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Michael Karsy, Cheryl A Palmer, Mark A Mahan
BACKGROUND: Laminins are extracellular matrix proteins that participate in endoneurial tubule formation and are important in the regeneration of nerves after injury. They act as scaffolds to guide nerves to distal targets and play a key role in neurite outgrowth. Because there is evidence that laminin architecture affects nerve regeneration, we evaluated endoneurial tubules by examining the laminin structure in clinical samples from patients with nerve injuries. METHODS: In a retrospective review of eight nerve injury cases, we evaluated nerve histology in relation to clinical history and injury type...
January 18, 2018: Curēus
Zhiping Chen, Keiichi Takehana, Takashi Mizowaki, Megumi Uto, Kengo Ogura, Katsuyuki Sakanaka, Yoshiki Arakawa, Yohei Mineharu, Yuki Miyabe, Nobutaka Mukumoto, Susumu Miyamoto, Masahiro Hiraoka
BACKGROUND: The aim of this study was to assess the clinical outcomes of acoustic neuromas (ANs) treated with hypofractionated stereotactic radiotherapy (hypo-FSRT) prescribed at a uniform dose. METHODS: Forty-seven patients with a unilateral AN were treated consecutively with hypo-FSRT between February 2007 and March 2012. Nineteen patients maintained a serviceable hearing status at the beginning of hypo-FSRT. The prescribed dose was 25 Gy delivered in five fractions per week to the isocenter, and the planning target volume was covered by the 80% isodose line...
March 19, 2018: International Journal of Clinical Oncology
Michael J Link, Morten Lund-Johansen, Christine M Lohse, Colin L W Driscoll, Ehrling Myrseth, Oystein Vesterli Tveiten, Matthew L Carlson
BACKGROUND: The goal of microsurgical removal of a vestibular schwannoma is to completely remove the tumor, to provide long-term durable cure. In many cases, less than gross total resection (GTR) is performed to preserve neurological, and especially facial nerve function. OBJECTIVE: To analyze long-term quality of life (QoL) in a cohort of patients who received either GTR or less than GTR. METHODS: Patients operated for vestibular schwannoma less than 3...
April 1, 2018: Neurosurgery
Anne Causeret, Isabelle Ract, Jérémy Jouan, Thierry Dreano, Mickaël Ropars, Raphaël Guillin
Lesion to subcutaneous nerves is a well-known risk of orthopedic surgery and a significant cause of postoperative pain and dissatisfaction in patients. High-resolution ultrasound can be used to visualize the vast majority of small subcutaneous nerves of the upper and lower limbs. Ultrasound detects nerve abnormalities such as focal hypoechoic thickening, stump neuroma, and scar encasement, and provides information not only about the peripheral nerve itself but also about its relationship to adjacent anatomical structures...
March 16, 2018: Skeletal Radiology
Aldo Berti, Michelle Granville, Robert E Jacobson
A case of an extremely healthy, active, 96-year-old patient, nonsmoker, is reviewed. He was initially treated for left V1, V2, and V3 trigeminal neuralgia in 2001, at age 80, with stereotactic radiosurgery (SRS) with a dose of 80 Gy to the left retrogasserian trigeminal nerve. He remained asymptomatic for nine years until his trigeminal pain recurred in 2010. He was first treated medically but was intolerant to increasing doses of carbamazepine and gabapentin. He underwent a second SRS in 2012 with a dose of 65...
January 12, 2018: Curēus
Evg A Kasparova, O I Sobkova, E A Kasparova, A A Kasparov
OBJECTIVE: The study objective was to develop a method for surgical treatment of advanced purulent corneal ulcer in the setting of neuroparalytic keratitis developed after acoustic neuroma removal and strokes. MATERIAL AND METHODS: The study included 12 patients (13 eyes). All patients underwent single-step keratoplasty, conjunctival autografting, and partial permanent tarsorrhaphy. RESULTS: The eye as an organ was spared in 100% of cases; vision was spared in 50% of cases and improved, from 0...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Samer Bassilios Habre, James Bradford Depew, Robert D Wallace, Petros Konofaos
Neuroma pain can be severe, persistent, and treatment-resistant. Forehead and scalp anesthesia is troublesome for patients. Following an iatrogenic ablative injury to the right supraorbital nerve, with subsequent painful neuroma formation, a human cadaveric nerve allograft (AxoGen, Alachua, FL) was used to restore sensation of the right forehead and treat pain. At 1-year follow-up, the patient was pain-free, and protective sensation to the right forehead was recovered with comparable static and dynamic 2-point discrimination between the injured (20 mm, 12 mm respectively) and the normal side (15 mm, 10 mm respectively)...
March 8, 2018: Journal of Craniofacial Surgery
B González-García, S García-Isidoro, J Contreras-Alcántara, J A Martínez-Gil, M A Díaz Y Orea, V O Castellanos-Sánchez
The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal» or «rustic» systems that hamper their adaptation process...
