BACKGROUND Very few cases of severe penetrating injuries to the skull base with a seemingly innocuous object have been described in the literature. Of the cases reported, only ten involve a penetrating screwdriver. However, the choice of therapeutic management, whether it be emergency surgical or non-surgical removal of the penetrating object as well as the selected surgical approach remain qui...

UNLABELLED Technical and technological innovations have spearheaded the expansion of the indications for the use of endoscopic endonasal approaches to extirpate malignancies of the sinonasal tract and adjacent skull base. OBJECTIVE Critical review of the available literature regarding the use of endoscopic endonasal approaches including indications, limitations, surgical techniques, oncologic...

Iatrogenic injuries of the frontal skull base commonly occur during endoscopic sinus surgery. In this paper, we present a rare case of cranial base injury after transnasal endotracheal intubation for dental surgery. A 61-year-old otherwise healthy man presented at the emergency department with headache, right leg weakness and watery nasal discharge on the left side. He underwent a dental surger...

INTRODUCTION During endoscopic anterior skull base surgery, reconstruction options for defects of the sella turcica or anterior cranial base require careful consideration of defect size, shape, location, and need for adjuvant therapy. A variety of techniques are available, ranging from single layer reconstruction to multilayer reconstruction with microvascular tissue transfer. Each method has p...

Farm workers are at increased risk for animal-inflicted head injuries that are associated with significant morbidity and occasionally may be fatal. These injuries may cause permanent eye damage with or without concomitant skull base fracture. Here, we present a male farmer who suffered a cow attack that resulted in perforating orbital injury with comminuted frontobasal cranial fracture caused b...

BACKGROUND Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that frequently occurs in soft tissues. Patients suffer from local recurrence and remote metastasis because of its malignant potential. Here, we present a rare case of EHE that originated from nasal cavity and invaded intracranially through the anterior skull base. CASE DESCRIPTION This is a 27-year-old woman who prese...

BACKGROUND Anterior craniofacial resection is a standardized procedure for the treatment of ethmoid and frontal orbital tumors with intracranial invasion. METHODS A retrospective review of 100 patients with sinonasal tumors involving the anterior skull base who underwent combined craniofacial surgery at the Hospital Central de Asturias. RESULTS The most frequent pathologic entity was adenoc...

INTRODUCTION In the opinion of the famous anatomist Testut, the skull base is similar to a ship. This illustrative image obviously takes into consideration the existence of a bow designed to balance the undulatory movements caused by the C1 – C2 occipital articulations. It’s about the exoskull, which allows through its apophyses the insertion of various muscle groups which ensure the equilibriu...

Endoscopic transnasal surgery is rapidly replacing more radical external 'open' procedures. At Groote Schuur Hospital, Cape Town, we performed 94 advanced endoscopic sinonasal and anterior skull base procedures over a 2-year period. Most of these would previously have been performed using large external incisions requiring more invasive surgery with significantly higher morbidity. Endoscopic su...

We report the first case of hepatoid adenocarcinoma of the skull base, as well as the first reported case in the head and neck region. Hepatoid adenocarcinoma is a rare, aggressive, extrahepatic malignancy with a distinct morphological similarity to hepatocellular carcinoma, in the absence of primary hepatic disease. A 45-year-old man presented with sinus headaches and retro-orbital pain and wa...