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Microsurgery

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https://www.readbyqxmd.com/read/29344779/trigeminal-neuropathy-in-vestibular-schwannoma-a-treatment-algorithm-to-avoid-long-term-morbidity
#1
Luke Galloway, Nachi Palaniappan, Geoffrey Shone, Caroline Hayhurst
BACKGROUND: Trigeminal neuropathy (TGN) can occur as a presenting feature of vestibular schwannoma (VS) or as an adverse effect of radiosurgery. This study was designed to evaluate a treatment algorithm for presenting symptoms of TGN in patients with VS, and a new radiosurgery dosimetric tolerance to avoid TGN after treatment. Outcome was measured after microsurgery (MS), stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy (HSRT), and fractionated radiotherapy (FRT)...
January 17, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29341294/topical-nitroglycerin-for-the-treatment-of-intraoperative-microsurgical-vasospasm
#2
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/29341038/-the-use-of-deep-inferior-epigastric-vessels-to-revascularise-free-flaps-for-reconstruction-of-complex-oncosurgical-defects-of-the-thigh-and-the-abdomen
#3
F Simunovic, U Wittel, B Passlick, S Wiesemann, M Czerny, M Südkamp, G B Stark, H Bannasch
BACKGROUND: The resection of large soft-tissue sarcoma requires reconstruction with free flaps. The choice of recipient vessels is crucial for the success of surgery. PATIENTS: We report four cases with large soft-tissue sarcomas with complex anatomical relationships: two tumors of the thigh surrounding the femoral neurovascular structures and two tumors of the abdomen with infiltration of the thorax and the abdomen. All cases received multimodal interdisciplinary treatment...
January 16, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29334768/angular-and-metric-analysis-of-the-neural-structures-in-the-cerebellopontine-angle
#4
Helbert de Oliveira Manduca Palmiero, Marcos Devanir Silva da Costa, Ricardo Lourenço Caramanti, Feres Eduardo Aparecido Chaddad-Neto
INTRODUCTION: The cerebellopontine angle (CPA) is a subarachnoid space in the lateral aspect of the posterior fossa. In this study, we propose a complementary analysis of the CPA from the cerebellopontine fissure. METHODS: We studied 50 hemi-cerebelli in the laboratory of neuroanatomy and included a description of the CPA anatomy from the cerebellopontine fissure and its relationship with the flocculus and the 5th, 6th, 7th, and 8th cranial nerves (CN) origins. RESULTS: The average distance from the 5th CN to the mid-line (ML) was 19...
January 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29334639/vestibular-schwannoma-and-hearing-preservation-usefulness-of-level-specific-ce-chirp-abr-monitoring-a-retrospective-study-on-25-cases-with-preoperative-socially-useful-hearing
#5
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto
BACKGROUND AND OBJECTIVES: Decision-making regarding the therapy of vestibular schwannoma (VS) changed over the last decades, during which curative microsurgery has been promoted. Goals of VS microsurgery are: extensive resection, facial nerve (FN) preservation and, in selected cases, hearing preservation (HP). The aim of this study is to evaluate postoperative HP with reference to tumor size in patients operated on with Level Specific (LS)-CE-Chirp® ABR monitoring. PATIENTS AND METHODS: Twentyfive consecutive patients with socially useful hearing (SUH) underwent VS microneurosurgery by retrosigmoid (RS) approach...
January 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29330600/the-impact-of-acoustic-neuroma-on-long-term-quality-of-life-outcomes-in-the-united-kingdom
#6
Wouter L Lodder, Bernard F A M van der Laan, Tristram H Lesser, Samuel C Leong
OBJECTIVE: To quantify the impact of acoustic neuroma on the quality-of-life (QOL) patients in the United Kingdom. STUDY DESIGN: Online questionnaire survey. PATIENTS: Members of the British Acoustic Neuroma Association received PANQOL questionnaires. RESULTS: Of the 880 BANA members contacted, 397 (45.1%) responded, although only 359 had complete datasets for analysis. Composite QOL scores were as follows: for microsurgery 58 (SD 35), for radiotherapy 56 (SD18), for combination of surgery and radiotherapy 49 (SD 14), and for the observation group 54 (SD 20)...
January 12, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#7
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/29322573/narrow-band-imaging-versus-laryngovideostroboscopy-in-precancerous-and-malignant-vocal-fold-lesions
#8
Anna Rzepakowska, Ewelina Sielska-Badurek, Raul Cruz, Maria Sobol, Ewa Osuch-Wójcikiewicz, Kazimierz Niemczyk
BACKGROUND: This is a comparative analysis of the diagnostic accuracy of narrow band imaging (NBI) and laryngovideostroboscopy (LVS) in the assessment of premalignant and malignant vocal fold lesions. METHODS: A prospective analysis was performed on 105 consecutive patients with vocal fold lesions. The NBI and LVS were obtained before the microsurgery. RESULTS: The NBI and LVS showed no significant differences in identifying premalignant and malignant pathologies...
