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Abstract
Use today’s latest technology and methods to optimize imaging of complex skull base anatomy. This practical reference offers expert guidance on accurate preoperative lesion localization and the evaluation of its relationship with adjacent neurovascular structures.
- Features a wealth of information for radiologists and surgeons on current CT and MR imaging as they relate to skull base anatomy.
- Covers localizing skull base lesions, reaching the appropriate differential diagnosis, and deciding which surgical approach is best.
- Consolidates today’s available information and guidance in this challenging area into one convenient resource.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Skull Base Imaging | i | ||
Skull Base Imaging | iii | ||
Copyright | iv | ||
Contributors | v | ||
Preface | ix | ||
Contents | xi | ||
1 - Anterior Skull Base | 1 | ||
ANATOMY | 1 | ||
KEY IMAGING CONSIDERATIONS | 1 | ||
Anterior Cranial Fossa Invasion | 2 | ||
Orbital Invasion | 3 | ||
ANTERIOR SKULL BASE NEOPLASMS | 4 | ||
Squamous Cell Carcinoma | 4 | ||
Esthesioneuroblastoma | 6 | ||
Adenocarcinoma | 7 | ||
Adenoid Cystic Carcinoma | 7 | ||
Sinonasal Lymphoma | 7 | ||
Sinonasal Undifferentiated Carcinoma | 7 | ||
Sarcoma | 7 | ||
Meningioma | 9 | ||
NONNEOPLASTIC LESIONS | 10 | ||
Fungal Sinusitis | 10 | ||
Mucocele | 13 | ||
Fibrous Dysplasia | 14 | ||
CONCLUSION | 15 | ||
REFERENCES | 17 | ||
2 - Imaging of the Paranasal Sinuses and Their Surgical Relevance | 21 | ||
THE NASAL SEPTUM AND NASAL MUCOSA | 21 | ||
FRONTAL SINUS DRAINAGE PATHWAY | 21 | ||
Anterior Ethmoid Cells/Frontal Recess Cells | 22 | ||
Agger Nasi Cells | 22 | ||
ETHMOID BONE | 23 | ||
Middle Turbinate and Basal Lamella | 24 | ||
Middle Turbinate Variants | 24 | ||
Ethmoid Bulla | 25 | ||
Ethmoid Infundibulum | 27 | ||
Uncinate Process | 28 | ||
Uncinate Process Variations | 30 | ||
Ethmoid Roof | 30 | ||
Anterior Ethmoid Artery | 32 | ||
Crista Galli | 33 | ||
Ethmoid Air Cells | 33 | ||
Haller cells | 34 | ||
Onodi cells (sphenoethmoidal cells) | 34 | ||
SPHENOID SINUS | 34 | ||
Sphenoethmoidal Recess | 34 | ||
Sphenoid Sinus Variations | 34 | ||
CONCLUSION | 35 | ||
REFERENCES | 37 | ||
3 - The Sphenoid Bone | 39 | ||
NORMAL ANATOMY | 39 | ||
SPHENOID BODY | 39 | ||
LESSER WING | 39 | ||
GREATER WING | 40 | ||
PTERYGOID PROCESSES | 42 | ||
SPHENOID BONE DISORDERS | 44 | ||
Sphenoid Sinus | 44 | ||
Foramen ovale, rotundum, and the vidian canal | 52 | ||
Bone | 52 | ||
CONCLUSION | 55 | ||
REFERENCES | 63 | ||
4 - Imaging in Endoscopic Endonasal Skull Base Surgery | 65 | ||
INTRODUCTION | 65 | ||
HISTORICAL PERSPECTIVE | 65 | ||
PREOPERATIVE PLANNING | 66 | ||
Surgical Approaches and Anatomic Limitations | 69 | ||
Sagittal plane | 70 | ||
Transcribriform. Typical disorders in the anterior cranial fossa accessed via the transcribiform approach include sinonasal tumo... | 70 | ||
