo-parietal muscle pedicle flap for reconstruction of the anterior skull base after resection of recurrent olfactory groove meningioma: a technical note

Reconstruction becomes the main issue in surgery for tumours penetrating the anterior skull base because it faces the nasal cavity. Vascularized flaps are desirable for preventing infection, but in re-opening surgery, tissue availability is limited. We report a case of recurrent olfactory groove meningioma in which the anterior skull base defect was reconstructed using a temporo-parietal muscle (TPM) pedicle flap. A 65-year-old woman presented with recurrent olfactory groove meningioma penetrating the anterior skull base. Because the frontal pericranium had been used in the initial surgery, the temporal fascia was harvested with a TPM pedicle flap from behind the initial bicoronal incision. After removal of the tumour, the pedicle flap reached the sphenoid planum easily and was sutured to the surrounding structures. The fascia lata was sutured as an inlay. The postoperative course was uneventful, and no cerebrospinal fluid leakage was observed. In re-opening surgery, a TPM pedicle flap can be an option for reconstruction of the anterior skull base.

Problems of Legal Regulation of Subsoil Use in Modern Russia

The article deals with public relations that affect controversial issues of subsoil use. The relevance of the topic is not in doubt, since article 9, paragraph 1 of the Constitution of the Russian Federation [1] defines that land and other natural resources are used and protected in the Russian Federation as the basis of life and activities of peoples living in the relevant territory. Among natural resources, a special place is occupied by subsoil resources, as they have a large amount of very valuable properties. In the modern Russian economy, the problem of effective subsoil use, which is associated with the need for advanced reconstruction of the mineral resource base and replenishment of strategic mineral reserves, should be one of the most important priorities of Russian state policy.

Incremental learning-based visual tracking with weighted discriminative dictionaries

Existing sparse representation-based visual tracking methods detect the target positions by minimizing the reconstruction error. However, due to complex background, illumination change, and occlusion problems, these methods are difficult to locate the target properly. In this article, we propose a novel visual tracking method based on weighted discriminative dictionaries and a pyramidal feature selection strategy. First, we utilize color features and texture features of the training samples to obtain multiple discriminative dictionaries. Then, we use the position information of those samples to assign weights to the base vectors in dictionaries. For robust visual tracking, we propose a pyramidal sparse feature selection strategy where the weights of base vectors and reconstruction errors in different feature are integrated together to get the best target regions. At the same time, we measure feature reliability to dynamically adjust the weights of different features. In addition, we introduce a scenario-aware mechanism and an incremental dictionary update method based on noise energy analysis. Comparison experiments show that the proposed algorithm outperforms several state-of-the-art methods, and useful quantitative and qualitative analyses are also carried out.

Suitability of Using the Hamate for Reconstruction of the Finger Middle Phalanx Base: An Assessment of Cartilage Thickness.

Osteochondral grafts are indicated for reconstructing the finger middle phalanx base when there is greater than 50% involvement of the articular surface and significant comminution. This study aims to compare the cartilage thickness of the distal surface of the hamate to the finger middle phalanx base to assess its suitability as an osteochondral graft. A 3-dimensional laser scanner and computer modelling techniques were utilized to determine the cartilage thickness of the distal surface of the hamate, and finger middle phalanx base using cadaver specimens. The mean, maximum, and coefficient of variation (CV%; a measure of uniformity of cartilage distribution), as well as cartilage distribution maps were determined. The mean cartilage thickness of the hamate was 0.73 ± 0.08 mm compared to the average mean thickness of the finger middle phalanx base of 0.40 ± 0.12 mm. The maximum cartilage thickness of the hamate was 1.27 ± 0.14 mm compared to the average maximum of the finger middle phalanx base of 0.67 ± 0.14 mm. The CV% of the hamate was 27.8 ± 4.2 compared to the average CV% for the finger middle phalanx base of 26.6 ± 8.1. The hamate and finger middle phalanx base have maximum areas that were most frequently at or spanning the median ridge; however, this was more consistently observed with the hamate. The distal surface of the hamate is a suitable osteochondral graft with respect to cartilage thickness and distribution providing sufficient cartilage for reconstruction of the finger middle phalanx base.