January 10, 2018: Head & Neck
https://www.readbyqxmd.com/read/29320962/replantation-and-revascularization-of-amputated-upper-limb-appendages-outcome-and-predicting-the-factors-influencing-the-success-rates-of-these-procedures-in-a-tertiary-hospital-an-8-year-retrospective-cross-sectional-study
#9
Tunku Kamarul, Azura Mansor, Noorzurani Robson, Salim Hh Albusaidi, Abdulrazzaq M Suhaeb, Ely Z Samsudin
PURPOSE: Worldwide advances in microsurgery have made salvaging of amputated hand via replantation and revascularization common procedures. The present study examines the outcome of these procedures in a tertiary hospital in Malaysia. METHODS: Patients with hand amputation who underwent replantation or revascularization from 2005 to 2012 were identified and reviewed for patient characteristics, amputation characteristics and survival rates. Successfully treated patients were interviewed to assess the functional outcome using Quick Disability of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and Michigan Hand Outcome Questionnaire (MHQ)...
January 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29315192/long-term-hearing-preservation-outcomes-for-small-vestibular-schwannomas-retrosigmoid-removal-versus-observation
#10
Weidong Zhu, Hongsai Chen, Huan Jia, Yongchuan Chai, Jie Yang, Zhaoyan Wang, Hao Wu
OBJECTIVE: Management of small vestibular schwannomas (VSs) consists of three options: serial observation, radiosurgery, and microsurgery. The authors reported the long-term hearing outcomes after retrosigmoid tumor removal in 110 patients and hearing follow-up outcomes in 160 serial observation patients with small VSs to explore the appropriate management strategy and predictive factors of hearing preservation for small VSs. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29315189/self-evaluated-quality-of-life-and-functional-outcomes-after-microsurgery-stereotactic-radiation-or-observation-only-for-vestibular-schwannoma-of-the-adult-patient-a-systematic-review
#11
Efstathios Papatsoutsos, Patrick M Spielmann
OBJECTIVE: To evaluate the impact of different management options on health-related quality of life (HRQoL) in vestibular schwannoma patients. DATA SOURCES: A systematic search of the Cochrane Database, Database of Abstracts of Reviews of Effectiveness, and the Ovid Medline & EMBASE was performed. English and German language studies published between 1980 and 2015 were considered. STUDY SELECTION: This is a systematic review of HRQoL of patients managed for vestibular schwannoma...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29309979/microsurgical-and-endovascular-treatments-of-spinal-extradural-arteriovenous-fistulas-with-or-without-intradural-venous-drainage
#12
Keisuke Takai, Masaaki Shojima, Hideaki Imai, Nobuhito Saito, Makoto Taniguchi
BACKGROUND: Limited information is available on spinal extradural arteriovenous fistulas (AVFs). OBJECTIVE: To present treatment strategies in relation to the angioarchitecture. METHODS: Fourteen patients treated at 2 hospitals were retrospectively analyzed. RESULTS: Fourteen AVFs included 4 cervical, 1 thoracic, and 9 lumbosacral lesions. Three key angiographic features were observed: 1) the feeding artery, 2) an enlarged extradural venous plexus, and 3) intradural retrograde venous drainage...
January 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29307442/augmentation-surgery-on-the-cartilaginous-portion-of-the-vocal-fold-in-a-patient-with-cricoarytenoid-joint-ankylosis
#13
Mioko Fukahori, Shun-Ichi Chitose, Kiminori Sato, Hiroyuki Kamimura, Kiminobu Sato, Ririko On, Hirohito Umeno
Surgical management of cricoarytenoid joint (CAJ) ankylosis is challenging and has the risk of worsening voice quality. In the present case, augmentation surgery was performed on the cartilaginous portion of the vocal fold in a patient with CAJ ankylosis. A 24-year-old man sustained blunt trauma to the anterior neck three years prior to developing severe breathiness. Posterior glottal insufficiency resulting from lateral fixation of the right vocal fold was observed during phonation under laryngoscopy. In addition, electromyography and CT scan revealed severe ankylosis of the right CAJ...
