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neurovascular surgery

Vinay Prabhu, Douglas Kondziolka, Travis C Hill, Carolina G Benjamin, Matthew S Shinseki, John G Golfinos, J Thomas Roland, Girish M Fatterpekar
BACKGROUND: Hearing preservation is a goal for many patients with vestibular schwannoma. We examined pretreatment magnetic resonance imaging (MRI) and posttreatment hearing outcome after stereotactic radiosurgery. METHODS: From 2004 to 2014, a cohort of 125 consecutive patients with vestibular schwannoma (VS) treated via stereotactic radiosurgery (SRS) were retrospectively reviewed. MRIs containing three-dimensional constructive interference in steady state or equivalent within 1 year before treatment were classified by two radiologists for pretreatment characteristics...
March 20, 2018: Otology & Neurotology
Masayuki Ishii, Atsushi Shimizu, Alan Kawarai Lefor, Yujirou Kokado, Hideaki Nishigori, Yasuko Noda
PURPOSE: The term "lateral rectal ligament" in surgery for rectal cancer has caused confusion regarding its true existence and contents. In previous studies, investigators claimed the existence of the ligament and described its topographical features as neurovascular structures and their surrounding connective tissues located at the anterolateral aspect of the distal rectum or the posterolateral aspect of the middle rectum. The purpose of this study is to evaluate the structure of the so-called "lateral rectal ligament" in cadaver dissections...
March 19, 2018: International Journal of Colorectal Disease
Stanley Yung-Chuan Liu, Douglas Sidell, Leh-Kiong Huon, Carlos Torre
Large, benign intramandibular lesions are frequently removed by resection followed by extensive free tissue transfer or delayed bone grafting. We outline a protocol to remove benign mandibular lesions using sagittal split osteotomy (SSO) with virtual surgical planning (VSP) to mitigate risks involved with this effective, tissue-saving approach. Patients with benign mandibular lesions accessed by SSO with VSP during 2014 were included in this study. Computed tomographic data were imported into VSP software. Using VSP, the exact locations of mandibular lesions and the inferior alveolar nerve canal were delineated...
March 2018: Ear, Nose, & Throat Journal
Marjan Waterloos, Tom Claeys, Maxime Sempels, Erik Van Laecke, Piet Hoebeke, Anne-Françoise Spinoit
The adrenogenital syndrome is an autosomal recessive disorder in which an enzyme defect in the steroid pathway leads to excessive prenatal exposure of androgens. In the female fetus, masculinization of the external genitalia is observed. Surgery aims for functional and aesthetical reconstruction. Many techniques have been described. A video of our modified pull-through reconstruction technique is hereby presented. A retrospective descriptive database was created with patients who underwent genitoplasty for a CAH-associated genital condition...
March 8, 2018: Journal of Pediatric Urology
Emmanuel Weyne, Johanna L Hannan, Thomas Gevaert, Yodi Soebadi, Hotaka Matsui, Fabio Castiglione, Koenraad van Renterghem, Dirk De Ridder, Frank Van der Aa, Trinity J Bivalacqua, Maarten Albersen
BACKGROUND: Previously, we found that the neuropeptide galanin was strongly upregulated soon after bilateral cavernous nerve injury (BCNI) and that galanin and its receptors were expressed in nitrergic erectile innervation. Galanin has been observed to exert neuroregenerative effects in dorsal root ganglion neurons, but evidence for these effects in the major pelvic ganglion (MPG) after BCNI is lacking. AIM: To evaluate the neurotropic effects of galanin receptor agonists and antagonists in vitro in nitrergic neurons and MPG and in vivo in rats after BCNI...
March 14, 2018: Journal of Sexual Medicine
Ahmed Hegazy, Hieder Al-Shami, Mohammed Fathy Adel Ali, Mohamad Fathallah, Ahmed Salah, Hashim Mohamed, Emad Ibrahim Ahmed, Haytham Hussien Mohammed Osman, Arundhati Biswas
Objective: The aim of this study was to determine whether adding mobilization of the outer cavernous sinus membrane as a part of the approach, in large spheno-clinoidal meningiomas without cavernous sinus extension, would reduce bleeding and increase the extent of resection. Methods: This prospective randomized controlled trial was held between February 2016 and April 2017 at Cairo University Hospitals. The study recruited 94 patients with spheno-clinoidal meningiomas without cavernous sinus involvement...
