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Microsurgical

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https://www.readbyqxmd.com/read/29148902/microsurgical-anatomy-and-approaches-around-the-lateral-recess-with-special-reference-to-entry-into-the-pons
#1
Osamu Akiyama, Ken Matsushima, Maximiliano Nunez, Satoshi Matsuo, Akihide Kondo, Hajime Arai, Albert L Rhoton, Toshio Matsushima
OBJECTIVE The lateral recess is a unique structure communicating between the ventricle and cistern, which is exposed when treating lesions involving the fourth ventricle and the brainstem with surgical approaches such as the transcerebellomedullary fissure approach. In this study, the authors examined the microsurgical anatomy around the lateral recess, including the fiber tracts, and analyzed their findings with respect to surgical exposure of the lateral recess and entry into the lower pons. METHODS Ten cadaveric heads were examined with microsurgical techniques, and 2 heads were examined with fiber dissection to clarify the anatomy between the lateral recess and adjacent structures...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148013/vitom%C3%A2-3d-system-in-surgeon-microsurgical-vascular-training-our-model-and-experience
#2
Vincenzo Davide Palumbo, Salvatore Fazzotta, Giuseppe Damiano, Attilio Ignazio Lo Monte
No abstract text is available yet for this article.
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148005/microsurgery-for-wrist-arteriovenous-fistula-creation-in-children-a-retrospective-cohort-study
#3
Afram Akturk, Roel Bakx, Michiel J S Oosterveld, Jim C H Wilde, Mirza M Idu
INTRODUCTION: Creating functional arteriovenous fistulae (AVF) at the wrist is challenging in paediatric patients because of the small calibre of the blood vessels. METHODS: We report our experience with AVF surgery in children younger than 15 years of age using microsurgical techniques. Twenty-five patients underwent AVF surgery between 2003 and 2015 (20 for haemodialysis, 4 for plasmapheresis and 1 for parenteral nutrition). Median (range) age was 9 (2-15) years and median weight was 24 (8-61) kg...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147637/subtotal-resection-of-a-thalamic-glioblastoma-multiforme-through-transsylvian-approach
#4
Rouzbeh Motiei-Langroudi, Homa Sadeghian, Alireza M Mohammadi
Glioblastoma multiforme (GBM) is a malignant brain tumor with an ominous prognosis. The standard treatment includes maximal safe resection plus adjuvant therapy. Thalamic GBMs, however, are unfavorable for microsurgical removal because of deep location and proximity to critical structures. We present a patient presenting with progressive hemiparesis and decreased consciousness with a large thalamic GBM who underwent subtotal resection through a transsylvian approach. His clinical and neurologic condition improved after surgery and he survived nine months after surgery...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29146958/third-repeat-microvascular-reconstruction-in-head-and-neck-cancer-patients-aged-65-years-and-older-a-longitudinal-and-sequential-analysis
#5
Jonas Löfstrand, Kai-Ping Chang, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Hsuan-Yu Chou, Huang-Kai Kao
Performing a sequential third free flap for reconstruction of a head and neck defect after cancer resection can be challenging, and the problem is further compounded in elderly patients. The outcomes in this clinical scenario are currently unknown and this study aims to compare the results in elderly patients with younger patients in a high-volume microsurgical unit. A retrospective review of 126 consecutive patients who had undergone three sequential free flap reconstructions after head and neck cancer was performed...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29143274/clinical-features-surgical-management-and-prognostic-factors-of-secretory-meningiomas-a-single-center-case-series-of-149-patients
#6
Xiaogang Tao, Kun Wang, Jinqian Dong, Zonggang Hou, Zhen Wu, Junting Zhang, Baiyun Liu
Secretory meningioma (SM) is a rare histological subtype of the meningioma family. Few reports investigating SM have been published due to its extremely low incidence; thus, the current understanding of this disease is poor. We analyzed the incidence and clinical, radiological, pathological, and prognostic features of SM. Approximately 12,380 intracranial meningiomas were surgically resected at Beijing Tiantan Hospital between April 2008 and January 2017. All pathologically confirmed SM cases were identified...
