Journal of Neurological Surgery Part B: Skull Base最新文献_第3页

The Evolution of Pituitary Surgery in an Australian Health Care Framework 垂体手术在澳大利亚医疗保健框架中的演变

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-15 DOI: 10.1055/s-0044-1786044

Nicholas G. Candy, Alistair K. Jukes, Eng H. Ooi, Rowan Valentine, Nick Vrodos, Stephen Santoreneos, Steve Floreani, Peter-John Wormald, Alkis J. Psaltis

{"title":"The Evolution of Pituitary Surgery in an Australian Health Care Framework","authors":"Nicholas G. Candy, Alistair K. Jukes, Eng H. Ooi, Rowan Valentine, Nick Vrodos, Stephen Santoreneos, Steve Floreani, Peter-John Wormald, Alkis J. Psaltis","doi":"10.1055/s-0044-1786044","DOIUrl":"https://doi.org/10.1055/s-0044-1786044","url":null,"abstract":"\u0000Background The outcomes in pituitary surgery have dramatically changed over the past 130 years. Endoscopic endonasal transsphenoidal approaches are now an accepted method for operating on pituitary tumors, a skillset which takes time to develop. The Australian health care framework provides a unique mixture of public and private care for a geographically dispersed population. In this article, we aim to examine how outcomes for patients in South Australia changed as endoscopic pituitary surgery was adopted and how the Australian health care framework influenced the development of a skull base team. \u0000Methods The case notes of all patients undergoing pituitary surgery between 2006 and 2020 in South Australia. All patients treated by this author group were included. \u0000Results A total of 428 pituitary adenomas were surgically treated. Overall, 182 out of 249 patients (70%) had a complete resection with no recurrence at follow-up, and 49 patients (19%) had a residual that was observed and did not require treatment. Therefore, 89% of patients between the years 2006 and 2020 did not require any further treatment following their pituitary surgery. Upon examination of the 142 patients with functional adenomas, 112 (79%) patients had no recurrence in hormonal dysfunction following surgery, and the remaining 30 (21%) patients required further treatment. \u0000Conclusion We have demonstrated that acceptable outcomes can be achieved in a low-to-moderate volume setting across multiple hospitals when a coordinated effort is made to consolidate these cases within a small group of subspeciality-trained surgeons, as opposed to a more generalist approach. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"3 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140565931","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 Usefulness of YouTube Videos Related to Endoscopic Sinus Surgery for Surgical Residents YouTube 上与内窥镜鼻窦手术相关的视频对外科住院医师的实用性

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-15 DOI: 10.1055/s-0044-1786045

Justin Shapiro, Marc Levin, Saud Sunba, Emily Steinberg, Vince Wu, John M. Lee

{"title":"The Usefulness of YouTube Videos Related to Endoscopic Sinus Surgery for Surgical Residents","authors":"Justin Shapiro, Marc Levin, Saud Sunba, Emily Steinberg, Vince Wu, John M. Lee","doi":"10.1055/s-0044-1786045","DOIUrl":"https://doi.org/10.1055/s-0044-1786045","url":null,"abstract":"\u0000Objective The use of online teaching modalities to supplement surgical learning has increased recently, demonstrating promising results. Previous studies have analyzed the value and usefulness of YouTube as an educational source to learners, including teaching surgical skills to Otolaryngology–Head and Neck Surgery (OHNS) trainees. YouTube videos on endoscopic sinus surgery (ESS) still need to be explored as ESS remains a common, yet challenging surgery that OHNS residents encounter regularly. This study aimed to objectively evaluate the usefulness of YouTube videos on ESS for surgical education. \u0000Design YouTube was searched using the following keywords: “uncinectomy,” “maxillary antrostomy,” “anterior ethmoidectomy,” and “ethmoid bulla resection.” These represent the initial ESS steps residents learn. Each video was assessed for eligibility by two independent reviewers. \u0000Outcome Measures The LAParoscopic surgery Video Educational Guidelines (LAP-VEGaS) and ESS-specific criteria were used to assess educational quality. Video popularity index (VPI) was used to calculate video popularity. \u0000Results Of the 38 videos that met inclusion criteria, the average LAP-VEGaS score was 6.59 (± ) 3.23 standard deviation. Most videos were designated low quality. There was a weak positive correlation between whether a video included ESS-specific criteria and LAP-VEGaS score (r = 0.269, p = 0.102). There was a significant positive correlation between VPI and LAP-VEGaS scores (r = 0.497, p = 0.003). \u0000Conclusions Overall, the quality of included videos was poor. OHNS residents should not rely solely or primarily on YouTube videos to learn surgical skills relevant to ESS. To maximize potential of online teaching, high-quality videos should be used to compliment other methods of teaching. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"10 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140565832","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

