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Microsurgical

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https://www.readbyqxmd.com/read/28655208/accuracy-in-identifying-the-source-of-subarachnoid-hemorrhage-in-the-setting-of-multiple-intracranial-aneurysms
#1
Jennifer L Orning, Sophia F Shakur, Ali Alaraj, Mandana Behbahani, Fady T Charbel, Victor A Aletich, Sepideh Amin-Hanjani
BACKGROUND: Subarachnoid hemorrhage cases with multiple cerebral aneurysms frequently demonstrate a hemorrhage pattern that does not definitively delineate the source aneurysm. In these cases, rupture site is ascertained from angiographic features of the aneurysm such as size, morphology, and location. OBJECTIVE: To examine the frequency with which such features lead to misidentification of the ruptured aneurysm. METHODS: : Records of patients who underwent surgical clipping of a ruptured aneurysm at our institution between 2004 and 2014 and had multiple aneurysms were retrospectively reviewed...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28650602/intraoperative-neurophysiological-monitoring-to-protect-the-facial-nerve-during-microsurgery-for-large-vestibular-schwannomas
#2
(no author information available yet)
OBJECTIVE: Microsurgery is the preferred treatment for large vestibular schwannomas (VSs). However, anatomical and functional preservation of the facial nerve (FN) remains a challenge during this surgery. The aim of this study was to determine whether it is beneficial to the preservation rates of the FN during microsurgical treatment of large VSs using intraoperative neurophysiological monitoring (IONM). METHODS: We retrospectively reviewed 53 patients with large VSs that underwent microsurgical resection via the retrosigmoid approach in our department during April 2009 to March 2016...
May 26, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28649476/a-practice-platform-for-systematic-development-of-microsurgical-instrument-technique
#3
Darius Bagli, Rakan Odeh, Frank Penna, Ethan Grober, Nicolas Fernandez, Armando Lorenzo, Lisa Satterthwaite, Adam Dubrowski
Many surgical disciplines, particularly those specializing in the pediatric age group, use microsurgical instruments with the assistance of either optical loupe or microscope magnification to perform high precision surgical procedures. We developed a course consisting of two parts: Part 1 consists of low fidelity, inanimate exercises or training and practice platform, and part 2 employed a rat model. In this report, we describe and provide templates for the first part of the course, namely the practice platform as an integral set of six low-fidelity exercises, each focusing on a specific aspect of instrument handling required to master the later use of the instruments during actual microsurgery...
May 16, 2017: Curēus
https://www.readbyqxmd.com/read/28649225/microsurgical-vs-endoscopic-excision-of-colloid-cysts-an-analysis-of-complications-and-costs-using-a-longitudinal-administrative-database
#4
Ian David Connolly, Eli Johnson, Layton Lamsam, Anand Veeravagu, John Ratliff, Gordon Li
OBJECTIVE: Open microsurgical and endoscopic approaches are the two main surgical options for excision of colloid cysts. Controversy remains as to which is superior. Previous studies consist of small cohort sizes. This topic has not been investigated using national administrative claims data which benefits from larger patient numbers. METHODS: Current Procedural Terminology (CPT) and International Classification of Disease version 9 (ICD-9) coding at inpatient visit was used to select for index surgical procedures corresponding to microsurgical or endoscopic excision of colloid cysts...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28648910/risk-of-aneurysm-residual-regrowth-recurrence-and-de-novo-aneurysm-formation-after-microsurgical-clip-occlusion-based-on-follow-up-with-catheter-angiography
#5
Jan-Karl Burkhardt, Michelle H J Chua, Miriam Weiss, Angelique Sao-Mai S Do, Ethan A Winkler, Michael T Lawton
INTRODUCTION: Established guidelines for radiologic surveillance after microsurgical treatment of intracranial aneurysms are lacking in the literature due to small sample size, poor definitions, and heterogeneous use of imaging modalities. We aimed to propose clinically meaningful definitions for postoperative aneurysm residual, recurrence, and de novo aneurysm formation and analyze our long-term follow-up (FU) catheter angiography results in patients with microsurgically treated intracranial aneurysms...
June 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28648581/is-long-term-post-operative-monitoring-of-microsurgical-flaps-still-necessary
#6
Giovanni Zoccali, Alexandra Molina, Jian Farhadi
Autologous microsurgical flap reconstruction has become commonplace in most plastic surgery units, and the success rates of this procedure have markedly increased over recent years. However, the possibility of flap failure still needs to be considered. A review of the literature reveals that the critical period for flap-threatening complications is the first 24-48 post-operative hours; however, the window for the onset of these complications remains open for up to 7 days post-operatively. In this study, we focus on the timing of flap complications, aiming to elucidate the time period over which meticulous flap monitoring can positively contribute to flap salvage rates...
