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https://www.readbyqxmd.com/read/29341294/topical-nitroglycerin-for-the-treatment-of-intraoperative-microsurgical-vasospasm
#1
Joseph A Ricci, Dhruv Singhal, Eugene Y Fukudome, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. This study aims to analyze the outcomes of this medication on flap complications compared with papaverine. METHODS: All consecutive free flaps performed for breast reconstruction at a single institution were reviewed...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29331084/baus-consensus-document-for-the-management-of-male-genital-emergencies-penile-amputation
#2
REVIEW
C J Shukla, G Brown, T Dorkin, M Lucky, R Pearcy, R W Rees, M Shabbir, D J Summerton, A Muneer
Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery available. A series of consensus statements have been developed by an expert consensus comprising BAUS Section of Andrology and Genitourethral Surgery together with experts from units throughout the UK. Penile amputation is a rare gentile emergency and requires prompt intervention and microsurgical reconstruction...
January 13, 2018: BJU International
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#3
Evgenii Belykh, Naomi R Onaka, Iraklii T Abramov, Kaan Yağmurlu, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. MATERIALS AND METHODS: A literature search of factors that may impact microsurgical performance was conducted using PubMed and Embase...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325945/impact-of-right-sided-aneurysm-rupture-status-and-size-of-aneurysm-on-perforator-infarction-following-microsurgical-clipping-of-posterior-communicating-artery-aneurysms-with-a-distal-transsylvian-approach
#4
Jun Tanabe, Tatsuya Ishikawa, Junta Moroi, Yoshinori Sakata, Hiromu Hadeishi
BACKGROUND: Posterior communicating artery (PCoA) aneurysms are among the most common aneurysms. Because blockage of the PCoA and perforators can cause adverse outcomes, occlusion of these arteries by surgical clipping should be avoided. The impact of factors on PCoA perforator infarction when using a distal transsylvian approach for PCoA aneurysms was examined. METHODS: A total of 183 patients underwent PCoA aneurysm clipping, excluding application of fenestrated clips...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29322603/the-nerve-supply-of-zygomaticus-major-variability-and-distinguishing-zygomatic-from-buccal-facial-nerve-branches
#5
A Kehrer, S Engelmann, R Bauer, C Taeger, S Grechenig, M Kehrer, L Prantl, E Tamm, Rlaw Bleys, V Mandlik
INTRODUCTION The zygomaticus major (ZM) is important for the human smile. There are conflicting data about whether the zygomatic or buccal branches of the facial nerve are responsible for its motor innervation. The literature provides no precise distinction of the transition zone between these two branch systems. In this study, a definition to distinguish the facial nerve branches at the level of the body of the zygoma is proposed. In the light of this definition, we conducted an anatomical study to determine how the source of innervation of the ZM was distributed...
January 11, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29319737/a-non-living-effective-model-for-microvascular-training
#6
Cristina Pires Camargo, Daniel Imbassahy de Sa Bittencourt de Camara E Silva, Fauze Camargo Maluf, Julio Morais-Besteiro, Rolf Gemperli
PURPOSE: To introduce a nonliving microvascular training model based on vessels diameter and feasibility. METHODS: We dissected ten oxen tongues, and divided the pedicles into three-thirds: proximal, middle and distal. We measured the external vessels diameter in all regions. We performed a descriptive statistical analysis. Three students (two beginner level and one intermediate level) performed this training. We evaluated the confidence, according Likert scale...
December 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29319579/how-big-is-too-big-pushing-the-obesity-limits-in-microsurgical-breast-reconstruction
#7
Jamie A Spitz, Perry S Bradford, Frank Aguilar, Sergey Y Turin, Marco F Ellis
PURPOSE: Obesity is a major public health concern in the United States, affecting nearly 79 million people. There have been promising results performing microvascular breast reconstruction in patients with obesity; however, the definition of obesity is often poorly defined or does not extend above a body mass index (BMI) of 35. Our goal was to examine outcomes of microvascular breast reconstruction in this questionably more risky population. METHODS: A retrospective review from 2013 to 2016 was performed of 2 surgeons' experience with abdominally based microvascular breast reconstructions...
February 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29318336/-decompression-for-cervical-disc-herniation-using-the-full-endoscopic-anterior-technique-german-version
#8
REVIEW
S Oezdemir, M Komp, P Hahn, S Ruetten
OBJECTIVE: Resection of a cervical disc herniation using a full-endoscopic technique with an anterior approach. INDICATION: Fresh disc herniation with monoradicular symptoms in the upper extremity. CONTRAINDICATIONS: Pure neck pain, cervical myelopathy, older and calcified disc herniations, higher grade of instability and deformity. SURGICAL TECHNIQUE: Introduction of a guidewire and dilatator to a cervical disc using an anterior approach...
