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https://www.readbyqxmd.com/read/27915350/rapid-brain-shift-with-remote-site-haemorrhage-after-arachnoid-cyst-excision-treatment-dilemmas
#1
Girish M Ramachandran, Rajesh P Nair, Lakshman I Kongwad, G Shanthakumar
Sylvian arachnoid cysts pose considerable management dilemmas. Surgical options include cyst fenestration, either endoscopically or microsurgically, and cysto-peritoneal shunt. One of the rare complications after rapid decompression of the arachnoid cysts is haemorrhage in the surrounding brain as well as in remote areas. We describe a case of multiple remote-site intra-parenchymal haemorrhage as a rare complication after surgical decompression of a sylvian fissure arachnoid cyst.
December 3, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27912820/modern-endodontic-microsurgery-concepts-a-clinical-update
#2
REVIEW
Spyros Floratos, Syngcuk Kim
Increased use of the surgical operating microscope in endodontic surgery has elucidated many shortcomings of previous techniques and along with microsurgical instruments and new more biologically acceptable root-end filling materials has started the new microsurgical era in surgical endodontics. Endodontic microsurgery is a minimally invasive technique that results in less postoperative pain and edema and faster wound healing. It offers a significantly higher success rate than traditional apical surgery technique...
January 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/27911236/patient-versus-physician-reported-facial-disability-in-vestibular-schwannoma-an-international-cross-sectional-study
#3
Øystein Vesterli Tveiten, Matthew L Carlson, Frederik Goplen, Erling Myrseth, Colin L W Driscoll, Rupavathana Mahesparan, Michael J Link, Morten Lund-Johansen
OBJECTIVE Patient-reported outcomes are increasingly used in studies of vestibular schwannoma (VS); however, few studies have examined self-evaluated facial nerve function and its relation to physician-reported outcomes. The primary objective of this study was to compare patient self-evaluations of facial disability with physician-evaluated facial nerve status and with self-evaluations of a healthy control group. The second objective was to provide insight into the controversial subject of the optimal initial management of small- and medium-sized VSs; consequently, the authors compared patient-reported facial nerve disability following treatment via observation (OBS), Gamma Knife surgery (GKS), or microsurgery (MS)...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27906440/supramicrosurgical-lymphatico-venular-anastomosis-lva-in-treating-lymphoedema-36-months-preliminary-report
#4
P Gennaro, G Gabriele, M Mihara, K Kikuchi, C Salini, I Aboh, F Cascino, G Chisci, C Ungari
OBJECTIVE: Lymphoedema of the extremities is a widespread pathological condition that mostly occurs as a complication of cancer resections, especially in women. Conventional therapy refers to conservative and physiotherapeutic approaches. Surgical strategies have been widely reported in the literature and are still challenging. Part of this literature focuses on the supra microsurgical lymphaticovenular anastomosis (LVA) technique. LVA is characterized by a high success rate, minimal invasivity and broad indications...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#5
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903113/microscopic-versus-endoscopic-approaches-for-craniopharyngiomas-choosing-the-optimal-surgical-corridor-for-maximizing-extent-of-resection-and-complication-avoidance-using-a-personalized-tailored-approach
#6
James K Liu, Ilesha A Sevak, Peter W Carmel, Jean Anderson Eloy
Resection remains the mainstay of treatment for craniopharyngiomas with the goal of radical resection, if safely possible, to minimize the rate of recurrence. Endoscopic endonasal and microscopic transcranial surgical approaches have both become standard methods for the treatment for craniopharyngiomas. However, the approach selection paradigm for craniopharyngiomas is still a point of discussion. Choosing the optimal surgical approach can play a significant role in maximizing the extent of resection and surgical outcome while minimizing the risks of potential complications...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#7
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#8
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#9
F Schuind, F Moungondo, W El Kazzi
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity...
November 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27896195/microsurgical-training-using-reusable-human-vessels-from-discarded-tissues-in-lymph-node-dissection
#10
Naohiro Ishii, Tomoki Kiuchi, Tomito Oji, Kazuo Kishi
The use of human vessels at the beginning of microsurgery training is highly recommended. But vessels with the appropriate length for training are not often obtained. Whether these vessels may be reused for training has not been reported. Accordingly, we harvested vessels from discarded tissues in lymph node dissection and demonstrated that vascular anastomosis training using the same human vessels several times is possible by placing the vessels in a freezer and defrosting them with hot water. Vascular walls can be stored for microsurgical training until about 4 years after harvest, as shown in the gross appearance and histologic findings of our preserved vessels...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896018/development-and-preliminary-results-of-bimanual-smart-micro-surgical-system-using-a-ball-lens-coupled-oct-distance-sensor
#11
Dongwoo Koo, Hyun-Cheol Park, Peter L Gehlbach, Cheol Song
Bimanual surgery enhances surgical effectiveness and is required to successfully accomplish complex microsurgical tasks. The essential advantage is the ability to simultaneously grasp tissue with one hand to provide counter traction or exposure, while dissecting with the other. Towards enhancing the precision and safety of bimanual microsurgery we present a bimanual SMART micro-surgical system for a preliminary ex-vivo study. To the best of our knowledge, this is the first demonstration of a handheld bimanual microsurgical system...
