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Microsurgical Anatomy

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https://www.readbyqxmd.com/read/28327921/the-superior-cerebellar-artery-aneurysm-a-posterior-circulation-aneurysm-with-favorable-microsurgical-outcomes
#1
Ana Rodríguez-Hernández, Brian P Walcott, Harjus Birk, Michael T Lawton
BACKGROUND: Superior cerebellar artery (SCA) aneurysms are usually grouped with aneurysms that arise from the upper basilar artery or more broadly, the posterior circulation. However, the SCA aneurysm has distinctive anatomy that facilitates safe surgical management, notably few associated perforating arteries, and excellent exposure in the carotid-oculomotor triangle. OBJECTIVE: To demonstrate the outcomes of patients treated with microsurgery in a continuous surgical series...
January 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28319260/the-second-time-flap-from-the-previously-used-anterior-thigh-donor-site-for-head-and-neck-microsurgical-reconstruction
#2
Nidal Farhan Al Deek, Chun-Ta Liao, Shiang-Fu Huang, Chung-Jan Kan, Kai-Ping Chang, Ku-Hao Fang, Chung-Kan Tsao
BACKGROUND: Multiple free tissue transfer from the same donor site is not well described for microsurgical head and neck reconstruction. METHODS: Between (8/2011 and 11/2012), 103 patients received 103 free ALT flaps for head and neck reconstruction; flaps were called first-time ALT flaps. Intra-operative findings were used to assess the presence of a favorable anatomy for a future second flap from the same donor site. And, between 9/2009 and 12/2013, second-time flaps from previously used anterior thighs were attempted either freely or guided by the intra-operative data from the previous surgery...
March 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28317283/radiological-and-microsurgical-anatomy-for-variation-of-the-mandible-comparative-study-of-human-and-macaca-fascicularis
#3
Joe Iwanaga, Koichi Watanabe, Tsuyoshi Saga, Yoko Tabira, Eishi Hirasaki, Christian Fisahn, R Shane Tubbs, Jingo Kusukawa, Koh-Ichi Yamaki
Recent studies using cone-beam computer tomography (CBCT) have added to our understanding of anatomical variation in the mandible of humans. However, the distribution of nerves cannot be revealed by CBCT. There have been investigations of the distribution of nerves relating to the mandible, but some proposed causes of these variations remain controversial. In this study, we observed a total of 10 sides from five mandibles of Macaca fascicularis of unknown age and sex using CBCT and dissection under stereomicroscopy...
March 20, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28302367/lateral-thigh-perforator-flap-for-breast-reconstruction-computed-tomographic-angiography-analysis-and-clinical-series
#4
Marco A Maricevich, Michael R Bykowski, M Asher Schusterman, Evan B Katzel, Michael L Gimbel
PURPOSE: Although abdominal-based flaps remain the first choice for autologous breast reconstruction, alternative donor sites are necessary when the abdomen is unavailable. Abdominal donor site suitability is determined, at times, according to deep inferior epigastric perforator (DIEP)-protocol computed tomographic angiography (CTA) results. CTA provides information about the pelvis/upper thigh that can be used to evaluate the suitability of other donor sites. This study aimed to examine the utility of DIEP-protocol CTA in the assessment of a lateral thigh perforator (LTP) flap...
February 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28272279/preoperative-computed-tomography-angiogram-cta-measurement-of-abdominal-muscles-is-a-valuable-risk-assessment-for-bulge-formation-after-microsurgical-abdominal-breast-reconstruction
#5
Elisabeth A Kappos, Jeff Jaskolka, Kate Butler, Anne C O'Neill, Stefan Op Hofer, Toni Zhong
BACKGROUND: A major shortcoming associated with abdominal tissue breast reconstruction is the long-term abdominal wall morbidity. Although abdominal core muscle size on computed tomography angiogram (CTA) has been correlated with morbidity following many abdominal surgeries, it has not been studied for abdominal breast reconstruction. Therefore, we evaluated the association between preoperative CTA-derived measurements of abdominal core muscles and postoperative abdominal wall morbidity after abdominal tissue breast reconstruction...
