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neurovascular surgery

Tressa D Amirthanayagam, Andrew A Amis, Peter Reilly, Roger J H Emery
BACKGROUND: The deltopectoral approach for total shoulder arthroplasty can result in subscapularis dysfunction. In addition, glenoid wear is more prevalent posteriorly, a region difficult to access with this approach. We propose a posterior approach for access in total shoulder arthroplasty that uses the internervous interval between the infraspinatus and teres minor. This study compares this internervous posterior approach with other rotator cuff-sparing techniques, namely, the subscapularis-splitting and rotator interval approaches...
October 10, 2016: Journal of Shoulder and Elbow Surgery
John Heesakkers, Fawzy Farag, Ricarda M Bauer, Jaspreet Sandhu, Dirk De Ridder, Arnulf Stenzl
CONTEXT: The incidence and awareness of postprostatectomy incontinence (PPI) has increased during the past few years, probably because of an increase in prostate cancer surgery. Many theories have been postulated to explain the pathophysiology of PPI. OBJECTIVE: The current review scrutinizes various pathophysiologic mechanisms underlying the occurrence of PPI. EVIDENCE ACQUISITION: A search was conducted on PubMed and EMBASE for publications on PPI...
October 6, 2016: European Urology
Achmad Fauzi Kamal, Agus Waryudi, Zuhri Effendi, Evelina Kodrat
INTRODUCTION: Prevalence of giant cell tumor (GCT) at atypical locations like bones of the feet are rare, seen in <1% of cases. GCT may have aggressive features, including cortical expansion or destruction with a soft-tissue component. Difficult diagnosis most often followed with complicated management and high recurrence rate remains a challenge that is rarely reported. PRESENTATION OF CASE: We presented a case of forty-six-year-old male patient with giant cell tumor of the right calcaneus Campanacci 3 with secondary aneurysmal bone cyst (ABC)...
September 28, 2016: International Journal of Surgery Case Reports
Natália Ferreira Sesoko, Sheila Canevese Rahal, Zara Bortolini, Natalie Bertelis Merlini, Carlos Roberto Teixeira
Anteater forelimbs are distinguished morphologically from domestic animals, especially due to their unique movement and their natural habits. A knowledge of the pectoral limb anatomy and the proper surgical approach are fundamental to success in osteosynthesis and other surgeries. This study aimed to describe the muscles and neurovascular structures of the pectoral limb and the surgical approach to the humeral shaft of the giant anteater ( Myrmecophaga tridactyla ). Dissections of the forelimbs of seven cadavers were performed to identify the major muscles and neurovascular structures...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Varun R Kshettry, Khaled Elshazly, James J Evans
Tuberculum sella and planum sphenoidale meningiomas pose a management challenge given their intimate relationship to surrounding critical neurovascular structures. The development and advancement of expanded endoscopic transnasal surgery has provided a good surgical option that in well-selected cases, may provide several advantages over a transcranial route. These include early devascularization, complete dura and bone removal, elimination of brain retraction and enhanced visualization of the optic apparatus perforating vessels...
October 2016: CNS Oncology
Hasan A Zaidi, David J Cote, William T Burke, Joseph P Castlen, Wenya Linda Bi, Edward R Laws, Ian F Dunn
INTRODUCTION: Pituitary tumor apoplexy can result from either hemorrhagic or infarctive expansion of pituitary adenomas, and related mass effect can result in compression of critical neurovascular structures. The time course of recovery of visual field deficits, headaches, ophthalmoparesis, and pituitary dysfunction after endoscopic transsphenoidal surgery has not been well established. METHODS: Medical records were retrospectively reviewed for all patients who underwent endoscopic transsphenoidal surgery for pituitary tumor apoplexy from April 2008 to November 2014...
