Journal of Neurological Surgery Part B: Skull Base最新文献_第2页

Pilot Program in Surgical Anatomy Education for Complex Cranial and Skull Base Procedures: Curriculum Overview & Initial 2-Year Experience at Mayo Clinic 复杂颅骨和颅底手术解剖教育试点项目：课程概述和梅奥诊所的两年初步经验

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-07-11 DOI: 10.1055/a-2364-3189

Juliana Capp, M. M. Bauman, Christopher S. Graffeo, L. Carlstrom, A. Perry, C. Pinheiro-Neto, J. V. van Gompel, David J. Daniels, Michael J. Link, L. Leonel, Maria Peris Celda

{"title":"Pilot Program in Surgical Anatomy Education for Complex Cranial and Skull Base Procedures: Curriculum Overview & Initial 2-Year Experience at Mayo Clinic","authors":"Juliana Capp, M. M. Bauman, Christopher S. Graffeo, L. Carlstrom, A. Perry, C. Pinheiro-Neto, J. V. van Gompel, David J. Daniels, Michael J. Link, L. Leonel, Maria Peris Celda","doi":"10.1055/a-2364-3189","DOIUrl":"https://doi.org/10.1055/a-2364-3189","url":null,"abstract":"Background: Cadaveric dissection remains a preferred and irreplaceable learning modality among neurosurgery residents. We aimed to develop and describe a tiered, quantifiable, and practical curriculum for cranial neurosurgical anatomy education. We report the structure and evaluation of our 2-year pilot study to serve as a suggested guide for other neurosurgery programs.\u0000\u0000Method: Our Complex Cranial Dissection Program is tailored to the needs of junior-level neurosurgery residents based on their post-graduation year (PGY) 1-4. Dissections are performed in a sequential manner, each of which emphasize a particular set of manual skills and neuroanatomic knowledge. Dissections are scored on a scale of 10 points. The grading was based on specific landmarks and anatomical structures which need to be exposed, explored, and preserved.\u0000\u0000Results: Out of 16 residents, 14 individuals (87.5%) attended the dissections in the first iteration of the program and 16 individuals (100%) attended the dissections in the second iteration. A total of seventeen dissections were performed across all years. In survey feedback about the program, 100% (Year 1) and 94% (Year 2) of residents considered the assigned dissections to be appropriate for their respective training level. Further, 100% (Year 1) and 94% (Year 2) of residents endorsed that the dissections were important and helpful for their practice prior to similar operating room experiences. \u0000\u0000Conclusions: The development and implementation of structured dissection programs within residency training, along with dedicated staff, and objective feedback serve a crucial role in neurosurgical education to further develop and enhance surgical skills in the operative setting.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Journey to the centre of the ovale: a novel, combined percutaneous fluoroscopic and image-guided approach to biopsy a Meckel’s cave lesion. 卵圆孔中心之旅：一种新颖的经皮透视和图像引导相结合的梅克尔洞病变活检方法。

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-07-08 DOI: 10.1055/a-2361-4912

Amad Naseer Khan, D. Anwar, Jonathan Hempenstall, Girish Vajramani

{"title":"Journey to the centre of the ovale: a novel, combined percutaneous fluoroscopic and image-guided approach to biopsy a Meckel’s cave lesion.","authors":"Amad Naseer Khan, D. Anwar, Jonathan Hempenstall, Girish Vajramani","doi":"10.1055/a-2361-4912","DOIUrl":"https://doi.org/10.1055/a-2361-4912","url":null,"abstract":"Introduction: \u0000The percutaneous Hartel’s technique is a well-described approach to targeting lesions in the Meckel’s cave. It is used as the standard approach for all percutaneous trigeminal neuralgia procedures for accessing the Gasserian ganglion through the foramen ovale. It has also been described to biopsy lesions in the Meckel’s cave and cavernous sinus using fluoroscopic guidance however there were a significant number of non-diagnostic samples. No one to date has described a combined fluoroscopic and image-guided approach to improve safety and accuracy.\u0000Methods:\u0000The patient had a 3-month history of left-sided facial numbness and a left VIth palsy causing diplopia and a squint. The CT of the chest, abdomen and pelvis was unremarkable as were the serum tumour markers. We describe the novel approach of using a percutaneous biopsy needle to obtain a cytological sample of a Meckel’s cave lesion using a combination of X-ray and EM image-guidance with use of StealthStation® S8® System (Medtronic Sofamor Danek, Memphis, USA). The need for a craniotomy and its associated morbidity and technical challenges was therefore obviated.\u0000Results:\u0000The procedure was performed under general anaesthesia and eight core samples were sent to neuro-pathology for analysis. The lesion was histologically confirmed to be lymphoma and the patient subsequently received oncological treatment. The patient had no immediate or post-operative complications and the use of the aforementioned combined approach improved safety and accuracy of targeting the lesion in real time.\u0000Conclusion:\u0000A combined percutaneous fluoroscopic and image-guided approach to biopsy a Meckel’s cave lesion is recommended.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sentiment Analysis of Transsphenoidal Surgery in the Cushing’s Subreddit 库欣氏病子论坛经蝶手术的情感分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-07-05 DOI: 10.1055/a-2360-9748