Reconstruction of the anterior skull base with free muscle flap after iatrogenic injury

Reconstruction of the anterior skull base with free muscle flap after iatrogenic injury

The advantages of using auto-fat tissue in the reconstruction of defects of the skull base in patients with CSF leak

Relevance: At present, the method of repair of the cerebrospinal fluid fistula using mucous flaps according to the “overlay” technique is widely used in the reconstruction of the skull base and is generally accepted. We have developed an original method for reconstructing defects of the skull base in the presence of a cerebrospinal fluid fistula, using an auto-fat tissue and placing it in two layers. Objectives: To conduct a comparative assessment of methods for the reconstruction of the skull base defect in patients with CSF leak using endoscopic endonasal approach. Materials and methods: Under our supervision there were 46 patients with CSF leak. Depending on the technique of cerebrospinal fluid fistula repair, all patients were divided into 2 groups. The first group of 20 patients consisted of patients who underwent surgery with auto-fat tissue according to our proposed technique. The second group - 26 patients were patients who underwent repair of the skull base defect using the standard overlay technique - a mucous flap on the feeding vascular pedicle. The criterion for evaluating the effectiveness of surgical treatment was patient complaints and data from objective research methods (endoscopic examination of the nasal cavity). Results: After 3 months after surgical treatment, a patient of group 1 had a recurrence of liquorrhea, patients of group 2 after 3 months had a recurrence of liquorrhea in 3 patients, after 6 months in 2 patients of group 2 there was a recurrence of liquorrhea. Findings: When the size of the bone defect of the base of the skull is up to 0.6 cm, the original technique proposed by us for plastics of the cerebrospinal fluid fistula with an auto-fat tissue in two layers provides a tight closure of the bone defect and the defect of the dura mater. When using this method of plastics, the risk of the development of a recurrence of CSF leak is significantly reduced in comparison with the plastics of the cerebrospinal fluid fistula with the use of overlay grafts.

Systematic Endoscopic Endonasal Approach to Pituitary Adenomas. Reconstruction of Skull Base with Pedicle Mucoperichondrial Flap versus Free Abdominal Fat Graft for Patients with Incidental Rupture of Sellar Diaphragma

Systematic Endoscopic Endonasal Approach to Pituitary Adenomas. Reconstruction of Skull Base with Pedicle Mucoperichondrial Flap versus Free Abdominal Fat Graft for Patients with Incidental Rupture of Sellar Diaphragma

Surgical treatment of lateral skull base lesions and reconstruction of the skull base: a report of 20 cases

Objective: To investigate the surgical treatment and related experience of lateral skull base lesions.Methods: In a retrospective, clinical data analysis of 20 patients with lateral skull base diseases, 11 cases with temporal bone space-occupying lesions and intracranial invasion were treated by translabyrinthine surgery, mastoid cavity drainage, or transmastoid surgery to remove the lesion; two cases of cholesteatoma with destruction of tympanic cavity and tympanic sinus canopy with intracranial invasion were treated by extended radical mastoidectomy; seven cases with lateral skull base bone destruction with cerebrospinal fluid otorrhea caused by trauma and deformity were treated by translabyrinth and transmastoid repair.Results: Eleven cases with temporal bone space occupying lesions were resected completely and were without recurrence after surgery. Two cases with intracranial infection secondary to cholesteatoma were rapidly relieved of symptoms without recurrence after radical mastoidectomy. The remaining seven cases of CSF otorrhea included two cases of Mondini malformation and five cases of temporal bone fracture. The leak was stemmed in all seven cases after surgery.Conclusion: Surgery is the main therapeutic option for the treatment of lateral skull base diseases. The surgical approach and the type of skull base reconstruction should be selected on an individual case-by-case basis.

A case of successful surgical treatment of a heavy penetrating mine blast brain wound

This is an observation of a heavy penetrating fragment mine blast brain wound. A fragment passed through the right and left cerebral hemispheres, caused heavy brain injuries, intracranial hematomas, blast skull base fractures and buttonhole vault fractures, falx and intracranial vessels injuries. The entrance wound was located in the left temporal area, and the exit wound in the right frontal area. The wound tract had signs of a penetrating diametric wound. The penetrating wound manifested itself in the patient’s extremely critical condition, deep coma, and vital functions disorder. The study also revealed combined trunk and extremities injuries. An extended initial surgical brain wound debridement was done, which included brain decompression, wound sanation, skull base and dural reconstruction, and tidal drainage. The patient was transferred to a military hospital with improvements for further rehabilitation treatment. The timely and complete surgical treatment allowed for an effective management of intracranial hypertension and prevented pyoinflammatory complications.

