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neuroma approach

Lubin Chen, Jianying Huang, Peng Zhao, Anna-Karin Persson, Fadia B Dib-Hajj, Xiaoyang Cheng, Andrew Tan, Stephen G Waxman, Sulayman D Dib-Hajj
Voltage-gated sodium channels NaV 1.7, NaV 1.8 and NaV 1.9 have been the focus for pain studies because their mutations are associated with human pain disorders, but the role of NaV 1.6 in pain is less understood. In this study, we selectively knocked out NaV 1.6 in dorsal root ganglion (DRG) neurons, using NaV 1.8-Cre directed or adeno-associated virus (AAV)-Cre mediated approaches, and examined the specific contribution of NaV 1.6 to the tetrodotoxin-sensitive (TTX-S) current in these neurons and its role in neuropathic pain...
March 1, 2018: Scientific Reports
Ali Kouhi, Varasteh Vakili Zarch, Ali Pouyan
The rate of hearing preservation after vestibular schwannoma surgery is variable and is not as high as expected, possibly due to injuries to the posterior semicircular canal while exposing the tumor. The aim of this study was to estimate the risk of posterior semicircular canal injuries using temporal bone computed tomography (CT) scan findings. Temporal bone CT scans of 30 patients selected between 2013 and 2015 were studied. The median age of the patients was 40 years. Two planes were studied: (1) the axial plane that shows the common crus of the posterior semicircular canal and (2) the coronal plane that shows the two crura of the posterior semicircular canal...
January 2018: Ear, Nose, & Throat Journal
Eric L Wan, A Lee Dellon
OBJECTIVE: The objective is to report the outcome of an anterior surgical approach to treat neuroma of the perineal branch of the pudendal nerve (PBPN). PATIENTS AND METHODS: An IRB-approved prospective study enrolled 14 consecutive male patients from 2011 through 2015 who had symptoms of perineal/scrotal pain. Each patient had a successful, diagnostic, pudendal nerve block. The surgical procedure was resection of the PBPN and implantation of the nerve into the obturator internus muscle...
February 2018: Microsurgery
Tomito Oji, Akiteru Hayashi, Akihiro Ogino, Kiyoshi Onishi
BACKGROUND: Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed. METHODS: A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients...
February 7, 2018: Journal of Craniofacial Surgery
Tun Hing Lui
Morton's neuroma is a compressive neuropathy resulting in perineural fibrosis rather than a neuroma of the plantar digital nerve. Surgical treatment is indicated for patients with a clear diagnosis of Morton's neuroma and no improvement with nonsurgical treatment. The surgical options include isolated intermetatarsal ligament division, isolated interdigital nerve excision, and interdigital nerve excision with intermetatarsal ligament division, with or without submuscular transposition. This can be performed via dorsal or plantar approach...
August 2017: Arthroscopy Techniques
Andrew Philpott, Callum Lawford, Simon C Lau, Simon Chambers, Michael Bozin, Andrew Oppy
BACKGROUND: Open reduction and internal fixation of Lisfranc injuries has typically used multiple longitudinal incisions or a single transverse incision to approach the tarso-metatarsal joint (TMTJ). The incidence of wound-related complications is considerable. We describe a novel single-incision approach that utilizes subcutaneous windows to the medial TMTJ. METHODS: A retrospective review identified 150 patients who underwent open reduction and internal fixation for Lisfranc injuries, via the modified dorsal approach, at our center between January 2011 and June 2016...
January 1, 2018: Foot & Ankle International
Hussam Abou-Al-Shaar, Nam Yoon, Mark A Mahan
Traumatic proximal sciatic nerve rupture poses surgical repair dilemmas. Disruption often causes a large nerve gap after proximal neuroma and distal scar removal. Also, autologous graft material to bridge the segmental defect may be insufficient, given the sciatic nerve diameter. The authors utilized knee flexion to allow single neurorrhaphy repair of a large sciatic nerve defect, bringing healthy proximal stump to healthy distal segment. To avoid aberrant regeneration, the authors split the sciatic nerve into common peroneal and tibial divisions...