Rose Dimitroyannis, Sharanya Thodupunoori, Ringo Leung, Rachel Nordgren, Sean P. Polster, Peleg Horowitz, Paramita Das, Christopher R. Roxbury

{"title":"Sentiment Analysis of Transsphenoidal Surgery in the Cushing’s Subreddit","authors":"Rose Dimitroyannis, Sharanya Thodupunoori, Ringo Leung, Rachel Nordgren, Sean P. Polster, Peleg Horowitz, Paramita Das, Christopher R. Roxbury","doi":"10.1055/a-2360-9748","DOIUrl":"https://doi.org/10.1055/a-2360-9748","url":null,"abstract":"ABSTRACT\u0000\u0000INTRODUCTION: While the definitive treatment of Cushing’s disease (CD) is transsphenoidal surgery (TSS), little is known about patients’ perceptions of their treatment experience. Reddit, an online forum, allows users to interact on “subreddits” specific to interests. We aimed to assess patient sentiments regarding TSS for CD on the Cushing's subreddit. \u0000METHODS: Cushing’s subreddit posts were sorted by “top” of “all time” to evaluate those with the most engagement throughout the site’s history. Posts unrelated to surgical management of CD were excluded. Descriptive statistics were performed to compare pre and postoperative posters. Sentiment analysis was performed using TextBlob, a Python library, and thematic analysis was done using grounded theory qualitative methods.\u0000RESULTS: From 68 entries, 53 (77.9%) were written by individuals who underwent TSS. Of posters with a history of TSS, many (68%, n=25/38) reported difficult recovery, but an overwhelming majority (91.3%, n=42/46) also reported positive long-term outcomes. Posters who had undergone TSS were more likely to post content with negative sentiment (p=0.007), often regarding issues with access to the surgery. Thematic analysis revealed general themes of seeking and sharing advice, healthcare access issues, excitement for TSS, short-term symptoms postoperatively, and long-term outcomes. \u0000CONCLUSION: This study is the first to utilize Reddit to analyze patient perceptions of TSS for CD. This analysis suggests that most posters feel positively regarding their long-term outcome, while negative sentiments are often related to difficulties accessing care. Further studies should assess access to care for those with CD. \u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Labyrinthectomy improves dizziness in patients with vestibular schwannoma 迷走神经切除术可改善前庭分裂瘤患者的头晕症状

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-07-05 DOI: 10.1055/a-2360-9474

Jeffrey I. Traylor, Pooja Venkatesh, Alex Fabiano, Aaron R. Plitt, Brandon Isaacson, Ankur Patel, Bruce Mickey, Samuel L Barnett

{"title":"Labyrinthectomy improves dizziness in patients with vestibular schwannoma","authors":"Jeffrey I. Traylor, Pooja Venkatesh, Alex Fabiano, Aaron R. Plitt, Brandon Isaacson, Ankur Patel, Bruce Mickey, Samuel L Barnett","doi":"10.1055/a-2360-9474","DOIUrl":"https://doi.org/10.1055/a-2360-9474","url":null,"abstract":"Objective: Dizziness is one of the most prevalent and debilitating symptoms associated with vestibular schwannoma (VS) and there is little data on contributing or alleviating factors in the perioperative setting. In this study, we aimed to evaluate whether vestibular nerve sectioning or labyrinthectomy concomitant with surgical resection would improve dizziness in the postoperative period. \u0000Methods: This is a retrospective study of a consecutive series of VS patients who underwent resection at a large tertiary care center between 2009 and 2023. Dizziness at 6-months was the primary endpoint while facial nerve and hearing outcomes were secondary endpoints. Fisher’s exact test was used to identify significant differences between categorical variables, and multivariate logistic regression analysis was performed to identify predictors of dizziness as well as facial nerve and hearing outcomes. \u0000Results: A total of 333 patients underwent resection of VS at our institution. There was no significant difference in binary reported dizziness based on surgical approach (p = 0.14). However, patients reported significantly less dizziness at discharge (p < 0.01) as well as 6-month (p = 0.02) and 1-year (p < 0.01) follow-up in the translabyrinthine group. On the other hand, patients who underwent labyrinth-sparing approaches reported a significant increase in dizziness that remained up to 1 year from the time of surgery. \u0000Conclusions: Our data suggests that labyrinthectomy may improve dizziness symptoms in patients with VS. Selective VN sectioning does not appear to affect dizziness or hearing outcomes. Finally, surgical approach does not affect facial nerve outcomes.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Just got diagnosed; what worked for you?”: A Mixed-Methods Analysis of Treatment Experiences in the Prolactinoma Subreddit "刚确诊，什么对你有效？泌乳素瘤子论坛治疗经验的混合方法分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-07-02 DOI: 10.1055/a-2358-9228