Transplanum. The transplanum approach to the suprasellar cistern and third ventricle allows the surgeon direct access without ha... | 70 | ||
Transsellar. The transsellar approach allows access to sellar lesions, such as pituitary adenomas and Rathke cleft cysts (this m... | 71 | ||
Transclival. The clivus is divided into the upper, middle, and lower thirds anatomically by the neural foramina. The upper third... | 71 | ||
Transodontoid. The transodontoid approach allows access to the inferior clivus, foramen magnum, and C1-C2 vertebrae | 71 | ||
Coronal plane | 72 | ||
Transorbital (orbital apex/superior orbital fissure/orbit). The transorbital approach allows access to orbital lesions, such as ... | 72 | ||
Medial petrous. The medial petrous apex is accessed via the medial petrous approach. Typical disorders involving the petrous ape... | 72 | ||
Transpterygoid (suprapetrous and infrapetrous modules). The suprapetrous and infrapetrous modules are both accessed by a common ... | 72 | ||
Contraindications | 72 | ||
Skull Base Reconstruction | 73 | ||
POSTOPERATIVE IMAGING | 75 | ||
Early Postoperative Imaging | 75 | ||
Late Postoperative Imaging | 77 | ||
COMPLICATIONS | 77 | ||
Intraoperative Complications | 77 | ||
Early Postoperative Complications | 78 | ||
Late Postoperative Complications | 79 | ||
CONCLUSION | 79 | ||
REFERENCES | 81 | ||
5 - Temporal Bone Inflammatory and Infectious Diseases | 83 | ||
INTRODUCTION | 83 | ||
EXTERNAL EAR: EXTERNAL OTITIS | 83 | ||
External Otitis | 83 | ||
Necrotizing External Otitis | 83 | ||
MIDDLE EAR AND MASTOID: OTOMASTOIDITIS | 83 | ||
Acute Otomastoiditis and Coalescent Mastoiditis | 83 | ||
Petrous Apicitis | 85 | ||
Chronic Otomastoiditis Without Cholesteatoma | 85 | ||
Chronic Otomastoiditis With Cholesteatoma | 90 | ||
INNER EAR: LABYRINTHITIS | 90 | ||
Acute Stage Labyrinthitis | 92 | ||
Fibrous Stage Labyrinthitis | 92 | ||
Ossifying Stage Labyrinthitis | 92 | ||
FACIAL NERVE | 94 | ||
CONCLUSION | 94 | ||
ACKNOWLEDGMENTS | 96 | ||
REFERENCES | 96 | ||
6 - Temporal Bone Tumors | 99 | ||
7 - Temporal Bone Trauma | 145 | ||
TEMPORAL BONE PSEUDOFRACTURES—FRACTURE MIMICS | 145 | ||
TEMPORAL BONE FRACTURES | 148 | ||
COMPLICATIONS OF TEMPORAL BONE FRACTURES | 151 | ||
Fistulous Communications | 151 | ||
Conductive Hearing Loss | 153 | ||
Sensorineural Hearing Loss | 157 | ||
Ossicular Fractures | 161 | ||
Facial Nerve Injury | 161 | ||
CONCLUSION | 165 | ||
REFERENCES | 167 | ||
8 - Update on Imaging of Hearing Loss | 169 | ||
INTRODUCTION | 169 | ||
IMAGING MODALITIES | 169 | ||
SENSORINEURAL HEARING LOSS | 171 | ||
Congenital SNHL Pathologies | 171 | ||
Acquired SNHL Pathologies | 176 | ||
CONDUCTIVE HEARING LOSS | 182 | ||
Congenital Conductive Hearing Loss | 182 | ||
Acquired Conductive Hearing Loss | 184 | ||
MIXED HEARING LOSS | 192 | ||
MHL Pathologies | 192 | ||
CONCLUSION | 192 | ||
DISCLOSURE | 192 | ||
REFERENCES | 192 | ||
9 - Imaging of the Facial Nerve | 197 | ||
ANATOMY | 197 | ||
Supranuclear Control | 197 | ||