Systematic Review: Success Rate of Endoscopic Endonasal versus Combined Endonasal and Transorbital Neuroendoscopic Approach for Nontraumatic Cerebrospinal Fluid Leak Repairs in the Lateral Recess of Sphenoid Sinus 系统性综述：鼻内镜与鼻内镜和经眶神经内镜联合方法用于非外伤性蝶窦外侧凹脑脊液漏修补术的成功率比较

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-04-08 DOI: 10.1055/s-0044-1785486

Umnia Nasir Ahmed, Mohammed Saqlain Siddiqui, Haissan Iftikhar, Karan Jolly, Hannah Nieto, Jameel Muzaffar

{"title":"Systematic Review: Success Rate of Endoscopic Endonasal versus Combined Endonasal and Transorbital Neuroendoscopic Approach for Nontraumatic Cerebrospinal Fluid Leak Repairs in the Lateral Recess of Sphenoid Sinus","authors":"Umnia Nasir Ahmed, Mohammed Saqlain Siddiqui, Haissan Iftikhar, Karan Jolly, Hannah Nieto, Jameel Muzaffar","doi":"10.1055/s-0044-1785486","DOIUrl":"https://doi.org/10.1055/s-0044-1785486","url":null,"abstract":"\u0000Background Cerebrospinal fluid (CSF) leaks from the lateral recess of the sphenoid sinus (LRS) occur due to a skull base defect and are important to treat due to the associated morbidity, e.g., life-threatening meningitis. Nontraumatic CSF leaks have a predilection toward obesity which is a rising phenomenon. LRS is notoriously difficult to access because of its lateral location and its associated neurovascular complications. An alternative surgical corridor has been explored which is the transorbital neuroendoscopic (TONES) approach. \u0000Objective To compare the success rate of the endoscopic endonasal with the TONES approaches. \u0000Rationale This is the first systematic review on the endoscopic endonasal and combined transorbital approaches to treat CSF leaks from the LRS. \u0000Method A PRISMA-concordant systematic review. PubMed, MEDLINE, EMBASE, Web of Science, and SCOPUS were searched. The studies underwent abstract and full-text screening by two reviewers. The data collected included patient demographic, surgical approach, reconstruction method, layers and materials, follow-up period, ROBINS-I bias, complications, and success rate. \u0000Results In total, 26 of 4,385 studies were included for further synthesis. Of these studies, a total of 336 patients were identified from a cohort of 910 patients. The endoscopic endonasal approach showed a repair success rate of 95.24% and the combined TONES and endonasal approach showed a success rate of 100%. \u0000Conclusion Both the endoscopic endonasal and transorbital approach provide a good success rate. However, due to the small TONES sample, large, randomized control trials are needed. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595517","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

Giant Meningiomas Invading the Cavernous Sinus: The “Inevitable Ones” 侵入海绵窦的巨型脑膜瘤：不可避免的肿瘤

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-28 DOI: 10.1055/a-2273-5509