March 6, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28259642/determining-the-best-recipient-vessel-site-for-autologous-microsurgical-breast-reconstruction-with-diep-flaps-an-anatomical-study
#6
Martin Lhuaire, Mikael Hivelin, Moustapha Dramé, Peter Abrahams, Reza Kianmanesh, Christian Fontaine, Laurent Lantieri
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is a reliable and reproducible technique for autologous microsurgical breast reconstruction. Several recipient vessels sites for microvascular anastomosis have been described such as the internal thoracic vessels, the thoracodorsal vessels, and the circumflex scapular vessels. Nonetheless, the choice of the recipient site depends mainly on individual operator's experience and preferences, and currently the best recipient vessel site is under debate...
February 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28217397/a5-segment-aneurysm-of-the-anterior-cerebral-artery-imbedded-into-the-body-of-the-corpus-callosum-a-case-report
#7
Fransua Sharafeddin, Ahmad Hafez, Martin Lehecka, Rahul Raj, Roberto Colasanti, Ahmadreza Rafiei, Joham Choque, Behnam R Jahromi, Mika Niemelä, Juha Hernesniemi
BACKGROUND: The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward. CASE DESCRIPTION: The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#8
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#9
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28175514/356%C3%A2-microsurgical-anatomy-of-the-brainstem-safe-entry-zones-a-cadaveric-study-with-high-resolution-magnetic-resonance-imaging-and-fiber-tracking
#10
Debraj Mukherjee, Veysel Antar, Bora Gurer, Ulas Cikla, Gabriel Neves, Mehmet Ekici, Tomer Hananya, Aaron S Field, Shahriar M Salamat, Mustafa Kemal Baskaya
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28160906/thumb-reconstruction-with-thin-proximal-ulnar-perforator-free-flap
#11
REVIEW
Mario Cherubino, Martina Corno, Luigi Valdatta, Roberto Adani
Soft tissue defects of the thumb with exposure of tendons, periosteum, or neurovascular bundles require a complex reconstruction aimed at restoring both skin coverage and the essential function of pinching and manipulation. When large defects are involved, a free tissue transfer is indicated. The proximal ulnar perforator flap represents an interesting solution without the drawbacks of other more widespread free flaps. This report describes the case of a patient with a squamous cell carcinoma of the thumb that required circumferential resection of the soft tissue of the distal phalanx and the interphalangeal joint...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28137542/developing-the-first-highly-specialized-neurosurgical-center-of-excellence-in-trujillo-peru-work-in-progress-first-four-months-results
#12
Joham Choque-Velasquez, Roberto Colasanti, Virginia Baffigo-Torre, Luisa Estela Sacieta-Carbajo, Jacqueline Olivari-Heredia, Yolanda Falcon-Lizaraso, Juan Huber Mallma-Torres, Humberto Elera-Florez, Juha Hernesniemi
BACKGROUND: Economic, cultural, and geographical reasons usually limit the access to specialized health centers in developing countries, especially in rural areas. Peruvian health system indicators still highlight significant unmet clinical need for neurosurgical patients. Our project is to develop the first highly specialized neurosurgical center in the EsSalud hospital of Trujillo, with the goal to improve the treatment of neurosurgical diseases in that region, thus optimizing their outcomes while decreasing expensive and risky patients transfer to the neurosurgical departments in the capital district...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28109859/microsurgical-anatomy-of-the-hypoglossal-and-c1-nerves-description-of-a-previously-undescribed-branch-to-the-atlanto-occipital-joint
#13
Joe Iwanaga, Christian Fisahn, Fernando Alonso, Daniel DiLorenzo, Peter Grunert, Matthew T Kline, Koichi Watanabe, Rod J Oskouian, Robert J Spinner, R Shane Tubbs
OBJECTIVE: Distal branches of the C1 nerve that travel with the hypoglossal nerve have been well investigated but relationships of C1 and the hypoglossal nerve near the skull base have not been described in detail. Therefore, the aim of this study was to investigate these small branches of the hypoglossal and first cervical nerves by anatomical dissection. METHODS: Twelve sides from six cadaveric specimens were used in this study. To elucidate the relationship among the hypoglossal, vagus, and first and cervical nerve, the mandible was removed and these nerves were dissected under the surgical microscope...