November 15, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29142778/-foramen-magnum-meningiomas-a-report-of-12-cases-and-literature-review
#7
Álvaro Campero, Pablo Ajler, Guillermo Roman, Conrado Rivadeneira
Objectives: The primary aim of this study was to assess the results attained for 12 patients with an anterior or lateral foramen magnum meningioma, treated microsurgically. Methods: Between June 2005 and December 2016, 12 patients with foramen magnum meningiomas underwent microsurgical resection. Patients' age and gender, tumor localization (anterior or lateral), symptoms, approach, and postoperative results were analyzed. Results: Eight of the 12 patients were women...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29142775/-relevance-of-simpson-s-grades-in-the-resection-of-grade-i-meningiomas
#8
Pablo Ajler, Sofía Beltrame, Daniela Massa, Julian Tramontano, Matteo Baccanelli, Claudio Yampolsky
Objective: Compare the number of recurrences in patients with WHO Grade I meningiomas that underwent microsurgical resection. Introduction: In 1957 Simpson established five grades for surgical resection for intracranial meningiomas and recurrence rate. He thought that an aggressive removal of these tumors with dura and bone was necessary to cure them. Development of new diagnostic methods, advances in anatomopathology and microsurgical technique lead us to question if this scale has a value nowadays...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29140901/-state-of-the-art-techniques-in-treating-peripheral-nerve-injury
#9
Carrie A Kubiak, Theodore A Kung, David L Brown, Paul S Cederna, Stephen W P Kemp
BACKGROUND -: Peripheral nerve injuries remain a major clinical concern as they often lead to chronic disability and significant health care expenditures. Despite advancements in microsurgical techniques to enhance nerve repair, biologic approaches are needed to augment nerve regeneration and improve functional outcomes after injury. METHODS -: Presented herein is a review of the current literature on state of the art techniques to enhance functional recovery for patients with nerve injury...
November 11, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29138975/distal-transsylvian-keyhole-approach-for-unruptured-anterior-circulation-small-aneurysms
#10
Ririko Takeda, Hiroki Kurita
BACKGROUND: To reduce complications associated with conventional pterional craniotomy, a transsylvian keyhole approach for unruptured small anterior circulation aneurysms is proposed. METHODS: A 7-cm linear scalp incision is made along the hairline, beginning at the zygoma, followed by minimal temporal muscle dissection. Two burr holes are drilled out at McCarty's point and the temporal bone, and a 3-cm equilateral triangle bone flap is made, whose apex is located above the sylvian point...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29134170/effectiveness-of-bilateral-inferior-petrosal-sinuses-sampling-in-tumor-lateralization-intraoperative-findings-and-postoperative-results
#11
Pablo Harker, Oscar Feo-Lee, Manuel Giraldo-Grueso, Juan Carlos Puentes
Object  Diagnosis and treatment of Cushing's disease (CD) is a demanding endeavor. We evaluated the effectiveness of inferior petrosal sinus sampling (IPSS) in preoperative tumor lateralization and surgical outcomes. Methods  Fifty-two consecutive patients with CD and normal magnetic resonance imaging (MRI) were enrolled between 2009 and 2015. Selective catheterization of petrosal sinuses for IPSS was performed. All patients underwent microsurgical dissection, and if a lesion was found, underwent lesion resection...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29134163/prognostic-indices-for-predicting-facial-nerve-outcome-following-the-resection-of-large-acoustic-neuromas
#12
Kurt Grahnke, Jonathan R Garst, Brendan Martin, John P Leonetti, Douglas E Anderson
This study analyzes the simple ratio of anterior-to-posterior extension of large (>2.5 cm) acoustic neuromas relative to the internal auditory canal (ICA; anterior-posterior [A/P] index) as a tool for predicting risk of facial nerve (FN) injury. In total, 105 patients who underwent microsurgical resection for large acoustic neuromas were analyzed retrospectively. House-Brackmann (HB) scores were assessed immediately postoperatively, at 1 month, and at 1 year. Lateral-medial, inferior-superior, A/P, and maximum diameters were measured from preoperative magnetic resonance images...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29132382/early-motor-function-after-local-treatment-of-brain-metastases-in-the-motor-cortex-region-with-stereotactic-radiotherapy-radiosurgery-or-microsurgical-resection-a-retrospective-study-of-two-consecutive-cohorts
#13
Bogdan Pintea, Brigitta Baumert, Thomas Mehari Kinfe, Konstantinos Gousias, Yaroslav Parpaley, Jan Patrick Boström
BACKGROUND: We compared the functional outcome and influential factors of two standard treatment modalities for central cerebral metastases: electrophysiological-controlled microsurgical resection (MSR) and stereotactic radiotherapy/stereotactic radiosurgery (SRT/SRS). METHODS: We performed a database search for central metastasis treatments during the period from January 2008 to September 2012 in two clinical registers: 1) register for intraoperative neuromonitoring (Department of Neurosurgery), and 2) prospective database for SRT/SRS (Department of Radiotherapy)...