Carlos Eduardo da Silva, Tamara Vidaletti

{"title":"Giant Meningiomas Invading the Cavernous Sinus: The “Inevitable Ones”","authors":"Carlos Eduardo da Silva, Tamara Vidaletti","doi":"10.1055/a-2273-5509","DOIUrl":"https://doi.org/10.1055/a-2273-5509","url":null,"abstract":"\u0000Introduction Giant meningiomas invading the cavernous sinus (GMICSs) are a subgroup of challenging tumors due to their volume and the extent of neurological impairment. Preserving quality of life is one of the most relevant aspects of treating patients with GMICS. \u0000Methods A retrospective study was conducted for surgeries performed between 2012 and 2022, including 33 patients presenting meningiomas with the largest diameter of at least 5 cm invading the cavernous sinus. The data from surgical intervention, Simpson grade of resection, tumor location, and morbimortality related to the surgeries were reviewed. \u0000Results The group comprised 25 women and 8 men with a median age of 56 years. The mean follow-up period was 52 months. The tumors were in the sphenoid wing, anterior clinoid, spheno-orbital, spheno-petroclival, petroclival, and Meckel's cave. Simpson grade I, II, and III were obtained in 70% of cases. The meningiomas were classified as WHO grade 1 in 94%, grade 2 in 3%, and grade 3 in 3%. The overall mortality was 3%. Permanent cranial nerve deficits occurred in 21%, transient cranial nerve deficits in 42%, cerebrospinal fistula in 15%, and hemiparesis in 18%. The recurrence/regrowth rate was 6%. The Karnofsky Performance Status score of 100 and 90 was 82%. \u0000Conclusions The surgical treatment of GMICS is an effective treatment modality with acceptable morbimortality and good long-term control. Involvement of the internal carotid artery is essential to determine the extent of resection inside the cavernous sinus, and training in the microsurgical laboratory is mandatory for safe surgical treatment. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"24 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140323420","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

Corrigendum: Grade 3 Meningioma Survival and Recurrence Outcomes in an International Multicenter Cohort. 更正：国际多中心队列中3级脑膜瘤的生存和复发结果。

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-14 eCollection Date: 2024-02-01 DOI: 10.1055/s-0044-1782669

Kira Tosefsky, Alexander D Rebchuk, Justin Z Wang, Yosef Ellenbogen, Richard Drexler, Franz L Ricklefs, Thomas Sauvigny, Ulrich Schüller, Christopher B Cutler, Brandon Lucke-Wold, Yusuf Mehkri, Sanju Lama, Garnette R Sutherland, Michael Karsy, Brian L Hoh, Manfred Westphal, Gelareh Zadeh, Stephen Yip, Serge Makarenko

引用次数: 0

Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands 荷兰对无症状 SDHx 变异携带者进行遗传性头颈部副神经管瘤的最佳筛查

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1781438

Anouk Frederique Heesters, Carli Tops, Thomas Potjer, Eleonora P.M. Corssmit, Jean-Pierre Bayley, Erik Hensen, Jeroen Jansen

{"title":"Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands","authors":"Anouk Frederique Heesters, Carli Tops, Thomas Potjer, Eleonora P.M. Corssmit, Jean-Pierre Bayley, Erik Hensen, Jeroen Jansen","doi":"10.1055/s-0044-1781438","DOIUrl":"https://doi.org/10.1055/s-0044-1781438","url":null,"abstract":"\u0000Background SDHx variant carriers have an increased risk of developing head and neck paraganglioma. The Dutch guidelines state that these patients require lifelong follow-up, but no clear recommendation is made about the frequency of screening. \u0000Objective To determine the annual risk of developing head and neck paraganglioma in SDHx variant carriers after a negative initial screening. \u0000Methods We conducted a retrospective single-center cohort study in the Netherlands that included 49 SDHA, SDHB, and SDHD variant carriers with a negative first screening and at least one follow-up. The main outcome measure was the annual risk of developing a paraganglioma for the SDHx variants separately. \u0000Results Between 2000 and 2022, nine patients developed a paraganglioma all of whom were carriers of a SDHD variant (n = 23). Neither the 24 SDHB-related cases nor the 2 SDHA variant carriers developed a paraganglioma after a median of 4.83 and 5.92 years of follow-up, respectively. \u0000Conclusion The 5-year risk for head and neck paragangliomas in pathological SDHx variant carriers is less than 20%. A 5-year interval for screening SDHx carriers seems sufficient to prevent the unnoticed development of head and neck paragangliomas that warrant treatment. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"10 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017115","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

Complications of Endonasal Odontoidectomy in Pediatric versus Adult Populations: A Systematic Review and Meta-Analysis 儿童与成人鼻内舌骨切除术的并发症：系统回顾与元分析

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/a-2257-5439

Nikitha Kosaraju, Christine K. Lee, Z. Jason Qian, Juan C. Fernandez-Miranda, Jayakar V. Nayak, Michael T. Chang