June 1, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28648003/-curative-effect-analysis-of-15-cases-of-cervical-intra-and-extra-spinal-tumors-by-microsurgical-resection
#7
Y Han, X L Zheng, L Li, Z Q Jiang, F Y Lou, S J Zhang
Objective: To explore the curative effect of microsurgical treatment of cervical intra- and extra-spinal tumors. Methods: The clinical data of 15 patients with cervical intra-and extra-spinal tumors in Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College from January 2013 to February 2017 were retrospectively analyzed. According to Shaw's tumor stage: 6 cases in stage Ⅰ, 5 cases in stage Ⅱ, 3 cases in stage Ⅲ, and 1 case in stage Ⅳ. About the surgical methods: 9 cases were treated via posterior median semi-laminectomy approach, of which were internal fixation in 2 cases, and via posterior median approach spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty in 3 cases, other 3 cases were operated via anterior cervical approach, including internal fixation in 1 case...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647662/microsurgical-bypass-training-rat-model-part-1-technical-nuances-of-exposure-of-the-aorta-and-iliac-arteries
#8
Ali Tayebi Meybodi, Michael T Lawton, Pooneh Mokhtari, Sonia Yousef, Sirin Gandhi, Arnau Benet
BACKGROUND AND OBJECTIVE: Animal models using rodents are frequently used for the purpose of practicing microvascular anastomosis - an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in two consecutive articles...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647654/the-clinical-features-and-surgical-outcomes-of-spinal-cord-tanycytic-ependymomas-a-report-of-40-cases
#9
Xiaogang Tao, Zonggang Hou, Shuyu Hao, Qi Zhang, Zhen Wu, Junting Zhang, Baiyun Liu
OBJECTIVE: Spinal cord tanycytic ependymomas (TEs) are rarely reported because of extremely low incidence. Understanding of this disease is therefore poor. The aim of this study was to analyze the incidence and clinical, radiological, pathological, and prognostic features of spinal cord TEs. METHODS: Approximately 4,000 spinal cord tumors were surgically resected in Beijing Tiantan Hospital between April 2009 and May 2016. We identified all cases of pathologically proved TEs among these patients...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642176/microsurgical-bypass-training-rat-model-part-2-anastomosis-configurations
#10
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Pooneh Mokhtari, Sirin Gandhi, Arnau Benet
BACKGROUND: Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal pre-clinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. OBJECTIVE: We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642060/microsurgically-assisted-inguinal-hernia-repair-and-simultaneous-male-fertility-procedures-rationale-technique-and-outcomes
#11
Michael L Schulster, Matthew R Cohn, Bobby B Najari, Marc Goldstein
PURPOSE: Inguinal herniorrhaphy is the most common general surgical procedure. It is associated with frequent complications such as recurrence (1.9% with mesh), post-operative hematoma (4.5%), reduced sensation (0 - 42.8%), chronic post-operative pain (5.1%), vasal injury (0.1 - 0.53%) and infection (3 - 6%)(1-5). Drawing on our experience utilizing the operating microscope for varicocelectomy, vasectomy reversal and repair of iatrogenic vasal obstruction from hernia repair, we employed it for inguinal hernia repair...