March 2018: Neurology India
Olabisi R Sanusi, Omar Arnaout, Rudy J Rahme, Craig Horbinski, James P Chandler
OBJECTIVE: Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiotherapy. The accepted standard of treatment for chordomas of the mobile spine which includes en-bloc resection with wide margins cannot be easily applied to the chordomas of the skull base given their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant radiation in the treatment of chordomas over 16 years...
March 12, 2018: World Neurosurgery
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Andrea Franzini, Federico Legnani, Elena Beretta, Francesco Prada, Francesco DiMeco, Sergio Visintini, Angelo Franzini
BACKGROUND: Laminoplasty and laminectomy are two common surgical procedures utilized in approaching degenerative and neoplastic disease of the spinal canal. Routinely adopted instruments, such as Kerrison rongeur or high-speed drill (HSD), entail some potentially serious complications such as dura injuring and thermal and mechanical damage to neurovascular structures. We have adopted piezoelectric bone surgery, which permits a selective cut of mineralized tissues, to perform posterior procedures on the thoracic spine, where the relationship between bone and the spinal cord are critical...
March 9, 2018: World Neurosurgery
Zhuming Yin, Liqiang Liu, Bingjian Xue, Jincai Fan, Wenlin Chen, Zheng Liu
INTRODUCTION: Prosthesis-assisted penile reconstruction has been performed extensively to restore a cosmetically acceptable phallus. However, a large number of patients will undergo revision surgery for various prosthesis-related complications. AIM: To develop a 1-stage prosthesis-free dynamic cavernosa reconstruction method using bilateral innervated gracilis muscles and to investigate the feasibility and reliability of the surgical design. METHODS: 10 fresh cadavers were dissected to assess the availability of bilateral gracilis muscles for functional cavernosa rebuilding...
March 7, 2018: Sexual Medicine
P Chandak, N Byrne, H Lynch, C Allen, G Rottenberg, A Chandra, N Raison, H Ahmed, V Kasivisvanathan, O Elhage, P Dasgupta
The surgical management of prostate cancer has been shown to be determined by the anatomical location of the tumour and its associated intricate relationship to the neurovascular bundle and the prostatic capsule. Studies have shown an improvement in decision making about preservation or resection of neurovascular bundles during robotic assisted prostatectomy (RARP) [1,2] during which the surgeon lacks the tactile feedback of conventional open surgery. This article is protected by copyright. All rights reserved...
March 6, 2018: BJU International
Justin Mascitelli, Jan-Karl Burkhardt, Sirin Gandhi, Michael T Lawton
BACKGROUND: Surgical resection of cavernous malformations (CM) in the posterior thalamus, pineal region, and midbrain tectum is technically challenging owing to the presence of adjacent eloquent cortex and critical neurovascular structures. Various supracerebellar infratentorial (SCIT) approaches have been used in the surgical armamentarium targeting lesions in this region, including the median, paramedian, and extreme lateral variants. Surgical view of a posterior thalamic CM from the traditional ipsilateral vantage point may be obscured by occipital lobe and tentorium...
February 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
Arianna Di Stadio, Roberta Colangeli, Laura Dipietro, Alessandro Martini A, Daniela Parrino, Ennio Nardello, Domenico D' Avella, Elisabetta Zanoletti
BACKGROUND: The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. CASE DESCRIPTION: Three patients with disabling tinnitus due to a loop in the Internal Auditory Canal (IAC) were evaluated with Magnetic Resonance Images (MRI), and tests of Pure Tone Auditory (PTA), Tinnitus, and Auditory Brain Response (ABR) to identify the features of the cochlear nerve involvement...
