Peter A Weisskopf, Evelyn L Turcotte, Rudy J Rahme, Bernard R Bendok
{"title":"Middle Fossa Approach for Resection of a Petrous Apex Cholesterol Granuloma: 2-Dimensional Operative Video.","authors":"Peter A Weisskopf, Evelyn L Turcotte, Rudy J Rahme, Bernard R Bendok","doi":"10.1227/ons.0000000000000374","DOIUrl":"https://doi.org/10.1227/ons.0000000000000374","url":null,"abstract":"Cholesterol granulomas (CGs) are the most common cyst of the petrous apex.1 The management options for CG include observation and surgical resection. Surgery is complicated by the proximity of these lesions to critical neurological and vascular structures, as with many skull base lesions; however, if left untreated, their growth may lead to mass effect resulting in conductive hearing loss, cranial nerve dysfunction, tinnitus, and/or chronic headaches.2,3 In this video, we present the case of 52-year-old woman who presented with medically refractory right retro-orbital headaches. MRI revealed a large, right-sided petrous apex cystic structure consistent with a CG. Computed tomography of the head demonstrated bony remodeling. Given the large size of the cyst and the patient's symptoms, surgery was proposed, and the patient agreed. We performed a middle fossa craniotomy and elevated the dura from the floor of the middle fossa, working posteriorly from the petrous ridge and extending anteriorly. The cyst was exposed and decompressed, and its wall was then dissected off. After all cystic components were removed, the cavity was packed with abdominal fat, which is believed to prevent cyst reaccumulation. Postoperative MRI demonstrated good resection, and the patient reported complete resolution of her headaches. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication.","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e322-e323"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Correction of a Double Major Adolescent Idiopathic Scoliosis Using Differential Rod Contouring, Derotation, and an Ultrasonic Bone Cutting Instrument, Including Technical Nuance: 2-Dimensional Operative Video.","authors":"Brandon Wilkinson, Michael Galgano","doi":"10.1227/ons.0000000000000394","DOIUrl":"https://doi.org/10.1227/ons.0000000000000394","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e329-e330"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40361528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan M J Bauman, Jeffrey R Janus, Jamie J Van Gompel
{"title":"Open and Endoscopic Endonasal Biopsies for Langerhans Cell Histiocytosis of the Hypothalamus: 2-Dimensional Operative Video.","authors":"Megan M J Bauman, Jeffrey R Janus, Jamie J Van Gompel","doi":"10.1227/ons.0000000000000386","DOIUrl":"https://doi.org/10.1227/ons.0000000000000386","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e328"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammet Enes Gurses, Abuzer Gungor, Elif Gökalp, Sahin Hanalioglu, Seda Yagmur Karatas Okumus, Ilkan Tatar, Mustafa Berker, Aaron A Cohen-Gadol, Uğur Türe
{"title":"Three-Dimensional Modeling and Augmented and Virtual Reality Simulations of the White Matter Anatomy of the Cerebrum.","authors":"Muhammet Enes Gurses, Abuzer Gungor, Elif Gökalp, Sahin Hanalioglu, Seda Yagmur Karatas Okumus, Ilkan Tatar, Mustafa Berker, Aaron A Cohen-Gadol, Uğur Türe","doi":"10.1227/ons.0000000000000361","DOIUrl":"https://doi.org/10.1227/ons.0000000000000361","url":null,"abstract":"<p><strong>Background: </strong>An understanding of the anatomy of white matter tracts and their 3-dimensional (3D) relationship with each other is important for neurosurgical practice. The fiber dissection technique contributes to this understanding because it involves removing the brain's white matter tracts to reveal their anatomic organization. Using this technique, we built freely accessible 3D models and augmented and virtual reality simulations of white matter tracts.</p><p><strong>Objective: </strong>To define the white matter tracts of cadaveric human brains through fiber dissection and to make 2-dimensional and 3D images of the white matter tracts and create 3D models and augmented and virtual reality simulations.</p><p><strong>Methods: </strong>Twenty cadaveric brain specimens were prepared in accordance with the Klingler method. Brain hemispheres were dissected step-by-step from lateral-to-medial and medial-to-lateral directions. Three-dimensional models and augmented reality and virtual reality simulations were built with photogrammetry.</p><p><strong>Results: </strong>High-resolution 3D models and augmented reality and virtual reality simulations of the white matter anatomy of the cerebrum were obtained. These models can be freely shifted and rotated on different planes, projected on any real surface, visualized from both front and back, and viewed from various angles at various magnifications.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first detailed study integrating various technologies (3D modeling, augmented reality, and virtual reality) for high-resolution 3D visualization of dissected white matter fibers of the entire human cerebrum.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"355-366"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Venu M Nemani, Jesse Shen, Rajiv K Sethi, Jean-Christophe Leveque
{"title":"Use of Cannulated Reamers to Facilitate Thoracic Diskectomy Using a Minimally Invasive Retropleural Thoracotomy Approach-Surgical Technique.","authors":"Venu M Nemani, Jesse Shen, Rajiv K Sethi, Jean-Christophe Leveque","doi":"10.1227/ons.0000000000000381","DOIUrl":"https://doi.org/10.1227/ons.0000000000000381","url":null,"abstract":"<p><strong>Background: </strong>The surgical treatment of symptomatic thoracic disk herniations is technically challenging. In the past decade, a minimally invasive retropleural thoracotomy approach has become more popular to treat this pathology. However, efficient bone removal to safely perform the diskectomy and spinal cord decompression is difficult with this technique because of the small incision size and long working distance in the thoracic cavity and the proximity of the compressed thoracic cord.</p><p><strong>Objective: </strong>To describe a novel surgical technique for performing a thoracic diskectomy using a minimally invasive lateral approach using cannulated reamers to facilitate bone removal.</p><p><strong>Methods: </strong>This technique was used in 7 consecutive patients who presented with thoracic myelopathy from a thoracic disk herniation. First, a standard lateral minimally invasive retropleural approach to the thoracic spine was performed. Partially threaded guide wires were placed in the posterior aspect of the vertebral bodies adjacent to the affected disk space, and sequential cannulated reamers were passed over the guidewires to perform partial corpectomies. The posterior annulus, posterior longitudinal ligament, and herniated disk material were then resected using Penfield dissectors and Kerrison rongeurs to complete the decompression.</p><p><strong>Results: </strong>All 7 patients who underwent thoracic diskectomy using this approach had stable or improved neurologic function postoperatively. There were no complications related to the use of the cannulated reamer technique.</p><p><strong>Conclusion: </strong>The use of cannulated reamers provides a simple and efficient method for safe bone removal to facilitate minimally invasive thoracic diskectomy using a lateral approach. This is an easily reproducible technique using commonly available equipment.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e313-e319"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33504824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}