January 9, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29317359/microsurgical-treatment-for-complex-basilar-artery-aneurysms-with-long-term-follow-up-in-a-series-of-35-cases
#9
Yaoling Liu, Xiangen Shi, K I Singh K C, Yuming Sun, Fangjun Liu, Hai Qian, Jie Zhang
BACKGROUND: There has been a massive shift in the balance toward endovascular therapy for basilar artery (BA) aneurysms in the modern era. METHODS: The authors retrospectively reviewed clinical and radiological data from patients with BA aneurysms who were treated in a single medical center during a 10-year period from August 2006 to May 2016. RESULTS: Thirty-five consecutive patients with 46 aneurysms during the 10-year period were included...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29316572/improvement-of-respiratory-depression-in-a-patient-with-primary-medullary-hemorrhage-following-removal-of-hematoma-in-the-half-sitting-position
#10
Shinya Ichimura, Helmut Bertalanffy, Masato Nakaya, Yoichi Mochizuki, Raita Fukaya, Goroku Moriwaki, Masahito Fukuchi, Koji Fujii
Primary medullary hemorrhage is a rare event that may result in ataxic respiration. Although it remains controversial whether primary medullary hemorrhage should be managed conservatively or surgically, recent advancements in neuroimaging and microsurgical techniques have shown promise for improving outcomes and prognosis following surgery. The present report discusses the case of a 70-year-old woman admitted to our institution due to sudden-onset nausea and vomiting. The patient underwent surgical removal of a right medullary hematoma for the treatment of daytime respiratory depression and nocturnal apnea while in the half-sitting position...
January 9, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29315193/the-application-of-sigmoid-sinus-tunnel-packing-or-push-packing-of-the-inferior-petrous-sinus-in-the-microsurgical-management-of-jugular-paragangliomas
#11
Mi Jang, Hongyan Liu, Chunfu Dai
OBJECTIVE: To analyze the outcomes of microsurgically treated jugular paragangliomas with control of bleeding from the inferior petrous sinus. STUDY DESIGN: Retrospective patient review. SETTING: A single university hospital. PATIENTS: Forty-three patients with jugular paragangliomas were diagnosed in the past 7 years in our clinic. MAIN OUTCOME MEASURES: Surgical tumor control, intraoperative blood loss, intraoperative management of the facial nerve, and the preoperative and postoperative function of the lower central nerves...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29311226/outcome-of-endoscopic-vs-microsurgical-transsphenoidal-resection-for-cushing-s-disease
#12
REVIEW
Nidan Qiao
INTRODUCTION: It is unclear whether the proportions of remission and the recurrence rates differ between endoscopic transsphenoidal surgery (TS) and microscopic TS in Cushing's disease (CD); thus, we conducted a systematic review and meta-analysis to evaluate studies of endoscopic TS and microscopic TS. METHODS: We conducted a comprehensive search of PubMed to identify relevant studies. Remission and recurrence were used as outcome measures following surgical treatment of CD...
January 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29307023/successful-microsurgical-treatment-of-intracranial-aneurysms-in-infants-a-retrospective-study-and-literature-review
#13
Yanming Ren, Shuzhen Zhao, Lunxin Liu, Hong Sun, Yi Liu, Hao Li, Lu Ma, Min He, Chao You, Jin Li
OBJECTIVE: Intracranial aneurysms are extremely rare in infants, especially less than 1 year old. This study aimed to analyze the frequency of infantile intracranial aneurysm in our department and investigate the clinical characteristics, treatment strategies, and outcomes of this disease. METHODS: Six infants under 1 year old in 4350 patients with intracranial aneurysms were retrospectively analyzed from January 2010 to December 2016. RESULTS: The patients (5 females and 1 male) ranged in age from 2 to 11 (mean age, 4...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29306525/cricoarytenoid-joint-ankylosis-classification-and-transoral-laser-microsurgical-treatment
#14
Ihab Atallah, Manjunath Mk, Ahmad Al Omari, Christian Adrien Righini, Paul F Castellanos
OBJECTIVE: This study aimed to describe a graduated approach for effective transoral mobilization of cricoarytenoid joint ankylosis (CJA) in the context of the Bogdasarian system of classifying posterior glottic web-based stenosis (PGWS). STUDY DESIGN: This is a retrospective cohort study through data from medical records and operative notes. A consecutive series of 23 patients who underwent reconstructive transoral laser microsurgery for PGWS with a significant degree of CJA (Bogdasarian grade III-IV) was included in the study...