January 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#14
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28039506/microsurgical-anatomy-of-branches-of-musculocutaneous-nerve-clinical-relevance-for-spastic-elbow-surgery
#15
C Thieffry, L Chenin, P Foulon, E Havet, J Peltier
PURPOSE: The neurotomy of musculocutaneous nerve is a treatment for patients who suffer from spastic elbow flexion when medical and reeducative treatments have failed. It consists in sectioning motor branches of musculocutaneous nerve which are destined to the biceps brachii and brachialis muscles, both being the main elbow flexor muscles. The aim of this study was to analyse the distance, where each motor branch arises from the musculocutaneous nerve to both biceps brachii and brachialis muscles, to establish precisely the localisation and length of the necessary incision to reach its branches for surgery...
December 30, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28024974/dual-image-videoangiography-during-intracranial-microvascular-surgery
#16
Alberto Feletti, Xiangdong Wang, Riki Tanaka, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Hirotoshi Sano, Yoko Kato
OBJECTIVE: Indocyanine green videoangiography (ICG-VA) is a valuable tool to assess vessel and aneurysm patency during neurovascular surgical procedures. However, ICG-VA highlights vascular structures, which appear white over a black background. Anatomic relationships are sometimes difficult to understand at first glance. Dual-image videoangiography (DIVA) enables simultaneous visualization of light and near-infrared fluorescence images of ICG-VA. METHODS: The DIVA system was mounted on an OPMI Pentero Flow 800 intraoperative microscope...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28017747/complications-and-management-of-large-intracranial-vestibular-schwannomas-via-the-retrosigmoid-approach
#17
Xiang Huang, Ming Xu, Jian Xu, Liangfu Zhou, Ping Zhong, Mingyu Chen, Kaiyuan Ji, Huiyu Chen, Ying Mao
OBJECTIVE: To investigate the common complications from the microsurgical treatment of large intracranial vestibular schwannoma (VS) via suboccipital retrosigmoid approach and to propose strategies for minimizing such complications. METHODS: We selected all patients with large unilateral VS from the collected database (1999-2013) who underwent microsurgical resection as their initial treatment for histopathologically confirmed VS. Tumors larger than 30 × 20 mm were defined as large...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27986388/-3d-anatomy-of-cerebellar-peduncles-based-on-fibre-microdissection-and-a-demonstration-with-tractography
#18
Ruben Rodríguez-Mena, José Piquer-Belloch, José Luis Llácer-Ortega, Pedro Riesgo-Suárez, Vicente Rovira-Lillo
OBJECTIVE: To perform an anatomical and radiological study, using fibre microdissection and diffusion tensor tractography (DTT), to demonstrate the three-dimensionality of the superior, middle and inferior cerebellar peduncles. MATERIAL AND METHODS: A total of 15 brain-stem, 15 cerebellar hemispheres, and 5 brain hemispheres were dissected in the laboratory under the operating microscope with microsurgical instruments between July 2014 and July 2015. Brain magnetic resonance imaging was obtained from 15 healthy subjects between July and December of 2015, using diffusion-weighted images, in order to reproduce the cerebellar peduncles on DTT...
December 13, 2016: Neurocirugía
https://www.readbyqxmd.com/read/27973959/three-dimensional-digitalized-virtual-planning-for-saphenous-artery-flap-a-pilot-study
#19
Yuan Z Zhang, Shu Z Wen, Hui Q Zhang, Ya G Li, Jian M Zhao, Yong Yang
OBJECTIVE: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. METHODS: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27867120/transforaminal-resection-of-cervical-dumbbell-schwannomas-in-patients-with-additional-tumors
#20
Ji Zhang, Xiang-Heng Zhang, Zi-Feng Wang, You-Ping Li, Zheng-Quan Zhu, Ji-Cheng Sun, Zheng-He Chen, Shao-Yong Wu, Ke Sai, Jian Wang, Yong-Gao Mou, Zhong-Ping Chen
BACKGROUND: It is rare for 2 primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible. METHODS: Twelve patients with concurrent CTs and CDSs were identified from 3 medical centers...
February 2017: World Neurosurgery
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