November 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#12
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
November 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#13
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27893637/timing-of-presentation-of-pediatric-compartment-syndrome-and-its-microsurgical-implication-a-retrospective-review
#14
Natalia I Ziolkowski, Leanne Zive, Emily Ho, Ronald Zuker
BACKGROUND: Forearm compartment syndrome in the pediatric population can lead to severe functional disability. Although it is known that earlier presentation with decompression leads to better outcomes, it is not known when presentation post-injury leads to significant loss of function requiring microsurgical intervention. AIM: To describe the rate of microsurgical reconstruction after forearm compartment syndrome in pediatric patients as related to timing of presentation...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27892447/a-study-on-variations-of-nutrient-foramen-of-humerus-with-its-clinical-implications
#15
D I Mansur, P Manandhar, M K Haque, D K Mehta, S Duwal, B Timalsina
Background Nutrient foramen is an opening into shaft of humerus which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Method The present study consisted of 253 (108 right and 145 left) dried humeri excluding any fracture or pathological abnormalities during the period of 15th December 2014 - 14th February 2015...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27891036/complete-morphometric-analysis-of-jugular-foramen-and-its-clinical-implications
#16
Sushant Swaroop Das, Sandeep Saluja, Neelam Vasudeva
INTRODUCTION: Tumors affecting structures in the vicinity of jugular foramen such as glomus jugulare require microsurgical approach to access this region. These tumors tend to alter the normal architecture of the jugular foramen by invading it. Therefore, it is not feasible to have correct anatomic visualization of the foramen in the presence of such pathologies. Hence, a comprehensive knowledge of the jugular foramen is needed by all the neurosurgeons while doing surgery in this region...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27890749/the-medial-and-lateral-lemnisci-anatomically-adjoined-but-functionally-distinct-fiber-tracts
#17
Ruben Rodríguez-Mena, Uğur Türe
OBJECTIVE: The dense and complex distribution of neural structures in the brain stem makes it challenging to understand their real configuration. We used the fiber microdissection technique to reveal the course of the medial and lateral lemnisci within the brain stem. Although these structures seem anatomically alike, they are functionally distinct. METHODS: Fifteen human brain stems and eight brain hemispheres (formalin-fixed and previously frozen) were dissected and studied under the operating microscope by applying the fiber microdissection technique...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27889116/total-phallic-reconstruction-using-radial-forearm-free-flap-after-iatrogenic-penile-amputation
#18
J C Angulo, I Arance, C Gómez-Llorens, C Esquinas, C Gómez-Martín, J L Fernández-Cañamaque
INTRODUCTION: The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. MATERIAL AND METHODS: A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customised inflatable prosthesis a year later. RESULTS: During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage...
November 23, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27885877/surgical-outcomes-of-middle-fossa-approach-in-intracanalicular-vestibular-schwannoma
#19
Woo Seok Kang, Shin Ae Kim, Chan Joo Yang, Sung Hoon Nam, Jong Woo Chung
CONCLUSION: Middle fossa approach (MFA) shows a hearing preservation rate of 86% and facial nerve function was preserved with HB grade I or II in 93%. MFA is a good treatment option for intra-canalicular vestibular schwannomas when surgical excision is needed. BACKGROUND: Surgical outcomes of vestibular schwannoma have progressively improved with the advancement of microsurgical instruments. MFA is known to have better chances to preserve hearing, while it has limited access to the posterior fossa, limitation of tumor size, and higher risk of post-operative facial nerve weakness...
November 25, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27884604/surgical-management-of-falcine-meningiomas-experience-of-95-patients
#20
REVIEW
Domenico Murrone, Danilo De Paulis, Valerio di Norcia, Hambra Di Vitantonio, Renato Juan Galzio
Falcine meningiomas, defined as a meningiomas arising from the falx not involving the superior sagittal sinus, account for 9% of all intracranial meningiomas. We analyzed 95 patients with falcine meningiomas who underwent surgical removal of their lesion at our institution between 2001 and 2014. Surgical management of these patients, focusing on anatomical and clinical features is described. Thus, based on our series, a surgical algorithm, classifying the falcine meningioma into four types, according to location at the falx, and using an ipsilateral interhemispheric approach in supine or prone position, is described...
November 21, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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