January 4, 2018: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29301049/treatment-of-an-anterior-inferior-cerebellar-artery-aneurysm-with-microsurgical-trapping-and-in-situ-posterior-inferior-cerebellar-artery-to-anterior-inferior-cerebellar-artery-bypass-case-report
#15
Bryan S Lee, Alex M Witek, Nina Z Moore, Mark D Bain
BACKGROUND: Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can involve microsurgical and/or endovascular techniques. Such treatment can be challenging and may carry a significant risk of neurological morbidity. OBJECTIVE: To demonstrate a case involving a complex AICA aneurysm that was treated with a unique microsurgical approach involving trapping the aneurysm and performing in Situ bypass from the posterior inferior cerebellar artery (PICA) to the distal AICA...
December 30, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29300931/combined-endovascular-and-microsurgical-management-of-an-unruptured-grade-2-parietal-arteriovenous-malformation-2-dimensional-operative-video
#16
Gary Rajah, Richard Justin Garling, Leonardo Rangel-Castilla
No abstract text is available yet for this article.
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29299526/chicken-thigh-microvascular-training-model-improves-resident-surgical-skills
#17
Francis X Creighton, Allen L Feng, Neerav Goyal, Kevin Emerick, Daniel Deschler
Objectives: Microsurgical techniques are essential for vessel anastomosis in free flap reconstructive surgery. However, teaching these skills intraoperatively is difficult. The chicken thigh microvascular model is a high-fidelity model that has been previously validated to differentiate between skill levels of surgeons. This study aims to determine if this model objectively improves microsurgical skills. Study Design: Validation study. Methods: Thirteen residents were given a tutorial on microvascular anastomosis and asked to perform anastomoses on the microvascular model...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29295569/extent-of-resection-in-newly-diagnosed-glioblastoma-impact-of-a-specialized-neuro-oncology-care-center
#18
Amer Haj, Christian Doenitz, Karl-Michael Schebesch, Denise Ehrensberger, Peter Hau, Kurt Putnik, Markus J Riemenschneider, Christina Wendl, Michael Gerken, Tobias Pukrop, Alexander Brawanski, Martin A Proescholdt
Treatment of glioblastoma (GBM) consists of microsurgical resection followed by concomitant radiochemotherapy and adjuvant chemotherapy. The best outcome regarding progression free (PFS) and overall survival (OS) is achieved by maximal resection. The foundation of a specialized neuro-oncology care center (NOC) has enabled the implementation of a large technical portfolio including functional imaging, awake craniotomy, PET scanning, fluorescence-guided resection, and integrated postsurgical therapy. This study analyzed whether the technically improved neurosurgical treatment structure yields a higher rate of complete resection, thus ultimately improving patient outcome...
December 25, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29291403/electrical-stimulation-as-a-conditioning-strategy-for-promoting-and-accelerating-peripheral-nerve-regeneration
#19
J L B Senger, V M K Verge, H S J Macandili, J L Olson, K M Chan, C A Webber
The delivery of a nerve insult (a "conditioning lesion") prior to a subsequent test lesion increases the number of regenerating axons and accelerates the speed of regeneration from the test site. A major barrier to clinical translation is the lack of an ethically acceptable and clinically feasible method of conditioning that does not further damage the nerve. Conditioning electrical stimulation (CES), a non-injurious intervention, has previously been shown to improve neurite outgrowth in vitro. In this study, we examined whether CES upregulates regeneration-associated gene (RAG) expression and promotes nerve regeneration in vivo, similar to a traditional nerve crush conditioning lesion (CCL)...
December 29, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29290044/aggressive-somatotrophinomas-lacking-clinical-symptoms-neurosurgical-management
#20
Mario Giordano, Amir Samii, Rudolf Fahlbusch
We report our experience about somatotrophinomas without clinical manifestation of acromegaly having radiological- and surgical-verified invasion of the cavernous sinus. We present the clinical, radiological and hormonal status of three patients affected by invasive GH-secreting pituitary adenomas without clinical signs and symptoms of acromegaly with elevation of serum IGF-1 from a series of 142 pituitary adenomas operated in our institute with the aid of intraoperative magnetic resonance imaging (MRI). Total tumor removal was possible in two of the three cases; the patients show normal hormonal status and no recurrence at long-term follow-up...
December 30, 2017: Neurosurgical Review
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