{"title":"Complications of Endonasal Odontoidectomy in Pediatric versus Adult Populations: A Systematic Review and Meta-Analysis","authors":"Nikitha Kosaraju, Christine K. Lee, Z. Jason Qian, Juan C. Fernandez-Miranda, Jayakar V. Nayak, Michael T. Chang","doi":"10.1055/a-2257-5439","DOIUrl":"https://doi.org/10.1055/a-2257-5439","url":null,"abstract":"\u0000Introduction Endonasal odontoidectomy (EO) is a procedure for addressing compressive pathology of the craniovertebral junction. While EO has been well established in adults, its complications and cervical fusion practices are less understood in pediatric patients, despite differences in sinonasal and craniocervical anatomy. This study summarizes and compares EO complications and need for cervical fusion in pediatric and adult patients. \u0000Methods This was a systematic review and meta-analysis. Literature review was conducted using PubMed, Web of Science, and Embase to identify studies reporting complications post-EO in adult and pediatric patients. Complications were categorized as neurologic, swallowing, or respiratory. Complication and posterior fusion rates were compared using a random-effects model. \u0000Results A total of 738 articles were identified, of which 28 studies including 307 adult cases and 22 pediatric cases met inclusion criteria for systematic qualitative and quantitative review. The rates for adult and pediatric cases, respectively, were: respiratory complications 13.4 versus 9.1%, swallowing complications 12.1 versus 4.5%, neurologic complications 8.5 versus 9.1%, and cervical fusion rates 73.3 versus 86.4%. Across eight studies qualifying for meta-analysis, there were no differences in cervical fusion (odds ratio [OR]: 0.5, 95% confidence interval [CI]: [0.1, 2.1]), respiratory complications (OR: 3.5, 95% CI: [0.8, 14.5]), or swallowing complications (OR: 3.5, 95% CI: [0.5, 26.0]); however, pediatric patients had a higher rate of neurologic complications (OR: 5.2, 95% CI: [1.1, 25.0]). \u0000Conclusion In EO, rates of aerodigestive complications and cervical fusion are similar in both populations. There may be an increased risk of neurologic complications in pediatric patients, although more high-quality studies are needed. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"22 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017078","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

Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors 锥形束计算机断层扫描高级导航优化颅底肿瘤动脉内化疗输注的可行性和安全性

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/a-2257-5590

Francois H. Cornelis, Eric Lis, Viviane Tabar, Andrew Lin

{"title":"Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors","authors":"Francois H. Cornelis, Eric Lis, Viviane Tabar, Andrew Lin","doi":"10.1055/a-2257-5590","DOIUrl":"https://doi.org/10.1055/a-2257-5590","url":null,"abstract":"\u0000Purpose To assess the feasibility and safety of cone-beam computed tomography (CBCT) advanced navigation for optimizing intra-arterial chemotherapy infusion (IACI) in patients with skull base tumors. \u0000Materials and Methods Retrospective review on 10 consecutive IACI procedures performed in five patients (four women, 1 man) over a 1-year period. The median age of the patients was 71 years (interquartile range: 34–74). During the procedures, a CBCT-based navigation software was employed to evaluate tumor perfusion and guide the infusion methods. Catheterization of the primary tumor feeding vessel was performed in seven cases when it originated from the external carotid artery, whereas a temporary balloon-assisted occlusion technique was utilized in the remaining three cases where the tumor was primarily fed by the internal carotid artery. Carboplatin, topotecan, and melphalan were injected over a 10-minute period. Fluoroscopy time, reference dose, and Kerma area product, which estimates effective dose, were analyzed. \u0000Results The technical success rate was 100%, with a median procedure length of 82 minutes (79–90). The median fluoroscopy time was 11.3 minutes (9.4–16.9), reference dose was 93.5 mGy (62–256.5), and Kerma area product was 11.6 Gy.cm2 (9.5–25.4). The median effective dose was 3.8 mSv (1.5–5.1). The median follow-up duration was 233.5 days (186.3–432). One severe adverse event was reported, involving a right brachial hematoma and brachiocephalic artery dissection related to catheterization through a type III aortic arch. Three patients exhibited disease progression, but two patients showed stable disease. \u0000Conclusion IACI for skull base tumors guided by CBCT navigation is both feasible and safe. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"67 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017018","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