CT-guided open craniocerebral operations for delayed traumatic cerebrospinal fluid rhinorrhea

Objective To investigate the value of CT lamellar scan on cranial base and three-dimensional reconstruction towards the diagnosis of traumatic cerebrospinal fluid rhinorrhea (TCFR) and the therapeutic effect of craniocerebral operations on delayed traumatic cerebrospinal fluid rhinorrhea. Methods TCFR in 9 male patients closed with autogroft multistrata repair after open craniotomy between May 2006 and December 2013 were analyzed. Consistency on ventage location determined by preoperative radiological examination and intraoperative probe was compared. Relapse of rhinorrhea and postoperative complications were concluded. Results Basal fracture(or defection), intracranial pneumatocele, and cerebromalacia focus noted on CT scan and three-dimensional reconstruction could accurately indicate the location of ventage. All the 9 patients got a full healing at one stage after rhinorrhea multistrata repair with free or peduncular autologous tissue transplants (e. g. temporal muscle anadesma, abdominal wall fat and temporal muscle flap). There was no relapse during the follow-up of 4-96 months. Except that one patient suffered from epilepsy postoperatively, no other complications occurred. Conclusions Preoperative CT lamellar scan on cranial base and three-dimensional reconstruction provide accurate ventage location of TCFR. Multistrata TCFR repair with autologous tissue transplants may result in a good therapeutic effect with less complications. Key words: Brain injuries; Cerebrospinal fluid rhinorrhea; Craniotomy; Tomography, X-ray computed

A Review on Co-Saliency Detection Methods for Complex Background Images

Human eye is perceptually more sensitive to certain colors and intensities and objects with such features are considered more salient. Co-saliency detection aims at discovering the common salient objects existing in multiple images, which is a relatively under-explored area. A review of various techniques used in co-saliency detection like cluster based co-saliency detection, Hierarchical segmentation, Base reconstruction, Low rank matrix recovery etc. are done in this paper. Detection of Salient image regions is useful in applications such as co-segmentation, common pattern discovery, co recognition, Image retrieval etc. The survey is represented in a tabular form for quick reference and also describes the advantages and disadvantages of papers.

Perioperative and Long-Term Outcome Comparison of Pericranial versus Free Tissue Transfer Reconstruction of the Anterior Cranial Base

Perioperative and Long-Term Outcome Comparison of Pericranial versus Free Tissue Transfer Reconstruction of the Anterior Cranial Base

A novel use of the facial artery based buccinator musculo-mucosal island flap for reconstruction of the oropharynx

The buccinator musculo-mucosal island or Zhao flap can be used to reconstruct a wide range of intra-oral defects including floor of mouth, tonsillar fossa and lateral tongue. We describe our experience with the inferiorly based facial artery buccinator musculo-mucosal flap for a novel use in the reconstruction of oropharyngeal tumours at the tongue base and lateral pharyngeal wall. We prospectively reviewed all patients who underwent buccinator musculo-mucosal island flap reconstruction examining indication, operative details, and post-operative outcomes. We describe our technique for its novel use in lateral pharynx/tongue base reconstruction through neck dissection access. Deeper flaps were adequately visualised and monitored using flexible nasoendoscopy. There were no flap failures with all patients achieving primary healing with minimal complications. All donor sites closed directly with minimal scarring. Two patients reported mild tightness on mouth opening and two patients reported transient weakness of the mandibular branch of the facial nerve. In our experience the buccinator musculo-mucosal island flap is an extremely versatile 'like for like' local flap option due to its long arc of rotation. As inset can be achieved via neck dissection access, this avoids lip/jaw split as per conventional oropharyngeal surgical management further minimising morbidity. We present the first series of its effective use in oropharyngeal reconstruction.

OP017: The Oxford experience with Buccinator and FAMM flaps for oral cavity and oropharyngeal reconstruction

Purpose The Buccinator and Facial Artery Musculo-Mucosal (FAMM) flaps can be used to reconstruct a wide range of intra-oral defects including floor of mouth, tonsillar fossa and lateral tongue. We describe our experience with the Buccinator and FAMM flaps in the aforementioned areas and a novel use for the reconstruction of oropharyngeal tumours at the tongue base and lateral pharyngeal wall. Materials and methods We retrospectively reviewed all patients who underwent Buccinator and FAMM flap reconstruction examining indication, operative details, and post-operative outcomes. We describe our technique for its novel use in lateral pharynx/tongue base reconstruction through neck dissection access. Results There were no flap failures with all patients achieving primary healing with minimal complications. All donor sites closed directly with mouth opening at pre-operative status by 21 days post-op. Deeper flaps were adequately visualised and monitored using flexible nasoendoscopy. Conclusion In our experience Buccinator and FAMM musculo-mucosal flaps are an extremely versatile ‘like for like’ local flap option due to their long arc of rotation that we have used for the first time to successfully reconstruct the tongue base and lateral pharynx. As inset can be achieved via neck dissection access this avoids lip/jaw split as per conventional oropharyngeal surgical management further minimising morbidity.