Motor Component | 197 | ||
Sensory, Special Sensory, and Parasympathetic | 197 | ||
Peripheral Course | 198 | ||
Vascular Supply of the Facial Nerve | 200 | ||
CLINICAL AND IMAGING EVALUATION | 200 | ||
CONGENITAL ANOMALIES | 202 | ||
VASCULAR DISORDERS OF THE FACIAL NERVE | 203 | ||
Venous Vascular Malformations | 203 | ||
FACIAL NERVE TRAUMA | 205 | ||
INFLAMMATORY DISORDERS | 206 | ||
TUMORS OF THE FACIAL NERVE | 207 | ||
Schwannomas | 207 | ||
Perineural Spread of Malignancy | 209 | ||
CONCLUSION | 211 | ||
REFERENCES | 211 | ||
10 - Imaging of the Postoperative Middle Ear, Mastoid, and Internal Auditory Canal | 215 | ||
INTRODUCTION | 215 | ||
TRANSCANAL APPROACH | 215 | ||
RETROAURICULAR AND ENDAURAL APPROACHES | 215 | ||
Meatoplasty and Canaloplasty | 215 | ||
Myringoplasty | 215 | ||
Tympanoplasty | 216 | ||
Ossiculoplasty | 216 | ||
Imaging After Stapedectomy | 218 | ||
Mastoidectomy | 218 | ||
FACIAL RECESS APPROACH | 220 | ||
Atticotomy | 220 | ||
IMAGING THE POSTOPERATIVE MASTOID | 220 | ||
MR Diffusion Imaging for Cholesteatoma | 220 | ||
Superior Canal Dehiscence—Postoperative Imaging | 222 | ||
Imaging of the Postoperative Internal Auditory Canal and Cerebellopontine Angle | 223 | ||
RETROSIGMOID APPROACH | 224 | ||
TRANSLABYRINTHINE APPROACH | 225 | ||
MIDDLE CRANIAL FOSSA APPROACH | 225 | ||
TWO-STAGE SURGERY FOR VS | 225 | ||
COMPLICATIONS | 225 | ||
POSTOPERATIVE IMAGING | 226 | ||
SUMMARY | 227 | ||
REFERENCES | 228 | ||
11 - Petrous Apex | 233 | ||
INTRODUCTION | 233 | ||
ANATOMY | 233 | ||
CLINICAL PRESENTATIONS | 234 | ||
ANATOMIC VARIATIONS AND PATHOLOGIC ENTITIES OF THE PETROUS APEX | 234 | ||
Aberrant internal carotid artery | 235 | ||
Petrous segment internal carotid artery aneurysm | 235 | ||
Narrow internal auditory canal syndrome | 235 | ||
Schwannoma | 236 | ||
Petrous apex effusion | 236 | ||
Giant air cell | 238 | ||
Petrous apex cephaloceles | 238 | ||
Arachnoid granulations | 238 | ||
Trauma | 238 | ||
Petrous apex mucoceles | 239 | ||
Fibrous dysplasia | 240 | ||
Paget disease | 240 | ||
Petrous apex osteomyelitis | 242 | ||
Petrous apex cholesteatomas | 242 | ||
Langerhans cell histiocytosis | 243 | ||
Chondrosarcoma | 243 | ||
Endolymphatic sac tumor | 243 | ||
Metastatic disease | 243 | ||
Plasmocytoma/multiple myeloma | 244 | ||
Lymphoma | 244 | ||
Paraganglioma | 244 | ||
Nasopharyngeal carcinoma | 244 | ||
REFERENCES | 245 | ||
12 - Imaging of the Cerebellopontine Angle | 247 | ||
INTRODUCTION | 247 | ||
ANATOMY | 247 | ||
IMAGING TECHNIQUES | 247 | ||
Magnetic Resonance Imaging | 247 | ||
Computed Tomography | 247 | ||
EXTRAAXIAL LESIONS | 248 | ||
Vestibular Schwannoma | 248 | ||
Other Schwannomas | 251 | ||
Meningioma | 251 | ||
Hemangiopericytoma | 251 | ||
Epidermoid Cysts | 251 | ||
Arachnoid Cysts | 254 | ||
Dermoid Cysts | 255 | ||
Lipomas | 255 | ||
Neurenteric Cysts | 256 | ||
Metastases | 257 | ||
INFECTIOUS/INFLAMMATORY LESIONS | 257 | ||
Neurosarcoidosis | 257 | ||
Tuberculosis | 258 | ||