November 13, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29132254/reverse-flow-intrinsic-fasciocutaneous-island-flaps-in-foot-reconstruction
#14
Sujin Bahk, GyeongHyeon Doh, Ki Yong Hong, SooA Lim, SuRak Eo
Reconstruction of soft tissue defects in the foot remains a challenge due to its specialized tissue for weightbearing and ambulation. Considering the principle of replacing "like with like," adjacent soft tissues would be a best option for a donor site. Although several kinds of reverse-flow island flaps for the lower leg have been well described, intrinsic foot reverse flow flaps have been rarely reported. We describe 3 kinds of reverse-flow intrinsic fasciocutaneous flaps (RIFFs) for foot reconstruction. From September 2012 to August 2015, a retrospective study was done on case notes of all patients who had a RIFF for coverage of soft tissue defects within the foot following trauma or tumor ablation...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29127655/the-endoscopic-endonasal-approach-is-not-superior-to-the-microscopic-transcranial-approach-for-anterior-skull-base-meningiomas-a-meta-analysis
#15
Ivo S Muskens, Vanessa Briceno, Tom L Ouwehand, Joseph P Castlen, William B Gormley, Linda S Aglio, Amir H Zamanipoor Najafabadi, Wouter R van Furth, Timothy R Smith, Rania A Mekary, Marike L D Broekman
OBJECT: In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. METHODS: A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values...
November 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29125412/stereotactic-radiosurgery-for-jugular-foramen-schwannomas-an-international-multicenter-study
#16
Hideyuki Kano, Antonio Meola, Huai-Che Yang, Wan-Yuo Guo, Roberto Martínez-Alvarez, Nuria Martínez-Moreno, Dusan Urgosik, Roman Liscak, Or Cohen-Inbar, Jason Sheehan, John Y K Lee, Mahmoud Abbassy, Gene H Barnett, David Mathieu, Douglas Kondziolka, L Dade Lunsford
OBJECTIVE For some jugular foramen schwannomas (JFSs), complete resection is possible but may be associated with significant morbidity. Stereotactic radiosurgery (SRS) is a minimally invasive alternative or adjunct to microsurgery for JFSs. The authors reviewed clinical and imaging outcomes of SRS for patients with these tumors. METHODS Nine participating centers of the International Gamma Knife Research Foundation identified 92 patients who underwent SRS between 1990 and 2013. Forty-one patients had prior subtotal microsurgical resection...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#17
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29123895/microsurgical-replantation-of-an-amputated-ear
#18
Tomoya Sato, Shigeru Ichioka
We report a case of successful microsurgical reattachment of an amputated ear. Microsurgical reattachment should be considered whenever possible.
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121249/surgical-management-of-anterolateral-and-posteromedial-incisural-tentorial-meningioma
#19
Andrea Talacchi, Antonio Biroli, Stefano Medaglia, Francesca Locatelli, Mario Meglio
BACKGROUND: Tentorial meningiomas are a broad and consistent category of tumors but their definition is still unclear and their classification uncertain. OBJECTIVE: To report the clinical and surgical characteristics of tentorial hiatus meningiomas based on a revised classification of tentorial meningiomas. METHODS: We reviewed the records of 14 patients who had undergone microsurgical removal of incisural tentorial meningioma. Two tumor subgroups, anterolateral (AL) and posteromedial (PM), were distinguished according to their site of attachment: the middle third and the posterior third of the tentorial free margin, respectively...
November 7, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29118790/rescue-treatment-with-pipeline-embolization-for-postsurgical-clipping-recurrences-of-anterior-communicating-artery-region-aneurysms
#20
Li-Mei Lin, Rajiv R Iyer, Matthew T Bender, Thomas Monarch, Geoffrey P Colby, Judy Huang, Rafael J Tamargo, Alexander L Coon
Background: Postsurgical clipping aneurysm recurrences or residuals can be difficult to manage with either traditional open microsurgical approaches or endosaccular coiling. Endoluminal parent vessel reconstruction with flow diversion may be an ideal method for treating these recurrences by avoiding reoperative surgery or intraprocedural aneurysm rupture with aneurysm access. Method: We retrospectively reviewed a single-center aneurysm database identifying all anterior communicating artery (ACom) region aneurysms with recurrences after microsurgical clipping...
October 2017: Interventional Neurology
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