September 2017: Acta Ortopédica Mexicana
D-Z Fang, Y-P Wang, J Liu, X-B Hui, X-D Wang, X Chen, D Liu
OBJECTIVE: Neuroma is the most common intracranial tumor. The mechanism of miRNA in glioma has gradually been understood. The purpose of this study was to investigate the role of MicroRNA-129-3p (miR-129-3p) in the pathogenesis of glioblastoma (GBM). PATIENTS AND METHODS: Differential expression of miR-129-3p in samples was analyzed by bioinformatics. PCR was used to detect the expression of miR-129-3p in samples. CCK8 assay was used to detect the cell viability...
February 2018: European Review for Medical and Pharmacological Sciences
Simon Zimmermann, Richard M Fakin, Pietro Giovanoli, Maurizio Calcagni
Introduction: The management of painful end-neuromas of the superficial branch of the radial nerve (SBRN) remains challenging due to high levels of pain relapse. The novel technique of stromal vascular fraction (SVF)-enriched fat grafting showed continuous pain relief, although failed to prove statistically significant. Besides acting as a mechanical barrier, SVF-enriched fat grafting might also affect the cellular level. The aim of this study was to compare clinical outcomes of SVF to the widely popular intramuscular transposition technique...
2018: Frontiers in Surgery
Josa M Frischer, Elise Gruber, Verena Schöffmann, Adolf Ertl, Romana Höftberger, Ammar Mallouhi, Stefan Wolfsberger, Christoph Arnoldner, Wilhelm Eisner, Engelbert Knosp, Klaus Kitz, Brigitte Gatterbauer
OBJECTIVE The authors present long-term follow-up data on patients treated with Gamma Knife radiosurgery (GKRS) for acoustic neuroma. METHODS Six hundred eighteen patients were radiosurgically treated for acoustic neuroma between 1992 and 2016 at the Department of Neurosurgery, Medical University Vienna. Patients with neurofibromatosis and patients treated too recently to attain 1 year of follow-up were excluded from this retrospective study. Thus, data on 557 patients with spontaneous acoustic neuroma of any Koos grade are presented, as are long-term follow-up data on 426 patients with a minimum follow-up of 2 years...
March 2, 2018: Journal of Neurosurgery
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
Yanyang Zhang, Zhiqi Mao, Shiyu Feng, Xinyun Liu, Lan Lan, Jun Zhang, Xinguang Yu
Introduction: In neuroimaging studies, long-term unilateral hearing loss (UHL) is associated with functional changes in specific brain regions and connections; however, little is known regarding alterations in the topological organization of whole-brain functional networks and whether these alterations are related to hearing behavior in UHL patients. Methods: We acquired resting-state fMRI data from 21 patients with UHL caused by acoustic neuromas and 21 matched healthy controls...
February 2018: Brain and Behavior
Akash Ganguly, Joanne Warner, Hifz Aniq
OBJECTIVE: Central metatarsalgia relates to abnormalities of the second, third, and fourth metatarsals and their respective metatarsophalangeal joints. A variety of disorders present with central forefoot pain; they range from traumatic lesions (acute or chronic repetitive), inflammatory and infective disorders, nonneoplastic soft-tissue lesions, and benign tumors to malignant lesions. Patients often present with symptoms of localized pain in the forefoot that worsens on weight bearing (walking or running), which can be sharp or dull and often is perceived as a lump felt inside or underneath the foot and described as walking on a marble or pebbles...
February 22, 2018: AJR. American Journal of Roentgenology
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
Nicholas Thomas, John Glod, Claudia Derse-Anthony, Emma L Baple, Nigel Obsborne, Rachel Sturley, Bijay Vaidya, Kate Newbold, Antonia Brooke
Vandetanib is a tyrosine kinase inhibitor (TKI) used in the treatment of medullary thyroid carcinoma occurring in >95% of patients with multiple endocrine neoplasia type 2b (MEN 2b). Pregnancy in women with MEN 2b on vandetanib is previously unreported and has multiple potential implications for both the mother and developing fetus [1]. We describe the case of a 22 year old woman with a background of MEN 2b who was first diagnosed aged 6 presenting with marfanoid habitus, and oral mucosal neuromas. This article is protected by copyright...
February 19, 2018: Clinical Endocrinology
Omid Moshtaghi, Khodayar Goshtasbi, Ronald Sahyouni, Harrison W Lin, Hamid R Djalilian
Objective To assess the decision-making process of patients with vestibular schwannoma (VS). Study Design Patients with VS completed a voluntary survey over a 3-month period. Setting Surveys were distributed online through email, Facebook, and member website. Subjects and Methods All patients had a diagnosis of VS and were members of the Acoustic Neuroma Association (ANA). A total of 789 patients completed the online survey. Results Of the 789 participants, 474 (60%) cited physician recommendation as a significant influential factor in deciding treatment...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Anne Bolleboom, Godard C W de Ruiter, J Henk Coert, Bastiaan Tuk, Jan C Holstege, Johan W van Neck
OBJECTIVE Traumatic neuromas may develop after nerve injury at the proximal nerve stump, which can lead to neuropathic pain. These neuromas are often resistant to therapy, and excision of the neuroma frequently leads to recurrence. In this study, the authors present a novel surgical strategy to prevent neuroma formation based on the principle of centro-central anastomosis (CCA), but rather than directly connecting the nerve ends to an autograft, they created a loop using a 3D-printed polyethylene Y-shaped conduit with an autograft in the distal outlets...
February 9, 2018: Journal of Neurosurgery
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
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