Neurocysticercosis | 258 | ||
SKULL BASE LESIONS | 258 | ||
Cholesterol Granuloma | 258 | ||
Paraganglioma (Glomus Tumors) | 259 | ||
Chondromas and Chondrosarcomas | 259 | ||
Chordoma | 259 | ||
Endolymphatic Sac Tumors | 259 | ||
Petrous Apicitis | 259 | ||
INTRAAXIAL LESIONS | 259 | ||
Glioma | 259 | ||
Choroid Plexus Papilloma | 259 | ||
Lymphoma | 260 | ||
Hemangioblastoma | 260 | ||
Ependymoma | 261 | ||
Medulloblastoma | 262 | ||
Metastases | 262 | ||
VASCULAR LESIONS | 262 | ||
Cavernoma | 262 | ||
OSSEOUS LESIONS | 262 | ||
CONCLUSION | 262 | ||
REFERENCES | 266 | ||
13 - Jugular Foramen | 269 | ||
APPLIED ANATOMY OF THE JUGULAR FORAMEN | 269 | ||
JUGULAR BULB VARIANTS AND ANOMALIES | 272 | ||
High-Riding and Dehiscent Jugular Bulb | 272 | ||
Jugular Bulb Diverticulum | 273 | ||
Jugular Bulb Pseudolesion | 273 | ||
VASCULAR CONDITIONS OR LESIONS | 273 | ||
Dural Arterial Venous Fistula | 273 | ||
Jugular Vein Thrombosis | 275 | ||
PRIMARY NEOPLASMS OF THE JUGULAR FORAMEN | 276 | ||
Paragangliomas (Glomus Jugulare and Jugulotympanicum) | 277 | ||
Jugular Foramen Schwannoma | 279 | ||
Primary Jugular Foramen Meningioma | 279 | ||
SECONDARY JUGULAR FORAMEN NEOPLASMS | 282 | ||
Metastatic Disease to Skull Base or Dura | 282 | ||
Skull Base Tumors | 283 | ||
Infiltration by Other Adjacent Tumors | 285 | ||
INFECTIVE AND INFLAMMATORY LESIONS | 285 | ||
CONCLUSION | 285 | ||
REFERENCES | 287 | ||
14 - Imaging of the Craniovertebral Junction | 291 | ||
EMBRYOLOGY AND CONGENITAL ANOMALIES | 291 | ||
MEASUREMENT COMMONLY USED IN EVALUATING THE CRANIOVERTEBRAL JUNCTION | 291 | ||
CONGENITAL ANOMALIES | 291 | ||
MALFORMATIONS OF THE OCCIPITAL BONE | 291 | ||
Platybasia | 291 | ||
Basilar Invagination (Basioccipital Hypoplasia, Basilar Impression) | 291 | ||
Condylar Hypoplasia | 293 | ||
Condylar Dysplasia (Condylus Tertius, Third Occipital Condyle) | 293 | ||
MALFORMATIONS OF THE ATLAS | 293 | ||
Atlas Assimilation (Atlantooccipital Assimilation, Occipitalization of the Atlas) | 293 | ||
Aplasia and Hypoplasia of the Atlas | 294 | ||
Atlas Arch Anomaly | 296 | ||
MALFORMATIONS OF THE AXIS AND ODONTOID PROCESS | 296 | ||
Aplasia or Hypoplasia of the Dens | 296 | ||
Persistent Ossiculum Terminale (Bergmann Ossicle) | 297 | ||
Ossiculum Odontoideum (Os Odontoideum) | 297 | ||
Klippel-Feil Anomaly | 297 | ||
FRACTURE | 298 | ||
Clivus Fracture | 298 | ||
Occipital Condyle Fracture | 299 | ||
Atlas Fracture | 300 | ||
Axis Fracture (Odontoid Fracture) | 302 | ||
DEGENERATIVE LESIONS OF THE CVJ | 302 | ||
Degenerative Arthritis | 302 | ||
Ossification of the Posterior Longitudinal Ligament | 304 | ||
Diffuse Idiopathic Skeletal Hyperostosis | 304 | ||
Retroodontoid Pseudotumor | 305 | ||
INFECTIOUS/INFLAMMATORY LESIONS OF THE CVJ | 306 | ||
Rheumatoid Arthritis | 306 | ||
Ankylosing Spondylitis | 308 | ||
Calcium Pyrophosphate Dihydrate Deposition Disease | 309 | ||
Pyogenic and Nonpyogenic Infection | 310 | ||
Osteoradionecrosis | 310 | ||