80th Anniversary of the journal chemical and oil-gas engineering

creative inspiration has been a difficult path. The first issue of the journal was published in July 1932 in Kharkov as the industrial-technical, scientific and technico-economic journal Khimicheskoe Mashinostroenie (Chemical Engineering). This was a time of tempestuous development of the national economy and industry of the country. The developing chemical industry at that time was acutely in need of increasing production volumes of chemical equipment to which establishments of the All-Union Association of Sugar and Chemical Engineering (VOSKhIM) located in Ukraine, for which the journal Chemical Engineering became the printing organ, contributed to a great extent. In endeavoring to publish the new edition, the VOSKhIM placed before the journal the task of assisting in the technical progress of chemical engineering, and raising the technical level of production and manufactured products. The following was emphasized in the journal’s program: “The 1932 Plan, and, in particular, perspective rough drafts for the second five-year plan places before chemical engineering a number of completely new, and diverse problems: organization of new productions, expansion and reconstruction of the current outdated production base, rationalization of production, and hence, the need for broad planning, establishment of types and forms of chemical equipment and the best designs, replacement of obsolete production methods by new ones, etc.” Papers devoted to studies of the development of new machines and equipment for chemical productions, scientific researches, and laboratory investigations had even been published in the first issue of the journal. The papers, among other things, touched upon effective processes for evaporators and heat exchangers, reactors, and pulverizing-grinding machines; analysis of welded joints in equipment; production problems in the fabrication of compressor components, foundry production, and a number of other problems of chemical engineering. The scientific-technical leaning of publications of the journal, the publication of which was soon transferred to Moscow, has been retained over the entire path of its publication, gaining it the respect of the scientific and engineering community. In the pre-war years, the journal was virtually the only source of information on scientific-technical achievements in chemical engineering. The publications, which shed light on questions concerning the development of science and engineering, contributed to practical studies involving the development and mastering of new highly productive equipment, expansion of the list of articles produced, and improvement of the technical equipment of businesses in the field. In the paper “Chemical engineering after 10 years,” which was published in the April edition of the journal in 1940, significant advancements were highlighted both in the expansion of the manufacture of chemical-production equipment and the mastering of many new machines and equipment. Even more critical problems involving chemical engineering surfaced in the post-war years when the country had embarked on a grandiose plan for restoration of the national economy. Chemical and Petroleum Engineering, Vol. 48, Nos. 7–8, November, 2012 (Russian Original Nos. 7–8, July–August, 2012)

Temporomandibular joint, skull base and mandibular ramus functional reconstruction with homologous bank tissue and free flap. A case report with 60 months follow-up

Temporomandibular joint, skull base and mandibular ramus functional reconstruction with homologous bank tissue and free flap. A case report with 60 months follow-up

Feasibility of a novel material for the reconstruction of skull base in a canine

To explore the therapeutic efficacy of a novel complex material of shape-memory alloy brace and artificial dura (nitinol brace and NormalGEN) for the reconstruction of skull base in a canine model with lateral media skull base defect. The complex of nitinol brace and NormalGEN was developed with corresponding apparatus. A common adult dog model with lateral media skull base defect was established and then reconstructed with the complex. At Month 3 post-operation, cranial lateral radiographic projection, three-dimensional reconstruction of computer tomography, 1.5T magnetic resonance imaging and histopathological examination were detected. Five animal models and cranial reconstructions were made. All survived without any complication, such as leakage of cerebrospinal fluid, local tissue eminence and neurological function defect. The imaging detection showed that nitinol brace was distinct and satisfactorily positioned without shift and artifact. And histopathological examination showed that granulation tissue substituted NormalGEN and grew around the brace with numerous fibroblasts. The complex of shape-memory alloy brace and artificial is suitable for the reconstruction of skull base on dog model with lateral media skull base defect.