Rose Dimitroyannis, David Fenton, Sharanya Thodupunoori, Stella Cho, Rachel Nordgren, Sean P. Polster, Peleg Horowitz, Paramita Das, Christopher R. Roxbury

{"title":"“Just got diagnosed; what worked for you?”: A Mixed-Methods Analysis of Treatment Experiences in the Prolactinoma Subreddit","authors":"Rose Dimitroyannis, David Fenton, Sharanya Thodupunoori, Stella Cho, Rachel Nordgren, Sean P. Polster, Peleg Horowitz, Paramita Das, Christopher R. Roxbury","doi":"10.1055/a-2358-9228","DOIUrl":"https://doi.org/10.1055/a-2358-9228","url":null,"abstract":"\u0000ABSTRACT\u0000\u0000INTRODUCTION\u0000With improvement in complication and remission rates, recent studies have suggested the viability of transsphenoidal surgery as first-line management for prolactinomas. Reddit, an online forum, allows posters to interact with one another, discuss symptoms, treatments, and disease courses through specialized forums known as “subreddits”. Given the lack of research comparing patient experience on pharmacotherapy versus surgery, we sought to assess the sentiment of treatment within the “r/Prolactinoma subreddit” community.\u0000\u0000METHODS\u0000A search was done by filtering the r/Prolactinoma subreddit. Posts were sorted by “top” of “all time,” meaning entries with the most engagement throughout the site's history. Welch’s t-test was used to analyze treatment type, while sentiment regarding treatment was analyzed using grounded theory qualitative methods.\u0000\u0000RESULTS\u0000From 189 total entries, 82 were included; 33% (n=27/82) were posts. Of posters disclosing their treatment, 11% underwent surgery (n=9/79), while 76% received medication (n=60/79). The proportion of positive: negative sentiment and level of engagement on posts regarding pharmacotherapy vs surgical treatments were not significantly different (p>0.05). Qualitative analysis showed themes of changes after medical treatment, immediate changes post-surgery, and online community. \u0000\u0000CONCLUSION\u0000Our mixed-methods study found statistically non-significant differences in sentiment when comparing Reddit posts from patients who underwent medical and surgical management. Qualitative analysis revealed several themes regarding patients’ perceptions of medical and surgical management and the benefits of an online community. The qualitative themes brought to light by this study may serve to inform future studies examining the patient experience with prolactinoma care. \u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Eyelid Trans-orbital Trans-cavernous Approach to the Basilar Apex: A Cadaveric Proof-of-Concept Study 眼睑经眶经腔入路至基底动脉窦：尸体概念验证研究

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-24 DOI: 10.1055/s-0044-1787148

Xiaochun Zhao, Jeremy Tan, Mohamed A. Labib, Rupen Desai, Christopher S. Graffeo, Andrew M. Bauer, Ian F. Dunn