TUMOR AND TUMOR-LIKE LESIONS | 311 | ||
Chondrosarcoma | 314 | ||
Miscellaneous benign bone tumors | 315 | ||
Miscellaneous malignant bone tumors | 316 | ||
Malignant lesions from adjacent soft tissue | 316 | ||
Nerve sheath tumors | 318 | ||
Congenital Cystic Lesions | 318 | ||
VASCULAR LESIONS | 320 | ||
Bow Hunter Syndrome | 320 | ||
Vertebral Artery Aneurysm at the Foramen Magnum | 320 | ||
Vertebral Artery Arteriovenous Fistula | 320 | ||
Dural Arteriovenous Fistulas | 320 | ||
DAVF at the foramen magnum | 321 | ||
Anterior condylar DAVF (hypoglossal-clival DAVF) | 322 | ||
REFERENCES | 325 | ||
15 - Skull Base Bone Lesions I: Imaging Technique, Developmental and Diffuse Bone Lesions | 329 | ||
INTRODUCTION | 329 | ||
IMAGING TECHNIQUE | 329 | ||
GENERAL IMAGING FEATURES OF BONE LESIONS HELPFUL IN THE DIFFERENTIAL DIAGNOSIS | 331 | ||
Developmental Bone Lesions of the Skull Base | 332 | ||
Lesions Originating From Embryonic Remnants | 334 | ||
Diffuse Bone Lesions or Tumor-Like Conditions | 341 | ||
SUMMARY | 347 | ||
REFERENCES | 347 | ||
16 - Skull Base Bone Lesions II: Benign and Malignant Tumors | 351 | ||
INTRODUCTION | 351 | ||
BONE TUMORS | 351 | ||
Benign Tumors | 351 | ||
Bone-forming tumors | 351 | ||
Cartilage-forming tumors | 356 | ||
Tumors without osteoid or chondroid matrix | 358 | ||
Malignant Bone Tumors (Primary and Secondary) | 362 | ||
SUMMARY | 369 | ||
REFERENCES | 369 | ||
17 - Neurointerventional Radiology for Skull Base Lesions | 373 | ||
EMBOLIZATION OF HYPERVASCULAR TUMORS LOCATED AT THE SKULL BASE | 373 | ||
GOALS OF PREOPERATIVE EMBOLIZATION | 373 | ||
FUNCTIONAL ANATOMY | 373 | ||
EMBOLIC MATERIALS | 374 | ||
Particulate Embolic Materials | 374 | ||
Liquid Embolic Materials | 374 | ||
METHODS OF EMBOLIZATION | 375 | ||
Transarterial Embolization | 375 | ||
Embolization by Direct Puncture | 377 | ||
COMPLICATIONS | 379 | ||
JUVENILE ANGIOFIBROMA | 379 | ||
TYMPANOJUGULAR PARAGANGLIOMAS | 380 | ||
EMBOLIZATION FOR VASCULAR LESIONS IN THE SKULL BASE | 382 | ||
Dural Arteriovenous Fistula | 382 | ||
Classification, clinical presentation, and diagnosis | 383 | ||
Principles of endovascular treatment | 384 | ||
Transarterial and transvenous embolization | 384 | ||
Embolic agents | 385 | ||
Ancillary techniques and alternative approaches | 385 | ||
Postprocedural care and follow-up | 389 | ||
Outcome of endovascular treatment | 389 | ||
Alternative treatments | 389 | ||
Traumatic Carotid-Cavernous Fistula | 390 | ||
Clinical features and diagnosis | 390 | ||
Principle of treatment | 390 | ||
Endovascular methods | 390 | ||
Postprocedural care and follow-up | 393 | ||
Outcome | 394 | ||
Alternative treatments | 394 | ||
REFERENCES | 394 | ||
Index | 401 | ||
A | 401 | ||
B | 401 | ||
C | 401 | ||
D | 402 | ||
E | 403 | ||
F | 404 | ||
G | 404 | ||
H | 404 | ||
I | 405 | ||
J | 405 | ||
K | 406 | ||
L | 406 | ||
M | 406 | ||
N | 406 | ||
O | 407 | ||
P | 407 | ||
R | 408 | ||
S | 408 | ||
T | 409 | ||
U | 410 | ||
V | 410 |