September 20, 2016: World Neurosurgery
Darnell T Josiah, SoHyun Boo, Abdul Tarabishy, Sanjay Bhatia
OBJECTIVE The objective of this study was to investigate the neurovascular and anatomical differences in patients with lumbosacral transitional vertebrae (LSTV) and the associated risk of neurovascular injury in minimally invasive spine surgery. METHODS The authors performed a retrospective study of CT and MR images of the lumbar spine obtained at their institution between 2010 and 2014. The following characteristics were evaluated: level of the iliac crest in relation to the L4-5 disc space, union level of the iliac veins and arteries in relation to the L4-5 disc space, distribution of the iliac veins and inferior vena cava according to the different Moro zones (A, I, II, III, IV, P) at the L4-5 disc space, and the location of the psoas muscle at the L4-5 disc space...
September 23, 2016: Journal of Neurosurgery. Spine
Robert S George, Richard Milton, Nilanjan Chaudhuri, Emmanuel Kefaloyannis, Kostas Papagiannopoulos
BACKGROUND: Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. In this study we report a totally endoscopic video-assisted thoracoscopic surgery (VATS) approach using tailored endoscopic instruments. METHODS: Ten patients (8 women; average age, 32.3 ± 5.6 years) with TOS underwent VATS first rib resection following failure of symptom improvement with physiotherapy...
September 19, 2016: Annals of Thoracic Surgery
G Esposito, R Messina, A Carai, G S Colafati, F Randi, A De Benedictis, S Cossu, M M Fontanella, C E Marras
INTRODUCTION: Intrameatal cochleovestibular neurovascular conflict is a rare condition with specific clinical and therapeutic implications. Although surgery is commonly indicated in other neurovascular conflicts, for this subset of patients there is little evidence to guide treatment decisions. Moving from a case description, we performed a review of the literature on this topic in order to systematically present the best available evidence to guide clinical decisions. MATERIALS AND METHODS: We performed a literature review on reported cases of surgically treated intrameatal anterior inferior cerebellar artery (AICA) - cochleovestibular nerve (CVN) neurovascular conflict, analyzing preoperative clinical data, surgical techniques, and outcomes...
September 16, 2016: World Neurosurgery
Bryan G Beutel, Scott D Lifchez, Eitan Melamed
BACKGROUND: Cardiovascular procedures are common and are trending toward endovascular interventions. With this increase in endovascular procedures, there is also increasing awareness of upper extremity morbidity resulting from treatment. METHODS: Articles indexed within PubMed between the years 1975 and 2015 that discussed such complications were reviewed. RESULTS: Percutaneous radial artery access can lead to nerve ischemia, especially in the setting of an incomplete arterial arch, whereas radial artery harvesting for bypass surgery more commonly causes frank tissue ischemia and radial neuropathy...
August 2016: Journal of Hand and Microsurgery
Khalid Nasser Fadle, Ahmed Gaber Hassanein, Abdin K Kasim
INTRODUCTION: Fibrous dysplasia (FD) is a non-neoplastic developmental fibro-osseous disease. It represents 2.5% of all bone tumors and 5% to 7% of the benign bone tumors. Orbitocranial region is involved in about 20% of the patients. The main presentations are craniofacial deformity and headache. Loss of vision is the most devastating result of this disease. There is no medical treatment to cure or prevent FD. Radiation therapy is contraindicated. Surgery for the orbitocranial FD is often challenging because of the proximity of neurovascular and ocular structures...
September 9, 2016: Journal of Craniofacial Surgery
Intan Iliana Iliassa, Wan Mohd Zahiruddin Wan Mohammad, Jun Jie Tan, Yasmin Ayob
BACKGROUND: Cryoprecipitate is generally used to treat bleeding patients with hypofibrinogenemia, and the transfusion decision is guided based on published guidelines. AIM: This study aimed to evaluate the practice appropriateness in accordance to cryoprecipitate transfusion guidelines in Hospital Kuala Lumpur. METHODOLOGY: This cross-sectional study of 117 cryoprecipitates transfused adult patients was conducted in Kuala Lumpur Hospital from January to June 2012...
July 2016: Asian Journal of Transfusion Science
Christine A Ho, David A Podeszwa, Anthony I Riccio, Robert L Wimberly, Brandon A Ramo
BACKGROUND: Neurovascular injury in pediatric supracondylar fractures (SCHFx) has been associated with fracture classification but not with soft tissue injury. The purpose of this study is to correlate clinical soft tissue damage to neurovascular injuries in SCHFx. METHODS: This is an institutional review board approved prospective study from January 2010 through December 2013 of 748 operatively treated pediatric SCHFx. Prospective data were gathered both preoperatively and intraoperatively regarding detailed neurovascular examination as well as soft tissue status, with qualitative descriptives for swelling (mild/moderate/severe), ecchymosis, abrasions, skin tenting, and skin puckering...