{"title":"The Eyelid Trans-orbital Trans-cavernous Approach to the Basilar Apex: A Cadaveric Proof-of-Concept Study","authors":"Xiaochun Zhao, Jeremy Tan, Mohamed A. Labib, Rupen Desai, Christopher S. Graffeo, Andrew M. Bauer, Ian F. Dunn","doi":"10.1055/s-0044-1787148","DOIUrl":"https://doi.org/10.1055/s-0044-1787148","url":null,"abstract":"\u0000 Objective The pretemporal transcavernous approach is an elegant technique that provides exposure to the basilar apex, which is conventionally completed with a frontotemporal incision. This can also be performed via a minimally invasive eyelid transorbital approach, which has unique attributes. This is a proof-of-concept cadaveric study to demonstrate details of the combination of these two approaches.\u0000 Design This study is a proof-of-concept study using cadaveric heads.\u0000 Setting This study is a proof-of-concept study in a cadaveric laboratory.\u0000 Participants A latex-injected cadaveric head.\u0000 Main Outcome Measures Detailed dissection was performed and demonstrated in a step-by-step fashion.\u0000 Results The eyelid transorbital approach provides the exact exposure required to complete the pretemporal osteotomy including an anterior clinoidectomy and dissection, so that a transcavernous approach can be completed. The basilar apex and its branches can also be accessed via the eyelid transorbital approach, with comparable exposure to the traditional approach; however, the access trajectory is much narrower. It takes advantages of the inferior corridor with a more medial access angle and provides a complementary perspective to the cavernous sinus contents and basilar apex complex.\u0000 Conclusion The combination of an eyelid transorbital and pretemporal transcavernous approaches can achieve a deep exposure via a minimally invasive incision, which may add an additional approach to the cavernous sinus and basilar apex regions.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ICSNT Primer for the Skull Base Community: Navigating the Landscape of Sinonasal Tumors with Synthesized Literature Guidance 颅底社区的 ICSNT 入门指南：在综合文献的指导下探索鼻窦肿瘤的全貌

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-23 DOI: 10.1055/s-0044-1787155

E. Kuan, Eric W. Wang, N. Adappa, D. Beswick, Adam L. Holtzman, N. London, Timothy L. Smith, Shirley Y. Su, Marilene B. Wang, James N. Palmer

引用次数: 0

Novel Eyelid Supraorbital Pretemporal Approach to the Anterior Communicating Artery Complex: A Quantitative Cadaveric Comparative Study 新型眼睑眶上颞前入路治疗前交通动脉复合体：尸体定量比较研究

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-13 DOI: 10.1055/a-2324-9499

Xiaochun Zhao, Alexander R Evans, Helen Shi, Panayiotis E. Pelargos, Jeremy Tan, Thai Do, Ian Dunn, Chris Graffeo, Andrew Bauer

{"title":"Novel Eyelid Supraorbital Pretemporal Approach to the Anterior Communicating Artery Complex: A Quantitative Cadaveric Comparative Study","authors":"Xiaochun Zhao, Alexander R Evans, Helen Shi, Panayiotis E. Pelargos, Jeremy Tan, Thai Do, Ian Dunn, Chris Graffeo, Andrew Bauer","doi":"10.1055/a-2324-9499","DOIUrl":"https://doi.org/10.1055/a-2324-9499","url":null,"abstract":"Objectives\u0000Access to the anterior communicating artery (ACom) complex may be achieved via the modified orbito-zygomatic (mOZ) or eyelid supraorbital (ES) approaches. Further, the ES approach may improve cosmesis at the cost of decreased exposure and maneuverability. Thus, a novel eyelid supraorbital pretemporal approach (ESP), a combination of the ES approach with a pretemporal dissection, may optimize the shortcomings of the ES approach.\u0000\u0000Design \u0000 This is a cadaveric study. \u0000\u0000Setting\u0000Five ES, ESP, and mOZ approaches were performed on cadaveric heads and compared. \u0000\u0000Participants\u0000 Cadaveric specimens were provided by the University of Oklahoma Health Science Center’s Willed Body Program.\u0000\u0000Main Outcome Measures\u0000 Quantitative measures of exposure, maneuverability, and angles of attack in horizontal and vertical planes were compared between approaches.\u0000\u0000Results \u0000The ESP approach was superior in terms of exposure and deep maneuverability when compared to the ES approach (P<.01). In addition, this approach demonstrated superior angles of attack in vertical (P<.01) and horizontal (P=.045) planes. When compared to the mOZ approach, the ESP approach provided significantly greater exposure to the contralateral A2 (P<.01) with a less favorable horizontal angle of attack (P<.01). The ESP provides exact exposure to complete the pretemporal osteotomy, offering a unique perspective to the ACom complex. \u0000\u0000Conclusion \u0000When accessing the ACom complex, the ESP approach yields superior exposure and maneuverability compared to the ES approach and is comparable to the mOZ approach, with unique advantages provided by the addition of pretemporal osteotomy and dissection. \u0000\u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of jugular venous pressure to optimize outcomes of vestibular schwannoma resection: a review of the literature and proof of concept 利用颈静脉压力优化前庭裂孔瘤切除术的效果：文献综述和概念验证

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-13 DOI: 10.1055/a-2324-9978

Benjamin Brakel, Jessica Wang, Jeremy Kam, Henrik Huttunen, Bali Dhaliwal, Jon McEwen, brian westerberg, Serge Makarenko, R. Akagami