February 24, 2018: World Neurosurgery
Maria Koutourousiou, Juan C Fernandez-Miranda, Eric W Wang, Carl H Snyderman, Paul A Gardner
The proximity of craniopharyngiomas to vital neurovascular structures and their high recurrence rates make them one of the most challenging brain tumors to treat. Although surgery remains the first line of therapy and offers the best chance of radical resection and oncological cure, the high recurrence tendency of craniopharyngiomas, even after apparent total removal, often makes adjuvant treatment essential. The endoscopic endonasal approach (EEA) has been recently introduced as a treatment option for both pediatric and adult craniopharyngiomas, rapidly gaining wide acceptance over the traditional transcranial approaches...
February 23, 2018: Journal of Neurosurgical Sciences
P Brandicourt, L Bonnet, Y Béjot, C Drouet, T Moulin, L Thines
INTRODUCTION: Moya-Moya angiopathy is a neurovascular disease that predisposes to ischemic or hemorrhagic strokes. It is generated by a steno-occlusion of the terminal portion of the internal carotid arteries, which induces the development of abnormal neovessels in the deep regions of the brain. Some pathologies such as sickle cell disease, Down syndrome or Graves' disease may be associated with Moya-Moya angiopathy. These syndromic forms harbor several differences compared with idiopathic Moya-Moya disease...
February 20, 2018: Neuro-Chirurgie
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Xiaoming Guo, Jose Juan González Sánchez, Halima Tabani, Sergio García, Jan-Karl Burkhardt, Arnau Benet
Anterior clinoidectomy is a difficult yet essential technique in skull base surgery. Two main techniques (extradural and intradural) with multiple modifications have been proposed to increase efficiency and avoid complications. In this study, the authors sought to develop a hybrid technique based on localization of the optic strut (OS) to combine the advantages and avoid the disadvantages of both techniques. Ten cadaveric specimens were prepared for surgical simulation. After a standard pterional craniotomy, the anterior clinoid process (ACP) was resected in 2 steps...
February 23, 2018: Journal of Neurosurgery
Sheriff D Akinleye, Garret Garofolo, Maya Deza Culbertson, Peter Homel, Orry Erez
Introduction: Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. Methods: The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Shatha M Sulaiman, Abdulmalik A Alkhodair, Shahd M Sulaiman, Lama M Sulaiman, Ahmed S Elkafafy
Replantation is the reattachment of a severed body part, with attempts to restore neurovascular and musculoskeletal integrity, function, and aesthetics. On September 7, 1964, the first extremity replantation-a completely amputated hand-by vascular anastomosis technique was successfully performed.1 Soon after, the first replantation of a complete thumb amputation using microvascular anastomosis in a human was successfully conducted by Komatsu et al.2 in 1968. The overall success rate of limb replantation surgery is around 83...
January 2018: Plastic and Reconstructive Surgery. Global Open
Joshua B Holt, Natalie A Glass, Apurva S Shah
BACKGROUND: Supracondylar humeral fractures (SCHF) are the most common elbow fractures in children. The epidemiology of these injuries in the United States is described. METHODS: The Nationwide Emergency Department Sample database was queried for all children (age, below 18 y) with SCHF treated in the emergency department (ED) from 2006 to 2011, and weighted estimates were extracted. RESULTS: A total of 63,348 ED visits for SCHF were identified...
February 16, 2018: Journal of Pediatric Orthopedics
Jamal N Shillingford, Joseph L Laratta, Lee A Tan, Nana O Sarpong, James D Lin, Charla R Fischer, Ronald A Lehman, Yongjung J Kim, Lawrence G Lenke
BACKGROUND: Spinopelvic fixation is an integral part of achieving solid fusion across the lumbosacral junction, especially in deformity procedures requiring substantial correction or long-segment constructs. Traditional S2-alar-iliac (S2AI) screw-placement techniques utilize fluoroscopy, increasing operative time and radiation exposure to the patient and surgeon. We describe a novel free-hand technique for S2AI screw placement in patients with adult spinal deformity. METHODS: We reviewed the records of 45 consecutive patients who underwent spinopelvic fixation performed with use of S2AI screws by the senior surgeon and various fellows or residents over a 12-month period (2015 to 2016)...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
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