September 3, 2016: Journal of Pediatric Orthopedics
Chunyue Duan, Jianzhong Hu, Xiyang Wang, Jianhuang Wu
OBJECTIVE: To explore the clinical value of early and one-stage posterior laminectomy decompression, fracture reconstruction and lateral mess screw fixation combined with anterior cervical corpectomy or discectomy for the treatment of fresh and severe lower cervical spine fracture and dislocation.
 METHODS: A total of 156 consecutive cases of severe fracture and dislocation of lower cervical spine were reviewed from January 2008 to January 2015. Skull traction was installed when the patients were enrolled in the hospital, so the operation was performed as early as possible...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Fuminari Komatsu, Masaaki Imai, Akihiro Hirayama, Kazuko Hotta, Naokazu Hayashi, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
Background Endoscopic microvascular decompression (MVD) offers reliable identification of neurovascular conflicts under superb illumination, and it provides minimally invasive surgery for trigeminal neuralgia and hemifacial spasm. Transposition techniques have been reported as a decompression method to prevent adhesion and granuloma formation around decompression sites, providing better surgical outcomes. The feasibility and effects of transposition under endoscopic MVD were evaluated. Material and Methods Fully endoscopic MVD was performed using 4-mm 0- and 30-degree endoscopes...
September 5, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jisoo Yoon, Nalini Pather
INTRODUCTION: The anterior ethmoidal foramen (AEF) and posterior ethmoidal foramina (AEF and PEF, respectively) on the medial wall and the cranio-orbital foramen (COF) on the lateral wall are used as landmarks in orbital surgeries. In surgery these foramina, the neurovascular structures they transmit and other orbital structures in close proximity need to be identified to minimise their risk of damage. Despite the clinical importance, the current understandings lack consistency in the precise location, microanatomy and morphology of the foramina...
September 4, 2016: Clinical Anatomy
D Moszkowicz, G Rougier, C Julié, K Nyangoh Timoh, A Beauchet, K Vychnevskaia, R Malafosse, B Nordlinger, F Peschaud
AIM: Whether or not nerve-sparing rectal-cancer surgery can effectively prevent removal of the pelvic autonomic nerves has not been substantiated microscopically. We aimed to analyse the quality of nerve preservation in female patients by quantifying residual nerve fibres in total mesorectal excision specimens, to analyse pro-erectile function of the nerve fibres removed and to determine risk factors for pelvic denervation. METHOD: Serial transverse sections from female patients, 64 ± 18 years of age, were studied after the mesorectal fascia was inked and studied histologically [using anti-S100 and anti-neuronal nitric oxide synthase (nNOS) antibodies]...
October 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
K Trieb
Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels...
September 2016: Bone & Joint Journal
Bowornsilp Chowchuen
BACKGROUND: Reconstruction of extensive lower lip defects is challenging, and functional outcomes are difficult to achieve. METHODS: A modified bilateral neurovascular cheek (MBNC) flap has been described. The data of patients with cancer of the lower lip treated with wide excision and reconstructed with the MBNC flap in the Plastic Surgery Unit, Srinagarind Hospital, Khon Kaen University, from 1966 to 2012 were reviewed. RESULTS: Of the total of 143 patients included, 90...
May 2016: Plastic and Reconstructive Surgery. Global Open
Erin L Mazerolle, Yuhan Ma, David Sinclair, G Bruce Pike
Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies of patients with cerebrovascular disease have largely ignored the confounds associated with abnormal cerebral blood flow, vascular reactivity and neurovascular coupling. We studied BOLD fMRI activation and cerebrovascular reactivity in moyamoya disease. To characterize the impact of remote vascular demands on BOLD fMRI measurements, we varied the vascular territories engaged by manipulating the experimental task performed by the participants...
August 30, 2016: Clinical Physiology and Functional Imaging
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