{"title":"Use of jugular venous pressure to optimize outcomes of vestibular schwannoma resection: a review of the literature and proof of concept","authors":"Benjamin Brakel, Jessica Wang, Jeremy Kam, Henrik Huttunen, Bali Dhaliwal, Jon McEwen, brian westerberg, Serge Makarenko, R. Akagami","doi":"10.1055/a-2324-9978","DOIUrl":"https://doi.org/10.1055/a-2324-9978","url":null,"abstract":"Background: Surgical resection of vestibular schwannoma (VS) and other benign posterior fossa tumors is often curative if gross total resection is achieved, however, these lesions pose unique challenges due to their intricate location and proximity to critical structures. Approaches for resection often utilize lateral head rotation and neck flexion in order to optimize the surgical field. However, this may inadvertently occlude cerebral venous drainage, elevating intracranial pressure (ICP) and increasing intraoperative bleeding, potentially increasing the operative risk to patients.\u0000\u0000Methods: We review relevant literature regarding the effects of head rotation and neck flexion on internal jugular vein (IJV) occlusion and ICP, and highlight the notion that head rotation and flexion may occlude the ipsilateral IJV, increasing ICP. Subsequently, we propose a novel technique using continuous, real-time monitoring of jugular bulb pressure (JBP) to detect obstructions in jugular venous flow and guide optimal head positioning prior to VS resection.\u0000\u0000Results: As proof of concept, we present a single-patient case in which JBP monitoring was employed to optimize head positioning prior to a VS resection, which shows a significant reduction in JBP compared to traditional positioning.\u0000\u0000Conclusion: This innovative approach offers promise in enhancing the safety and efficacy of intracranial surgery for VS and other neurosurgical procedures.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and Radiological Response following Single-Session Gamma Knife Radiosurgery in Cavernous Sinus Hemangiomas. 海绵窦血管瘤单次伽玛刀放射手术后的临床和放射学反应

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-13 DOI: 10.1055/a-2324-9849

Anand Kalgudi, Abhijit Goyal-Honavar, Nishanth Sadashiva, Kaviyarasan Mp, Mohammed Nadeem Mohammed Nadeem, Subhas K Konar, Prabhuraj Ar, Vikas Vazhayil, A. Arimappamagan, Jeeva Balukrishnan, Ponnusamy Natesan

{"title":"Clinical and Radiological Response following Single-Session Gamma Knife Radiosurgery in Cavernous Sinus Hemangiomas.","authors":"Anand Kalgudi, Abhijit Goyal-Honavar, Nishanth Sadashiva, Kaviyarasan Mp, Mohammed Nadeem Mohammed Nadeem, Subhas K Konar, Prabhuraj Ar, Vikas Vazhayil, A. Arimappamagan, Jeeva Balukrishnan, Ponnusamy Natesan","doi":"10.1055/a-2324-9849","DOIUrl":"https://doi.org/10.1055/a-2324-9849","url":null,"abstract":"Purpose: Cavernous sinus hemangiomas (CSH) represent 2-3% of lesions occupying the cavernous sinus. The optimal management strategy for CSH in not established, with microsurgical resection and radiosurgery employed alone or in combination. Therefore, we aimed to analyse the efficacy and safety of Gamma Knife Radiosurgery(GKRS) for CSH in a cohort of primary and residual CSH. \u0000Methods: A retrospective analysis of 33 patients(26 primary and 7 residual CSH) that underwent single-session GKRS between 2012 and 2021 for CSH was performed. Demographic, clinical, radiological and follow-up data were acquired, and clinicoradiological response following GKRS was assessed. \u0000Results: The mean age of the cohort was 4313.5 years(range 10–77). There were 9 males (27.3%) and 24 females(72.7%). The median lesion volume was 6.9cc, ranging 1.46 to 19.06cc. The mean dose administered to the tumor margin was 13.501.5Gy(Range 12 to 15Gy). The median duration of clinical follow-up was 41 months, over which period the mean reduction in tumor volume was 87.6%. Complete response, defined as absence of tumor on follow-up imaging occurred in 23 patients(69.7%). Twenty-three patients(69.7%) showed clinical improvement following GKRS. There were no radiation-induced complications. \u0000Conclusions: CSH have a distinct radiological appearance and a predictable response to radiosurgery. When used primarily in radiologically diagnosed CSH and as adjunctive therapy supplementing a subtotal excision, GKRS produces a high rate of volume reduction with improvement of neurological function and minimal cranial nerve morbidity. Therefore, GKRS presents a viable alternative to surgery without the morbidity associated with surgical resection. \u0000","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0