January 4, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29307348/the-role-of-surgery-for-brain-metastases-from-solid-tumors
#14
Niklas Thon, Friedrich-Wilhelm Kreth, Joerg-Christian Tonn
Surgery, stereotactic radiosurgery, radiotherapy, and chemotherapy including novel targeted therapy strategies and any combination thereof as well as supportive care are the key elements for treatment of brain metastases. Goals of microsurgery are to obtain tissue samples for histologic diagnosis (particularly in case of uncertainty about the unknown primary tumor but also in the context of future targeted therapies), to relieve burden from space-occupying effects, to improve local tumor control, and to prolong overall survival...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29306525/cricoarytenoid-joint-ankylosis-classification-and-transoral-laser-microsurgical-treatment
#15
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/29291278/treatment-preferences-in-patients-with-early-glottic-cancer
#16
Yda van Loon, Martine Hendriksma, Ton P M Langeveld, Martin A de Jong, Rob J Baatenburg de Jong, Elisabeth V Sjögren
OBJECTIVE: For early glottic carcinoma, the 2 main treatment modalities are radiotherapy (RT) and transoral CO2 laser microsurgery (TLM). The aim of this study was to investigate treatment preferences and considerations in patients with early glottic carcinoma (T1-T2) who were given a choice between TLM and RT. SUBJECTS AND METHODS: Patients with early glottic cancer (suspected or confirmed extended T1 or limited T2) were counseled by an ENT-surgeon. A subset of 32 patients was also counseled by a radiotherapist...
December 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29290320/-sarcomatoid-carcinoma-of-larynx-a-histological-challenge
#17
Alejandra Osorio-Velásquez, Carlos M Chiesa-Estomba, Frank A Betances-Reinoso, M Pilar San Miguel-Fraile, José A Ortiz-Rey
INTRODUCTION: Sarcomatoid carcinoma can occur in any part of the body; in the head and neck it occurs most frequently in the major salivary glands, with only about 1% of cases found in the larynx. As it has both epithelial and mesenchymal components, there are many theories concerning its origin and it can prove a diagnostic challenge. CASE REPORT: A 76 year old male smoker presented with dysphonia. Vocal cord injury was found on examination but no lymphadenopathy or metastases were present...
January 2018: Revista Española de Patología
https://www.readbyqxmd.com/read/29288615/synchronous-locally-advanced-rectal-cancer-with-clinical-complete-remission-and-important-downstaging-after-neoadjuvant-radiochemotherapy-personalised-therapeutic-approach
#18
Dragoş Eugen Georgescu, Mihai Teodor Georgescu, Florin Teodor Bobircă, Teodor Florin Georgescu, Horia Doran, Traian Pătraşcu
Introduction: The current practice for patients with good response, important downstaging or complete remission after preoperative chemoradiation, is to perform surgery on the basis of initial pretherapeutical staging. In literature, varying approaches, like transanal endoscopic microsurgery and even "wait and see", are described for patients with good response after chemoradiation. However, considering the present level of available evidence, the wide-spread adoption of a "watch and wait" policy in those achieving a complete clinical remission cannot be justified...
November 2017: Chirurgia
https://www.readbyqxmd.com/read/29288190/can-we-save-the-rectum-by-watchful-waiting-or-transanal-microsurgery-following-chemo-radiotherapy-versus-total-mesorectal-excision-for-early-rectal-cancer-star-trec-study-protocol-for-a-multicentre-randomised-feasibility-study
#19
Anouk J M Rombouts, Issam Al-Najami, Natalie L Abbott, Ane Appelt, Gunnar Baatrup, Simon Bach, Aneel Bhangu, Karen-Lise Garm Spindler, Richard Gray, Kelly Handley, Manjinder Kaur, Ellen Kerkhof, Camilla Jensenius Kronborg, Laura Magill, Corrie A M Marijnen, Iris D Nagtegaal, Lars Nyvang, Femke P Peters, Per Pfeiffer, Cornelis Punt, Philip Quirke, David Sebag-Montefiore, Mark Teo, Nick West, Johannes H W de Wilt
INTRODUCTION: Total mesorectal excision (TME) is the highly effective standard treatment for rectal cancer but is associated with significant morbidity and may be overtreatment for low-risk cancers. This study is designed to determine the feasibility of international recruitment in a study comparing organ-saving approaches versus standard TME surgery. METHODS AND ANALYSIS: STAR-TREC trial is a multicentre international randomised, three-arm parallel, phase II feasibility study in patients with biopsy-proven adenocarcinoma of the rectum...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29284164/current-practices-in-the-management-of-postoperative-arterial-vasospasm-in-microsurgery
#20
Sergey Y Turin, Robert L Walton, Gregory A Dumanian, John B Hijjawi, John A LoGiudice, Mohammed Alghoul
BACKGROUND:  Postoperative microvascular arterial vasospasm is a rare clinical entity. There are no published management algorithms and also the pathophysiology of this phenomenon has not been elucidated. METHODS:  An email survey of American Society for Reconstructive Microsurgery (ASRM) and World Society for Reconstructive Microsurgery (WSRM) members regarding their experiences with postoperative arterial vasospasm was conducted, returning 116 responses. A comprehensive literature search was conducted regarding the current body of knowledge on this entity...
December 28, 2017: Journal of Reconstructive Microsurgery
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