January 2018: Neurosurgical Focus
Daniele Marchioni, Davide Soloperto, Barbara Masotto, Cristoforo Fabbris, Stefano De Rossi, Domenico Villari, Livio Presutti
BACKGROUND: Recently, the transcanal approach for the removal of acoustic neuromas has been introduced. Facial nerve (FN) preservation is one of the main challenges of this kind of surgery. OBJECTIVE: To describe our experience in the surgical treatment of acoustic neuromas, focusing on the functional results of FN preservation after a transcanal approach. METHODS: A retrospective chart review was carried out on clinical data and videos from operations on 49 patients who underwent surgery with a totally transcanal exclusive endoscopic approach for Koos stage I-II lesions, or an enlarged transcanal transpromontorial approach for Koos stage II-III tumors, between March 2012 and February 2017...
February 2018: Otology & Neurotology
F Sancho-Barroso, J Strassburger-Weidmann, V Castillo-Anaya
BACKGROUND: The purpose of this paper is to assess pain, function and complications after decompression of Mortons neuroma using a minimally invasive dorsal approach. METHOD AND RESULTS: 16 patients who underwent 19 decompressions were followed-up for 18 months. Pain was assessed with the visual analog scale (VAS), and function was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) scale. Data was analyzed with the Student t test for related samples, which yielded a p value 0...
May 2017: Acta Ortopédica Mexicana
Jeffrey H Zimering, Jonathan J Stone, Audrey Paulzak, John D Markman, Mahlon D Johnson, G Edward Vates
The authors report the case of a 52-year-old man who presented with rapid-onset lancinating facial pain consistent with trigeminal neuralgia. Magnetic resonance imaging revealed a nonenhancing small lesion on the right trigeminal nerve concerning for an atypical schwannoma or neuroma. The patient underwent resection of the mass via a right retrosigmoid approach. His facial pain completely resolved immediately postoperatively and had not recurred at 6 months after surgery. The mass was consistent with normal brain tissue (neurons and glial cells) without evidence of mitoses...
December 1, 2017: Journal of Neurosurgery
Evg A Kasparova, O I Sobkova, E A Kasparova, A A Fedorov, A A Kasparov
AIM: to develop a surgical approach to the treatment of purulent corneal ulcer in eyes with neurotrophic keratitis with lagophthalmos after auditory neuroma removal or stroke. MATERIAL AND METHODS: A total of 12 patients (13 eyes) have been managed. All received combined surgery that included simultaneous keratoplasty, autoconjunctivoplasty, and permanent partial tarsorrhaphy. RESULTS: Ocular integrity was preserved in all cases, and also vision - in half of them...
2017: Vestnik Oftalmologii
Juan F Villalonga, Andrés Cervio
Objective: To evaluate the usefulness of hemilaminectomy as a surgical approach in patients with intradural-extramedullary tumors. Methods: Retrospective analysis of patients in which hemilaminectomy was as surgical approach in intradural-extramedullary tumors between June 2006 and December 2015. Demographics, preoperative symptoms, imaging characteristics, intraoperative findings, histological lineage, and postsurgical complications were analyzed. The average follow-up was 48...
2017: Surgical Neurology International
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
Peter Cipriano, Daehyun Yoon, Harsh Gandhi, Dawn Holley, Dushyant Thakur, Ma Ith, Brian Hargreaves, David Kennedy, Matthew Smuck, Ivan Cheng, Sandip Biswal
Chronic sciatica is a major cause of disability worldwide, but accurate diagnosis of the offending pathology remains challenging. In this report, the feasibility of a fluorodeoxyglucose ((18)F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) approach for improved diagnosis of chronic sciatica is presented. Methods:(18)F-FDG PET/MRI was performed on 9 chronic sciatica patients and 5 healthy volunteers. Region-of-interest analysis using maximum standardized uptake values (SUVmax) was performed, and (18)F-FDG uptake in lesions was compared with the corresponding areas in healthy controls...