June 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28638701/reinnervation-of-denervated-muscle-by-implantation-of-nerve-muscle-endplate-band-graft-to-the-native-motor-zone-of-the-target-muscle
#12
Liancai Mu, Stanislaw Sobotka, Jingming Chen, Themba Nyirenda
INTRODUCTION: Motor endplate reinnervation is critical for restoring motor function of the denervated muscle. We developed a novel surgical technique called nerve-muscle-endplate band grafting (NMEG) for muscle reinnervation. METHODS: Experimentally denervated sternomastoid muscle in the rat was reinnervated by transferring a NMEG from the ipsilateral sternohyoid muscle to the native motor zone (NMZ) of the target muscle. A NMEG pedicle contained a block of muscle (~ 6 × 6 × 3 mm), a nerve branch with axon terminals, and a motor endplate band with numerous neuromuscular junctions...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28637249/bypass-surgery-for-complex-intracranial-aneurysms-15-years-of-experience-at-a-single-institution-and-review-of-pertinent-literature
#13
Seung Pil Ban, Won-Sang Cho, Jeong Eun Kim, Chang Hyeun Kim, Jae Seung Bang, Young-Je Son, Hyun-Seung Kang, O-Ki Kwon, Chang Wan Oh, Moon Hee Han
BACKGROUND: Bypass surgery is a treatment option for complex intracranial aneurysms. OBJECTIVE: To determine the utility of bypass surgery for the treatment of complex intracranial aneurysms and to review the literature on this topic. METHODS: Sixty-two patients were included in this retrospective study. Unruptured aneurysms were dominant (80.6%), and the internal carotid artery was the most common location of the aneurysm (56.4%), followed by the middle cerebral artery (21...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28637207/the-use-of-semitranslucent-rubber-pledgets-during-microsurgical-dissection-of-cerebellopontine-angle-tumors-technical-note
#14
Marcus D Mazur, Richard Gurgel, Joel D MacDonald
BACKGROUND AND IMPORTANCE: Dissection of cerebellopontine angle (CPA) tumors that abut or adhere to the brainstem or cranial nerves can be a challenging surgical endeavor. We describe the use of semitranslucent latex rubber pledgets in the tumor-brain interface as a method to improve visualization and protection of vital tissue during microsurgical dissection of CPA masses. The rubber pledgets are fashioned by cutting circular discs out of the cuff portion of talc-free, partially opaque latex gloves...
June 20, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28637115/ruptured-carotid-ophthalmic-aneurysm-treatment-a-non-inferiority-meta-analysis-comparing-endovascular-coiling-and-surgical-clipping
#15
Alberto Falk Delgado, Tommy Andersson, Anna Falk Delgado
INTRODUCTION: Aneurysms of the carotid-ophthalmic segment are relatively rare, comprising only five percent of all intracranial aneurysms. There is no consensus regarding the optimal management for ruptured carotid-ophthalmic aneurysms, whether endovascular coiling or surgical clipping provide the most favourable patient outcome. The aim of this meta-analysis is to analyse these two treatment modalities for ruptured carotid-ophthalmic aneurysms with respect to independent clinical outcome...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28634821/cavernous-malformations-of-central-nervous-system-in-pediatric-patients-our-single-centered-experience-in-50-patients-and-review-of-literature
#16
Dattaraj Paramanand Sawarkar, Suveen Janmatti, Rajinder Kumar, Pankaj Kumar Singh, Hitesh Kumar Gurjar, Shashank Sharad Kale, Bhawani Shanker Sharma, Ashok Kumar Mahapatra
PURPOSE: Cavernous malformations (CMs) are rare developmental cerebrovascular malformations of the central nervous system with a childhood prevalence of 0.3 to 0.53%. Our purpose was to assess the clinical features and microsurgical outcome in pediatric central nervous system (CNS) CMs. MATERIAL AND METHODS: We retrospectively enrolled all the CM patients admitted to our institute from 1 January 2001 to 31 December 2014. Data was analyzed for their clinical features and surgical outcome...
June 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#17
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
June 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28626100/-neuronavigator-assisted-microsurgical-resection-of-glioma-located-in-cerebral-functional-areas
#18
Guohui Su, Zhixiong Liu, Lei Huo, Chuntao Li, Mingyu Zhang
To evaluate value of neuronavigator-assisted microsurgery of glioma located in cerebral functional areas.
 Methods: Patients with glioma located in cerebral functional areas were underwent operation in Xiangya Hospital. Of 64 patients, 34 patients were performed neuronavigator-assisted microsurgery, and 30 were underwent routine surgical operation.
 Results: The neuronavigator-assisted microsurgery group showed high complete resection rate with low neurological deficit and cerebral edema compared with the routine surgical group (P<0...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28619498/microsurgical-treatment-of-colloid-cysts-of-the-third-ventricle
#19
Alexander N Konovalov, David I Pitskhelauri, Michael Shkarubo, Svetlana B Buklina, Anna A Poddubskaya, Mariya Kolycheva
No abstract text is available yet for this article.
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28619497/long-term-functional-outcome-of-symptomatic-unruptured-intracranial-aneurysms-in-an-interdisciplinary-treatment-concept
#20
M Kunz, F Dorn, T Greve, V Stoecklein, J C Tonn, H Brückmann, Ch Schichor
OBJECTIVE: In symptomatic unruptured intracranial aneurysms (UIA), data on long-term functional outcome are sparse in the literature, even in the light of modern interdisciplinary treatment decisions. We therefore analysed our in-house database for prognostic factors and long-term outcome of neurological symptoms after microsurgical/endovascular treatment. METHODS: Patients treated between 2000 and 2016 after interdisciplinary vascular board decision were included...
June 12, 2017: World Neurosurgery
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