The proposed endoscopic classification outlines key anatomic reference points independent of the vessel's geometry or the sinonasal pneumatization, thus serving as (1) a practical guide to navigate the ventral cranial base while avoiding injury to the ICA and (2) further foundation for a modular access system.

Calcifying pseudoneoplasms of the neuraxis are rare, poorly understood masses that may arise throughout the CNS. Although these lesions are generally considered benign and noninfiltrative, reports exist that document growth of these masses on serial plain radiographs. The authors report a case of a posterior fossa calcifying pseudoneoplasm of the neuraxis demonstrating interval development of peritumoral edema on serial MRI. Their findings suggest that these lesions may sometimes behave in a more aggressive manner than commonly thought.

Object Coccygodynia is disabling pain in the coccyx and is usually provoked by sitting or rising from sitting. The diagnosis can be missed by neurosurgeons likely to encounter the disorder, and surgical treatment for coccygodynia has historically been viewed with caution. The authors conducted a retrospective review of 62 successive coccygectomy surgeries for coccygodynia performed at their institution. Methods Sixty-two consecutive cases of coccygectomy for coccygodynia in 61 unique patients were identified from the surgical database; they had been treated between 1997 and 2009. The authors succeeded in contacting 26 patients for follow-up (42.6%). A retrospective chart review was performed, and a telephone questionnaire was administered to these patients. Data collected included cause, pre- and postoperative visual analog scale, a graded outcome measure, and patient satisfaction. The median follow-up time was 37 months (range 2–133 months). Results The clinical results among the 26 patients with follow-up were as follows: 13 excellent, 9 good, 2 fair, and 2 poor. The overall favorable (excellent and good) outcome after coccygectomy was 84.6%. There were 3 wound infections (11.5%). There were no rectal injuries. An overwhelming majority of patients were satisfied with the procedure. Conclusions The authors report the results of their clinical case series, which to date is the largest in North America. The results closely concur with previously published case series from Europe. Coccygectomy for chronic intractable coccygodynia is simple and effective, with a low complication rate. A comprehensive literature review and discussion of coccygectomy is provided.

ObjectiveA review of the literature on coccygectomy and our patients was performed to assess the effectiveness of coccygectomy for chronic refractory coccygodynia.MethodsAn English language PubMed search was conducted with the terms "coccygodynia" and "coccygectomy" from January 1980 to January 2012. We retrospectively reviewed the medical records and performed telephone questionnaire on 61 patients who underwent coccygectomy at UCDMC between 1997 and 2009.ResultsThere were 28 case series from 1980 to 2012 for a total of 742 patients who underwent coccygectomy following failed conservative management. The mean age ranged from 26.4 to 52.8 years. The most common cause was direct trauma (58.5%) with a male:female ratio of 1:5.2. Most patients (84%) had a good to excellent outcome after coccygectomy. The most common complication is wound infection (10.0%). The overall complication rate was 13.3%. Similarly, 84.6% of patients from our own surgical case series reported good to excellent outcomes with 11.5% wound infection.ConclusionCoccygectomy is an effective treatment for chronic refractory coccygodynia. The surgery isrelatively simple to perform but precaution must be taken to avoid wound infection.