November 2, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
H Y Tan, Z Y Wang, H Wu
Over the past 50 years, the focus of acoustic neuroma surgery has shifted from low mortality and tumor resection to retention of neurological function. Hearing preservation is another point in addition to facial nerve function preservation. Hearing preservation rates overall ranged from 2% to 93% in recent studies. Characteristics such as approach, pre-operative neurological function, tumor size, nerve of origin and fundal fluid of the internal auditory canal have been reported as possible influencing factors...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Nathaniel Preston, Daniel Peterson, Jamey Allen, Jill S Kawalec, Jeffrey Whitaker
BACKGROUND: In the dorsal incisional approach for Morton's neuroma, it is required to transect the deep transverse metatarsal ligament (DTML) that lies in the interspace between the third and fourth metatarsal heads. The purpose of this study was to evaluate the relationship between transection of the DTML in the third intermetatarsal space and the metatarsal alignment. METHODS: Nine human cadaveric lower extremity limbs were used for this study. Each limb was mounted to the MTS 858 Mini Bionix biomechanical test system and loaded to 120% of the donor's documented body weight at a rate of 15 lbf/s, in order to simulate peak weightbearing ground reactive forces on the forefoot...
October 1, 2017: Foot & Ankle Specialist
Noritaka Aihara, Hiroshi Yamada, Mariko Takahashi, Akira Inagaki, Shingo Murakami, Mitsuhito Mase
To estimate the duration of postoperative headache after surgery for acoustic neuroma and the effects of age, sex, tumor size, extent of tumor resection, type of skin incision, surgical duration, hearing preservation, and postoperative facial nerve palsy. This retrospective review analyzed clinical data from 97 patients who had undergone surgery for unilateral acoustic neuroma via the retrosigmoid approach >1 year previously. We investigated whether patients had headache at hospital discharge and during attendance at outpatient clinics...
October 12, 2017: Neurologia Medico-chirurgica
Mohamed Aboshanif, Eigo Omi, Shinsuke Suzuki, Teruyuki Sato, Koh Koizumi, Kazuo Ishikawa, Masataka Takahashi
Facial nerve schwannoma is a very rare benign tumor representing less than 1% of intrapetrous lesions. Our patient is a forty-one year old female who has suffered from recurrent right facial palsy for the last six years. She was first misdiagnosed as having Bell's palsy and received corticosteroids which resulted in little improvement. She then had facial nerve decompression surgery which resulted in a partial improvement. Since then, she has suffered from recurrent attacks of facial palsy. Two years ago, she came to our hospital seeking further treatment options...
October 5, 2017: Auris, Nasus, Larynx
Mihaela Rapolti, Cindy Wu, Olga A Schuth, Charles Scott Hultman
Chronic neuropathic pain after burn injury may have multiple causes, such as direct nerve injury, nerve compression, or neuroma formation, and can significantly impair quality of life and limit functional recovery. Management includes a team-based approach that involves close collaboration between occupational and physical therapists, plastic surgeons, and experts in chronic pain, from neurology, anesthesia, psychiatry, and physiatry. Carefully selected patients with an anatomic cause of chronic neuropathic pain unequivocally benefit from surgical intervention...
October 2017: Clinics in Plastic Surgery
Julia Kristin, Marcel Fabian Glaas, Igor Stenin, Angelika Albrecht, Thomas Klenzner, Jörg Schipper, Katrin Eysel-Gosepath
BACKGROUND: Monitoring the health-related quality of life (HRQOL) for patients with vestibular schwannoma (VS) has garnered increasing interest. In German-speaking countries, there is no disease-specific questionnaire available similar to the "Penn Acoustic Neuroma Quality-of-life Scale" (PANQOL). METHOD: We translated the PANQOL for German-speaking patients based on a multistep protocol that included not only a forward-backward translation but also linguistic and sociocultural adaptations...
November 2017: Acta Neurochirurgica
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