Utilization of Polydioxanone Plate for Endoscopic Anterior Skull Base Repair: Operative Technique and Long-Term Cohort Outcomes 在内窥镜颅底前路修复术中使用聚二氧酮板：手术技术和长期队列结果

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/a-2262-8050

Jorge A. Gutierrez III, Zachary M. Soler, Thomas Larrew, Nikita Chapurin, Jeffrey E. Wessell, Rodney J. Schlosser, W. Alexander Vandergrift III

{"title":"Utilization of Polydioxanone Plate for Endoscopic Anterior Skull Base Repair: Operative Technique and Long-Term Cohort Outcomes","authors":"Jorge A. Gutierrez III, Zachary M. Soler, Thomas Larrew, Nikita Chapurin, Jeffrey E. Wessell, Rodney J. Schlosser, W. Alexander Vandergrift III","doi":"10.1055/a-2262-8050","DOIUrl":"https://doi.org/10.1055/a-2262-8050","url":null,"abstract":"\u0000Objective The purpose of this study is to report the technical procedure and our experience using a polydioxanone suture (PDS) plate with dural substitute as part of a fully resorbable gasket seal technique to repair anterior skull base defects. \u0000Methods A series of patients undergoing anterior skull base reconstruction utilizing our resorbable gasket seal technique from January 2014 to July 2022 was reviewed. \u0000Results A total of 155 patients were included. Nine (5.8%) of the included patients developed postoperative cerebrospinal fluid (CSF) leaks requiring reoperation. There were no cases of intraoperative cranial nerve injury or internal carotid artery injury. A total of 103 (66.5%) patients were observed to have an intraoperative CSF leak, including 57 low-flow leaks and 46 high-flow leaks; 1 of 57 (1.8%) patients with low-flow leaks and 8 of 46 (17.4%) patients with high-flow leaks developed a postoperative CSF leak. During the first 3 years that this technique was utilized at our center for the management of high-flow intraoperative CSF leaks, postoperative CSF leaks were documented in 4 of 12 (33.3%) patients, in comparison to 4 of 34 (11.8%) in the following years. \u0000Conclusion PDS plate reconstruction confers several advantages and can be used in a diverse set of operative scenarios in conjunction with other reconstruction options. There appeared to be an associated learning curve as surgeons at our center gained experience with this new technique. Our findings show that the PDS plate reconstruction is safe and effective in repairing the skull base. ","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"45 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017076","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

Abducens Nerve Duplication: Novel Intraoperative and Radiographic Observation of a Rare Anatomical Variant Abducens Nerve Duplication：罕见解剖变异的术中和影像学观察新发现

IF 0.9 4区医学

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779736

{"title":"Abducens Nerve Duplication: Novel Intraoperative and Radiographic Observation of a Rare Anatomical Variant","authors":"","doi":"10.1055/s-0044-1779736","DOIUrl":"https://doi.org/10.1055/s-0044-1779736","url":null,"abstract":"Objectives The abducens nerve has a long, serpentine subarachnoid course with complex topographical relationships, rendering abducens nerve palsy the most common ocular motor cranial nerve palsy in adults and second most common in pediatric patients, with anatomical variants reported in the literature. Preoperative awareness of abducens nerve variant anatomy may help prevent inadvertent intraoperative injury. Design This study is a case report with a review of the abducens nerve anatomy and variants. Setting The study setting included outpatient, inpatient, and operating room in the neurosurgery department of a quaternary referral center. Participants The study included a woman in her early 30s with a diagnosis of petrous meningioma. Main Outcome Measures In vivo documentation of a type 3 abducens nerve duplication was carried out. Results A left extended retrosigmoid craniotomy was recommended for the petroclival meningioma resection. Intraoperatively, a complete duplication of the left abducens cisternal segment was encountered and photographed. The left unilateral abducens nerve duplication was confirmed with postoperative volumetric magnetic resonance imaging using the FIESTA (fast imaging employing steady-state acquisition) sequence, revealing the union of the duplicated cisternal abducens nerves into a single trunk from Dorello's canal distally. Conclusions Abducens nerve variants are uncommon, and although reported in the setting of cadaveric dissection, in vivo documentation of them is limited. This case report of an in vivo type 3 abducens nerve duplication with intraoperative photographic and radiographic images highlights the need for clinical awareness to avoid inadvertent intraoperative injury.","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"33 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017332","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