{"title":"In Reply: Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.","authors":"Rashad Jabarkheel, John Y K Lee","doi":"10.1227/ons.0000000000001618","DOIUrl":"https://doi.org/10.1227/ons.0000000000001618","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991871","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}
{"title":"Letter: Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.","authors":"Shusaku Noro, Bunsho Asayama, Hirohiko Nakamura","doi":"10.1227/ons.0000000000001617","DOIUrl":"https://doi.org/10.1227/ons.0000000000001617","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052159","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}
Yang Li, Boyang Cao, Hailiang Shi, Hanxuan Wang, Haowei Shi, Jianzhong Cui, Tao Qian
{"title":"A Comparative Study of Traditional and Synchronous Video Lateral Spread Response Monitoring in Predicting Long-Term Hemifacial Spasm Relief After Microvascular Decompression Surgery.","authors":"Yang Li, Boyang Cao, Hailiang Shi, Hanxuan Wang, Haowei Shi, Jianzhong Cui, Tao Qian","doi":"10.1227/ons.0000000000001576","DOIUrl":"https://doi.org/10.1227/ons.0000000000001576","url":null,"abstract":"<p><strong>Background and objectives: </strong>The study aims to investigate the significance of using synchronous video monitoring for lateral spread response (LSR) during microvascular decompression (MVD) surgery for hemifacial spasm.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from 75 patients with primary hemifacial spasm who underwent MVD treatment at our hospital between September 2018 and June 2019. Traditional intraoperative LSR monitoring and synchronous video LSR monitoring were compared to predict postoperative spasm relief outcomes at 1 week, 1 month, 6 months, 1 year, and 5 years, alongside actual clinical observations. Traditional LSR monitoring showed moderate agreement with actual clinical observations at 1 week postoperatively (K1w = 0.433;, fair agreement at 1 month, 6 months, and 1 year (K1m = 0.386, K6m = 0.295, K1y = 0.225); and poor agreement at 3 years and 5 years (K3y = 0.182, K5y = 0.138).</p><p><strong>Results: </strong>In comparison, synchronous video LSR monitoring demonstrated moderate agreement at 1 week, 1 month, 6 months, and 1 year (K1w = 0.533, K1m = 0.535, K6m = 0.574, K1y = 0.182) and fair agreement at 3 years and 5 years (K3y = 0.321, K5y = 0.217). Patients with intraoperative LSR changes experienced earlier symptom relief within 6 months compared with those without LSR changes. The overall relief rates at 1 year, 3 years, and 5 years were 93.33%, 94.67%, and 96.00%, respectively. The delayed resolution rates were 70.59%, 76.47%, and 82.35% at 1 year, 3 years, and 5 years, respectively.</p><p><strong>Conclusion: </strong>The application of synchronous video LSR monitoring facilitates the assessment of patients' clinical prognosis within 6 months postoperatively, thereby guiding surgical interventions. In predicting the consistency of post-MVD spasm relief, synchronous video LSR monitoring outperforms traditional LSR monitoring methods.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053515","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}
Operative NeurosurgeryPub Date : 2025-05-01Epub Date: 2024-08-29DOI: 10.1227/ons.0000000000001346
Ivo Peto, Elliot Pressman, Keaton Piper, Gabriel Flores-Milan, Casey Ryan, Kunal Vakharia, Harry van Loveren, Siviero Agazzi
{"title":"Application of Topographical Anatomy of the Trochlear Nerve in Transtentorial Approaches: An Anatomic Study.","authors":"Ivo Peto, Elliot Pressman, Keaton Piper, Gabriel Flores-Milan, Casey Ryan, Kunal Vakharia, Harry van Loveren, Siviero Agazzi","doi":"10.1227/ons.0000000000001346","DOIUrl":"10.1227/ons.0000000000001346","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transection of the free edge of tentorium (FET) might be necessary when approaching cavernous sinus lesions, clip placement in certain posterior communicating artery aneurysms, or during transpetrosal and retrosigmoid transtentorial approaches. No anatomic study has investigated the relationship of the trochlear and oculomotor nerve and FET in an attempt to identify a safe zone for such maneuver.</p><p><strong>Methods: </strong>Ten embalmed specimens (20 sides) were studied and the following morphometric measurements were taken using digital microcalipers: trochlear (TP) to oculomotor porus (OP), length of the intratentorial segment of cranial nerve (CN) IV, nerve free FET, and distance along the oculomotor (CN III) from its OP to CN III/trochlear (CN IV) crossing and angle between the long-axis petrous ridge and TP (petrotrochlear angle).</p><p><strong>Results: </strong>The CN IV pierced the deep layer of the FET in all cases at a mean distance 8.11 mm (4.43-11.33) posterior to the OP, measured along the FET. CN IV continued within the tentorial edge for a mean of 6.17 mm (3.18-11.33) before entering the cavernous sinus at a mean distance of 1.9 mm (0-5.46 mm) from the posterior-most aspect of the OP. A nerve-free portion of FET was 1.93 mm (mean) (0-5.46). No nerve-free FET segment (<1 mm) was observed in 4 sides (20%), and a nerve-free FET segment <2.00 mm was seen in 55% of cases. The mean distance from OP to the CN III/IV crossing was 10.17 mm (1.00-15.57). The mean petrotrochlear angle was 164.49° (140.01-183.85), and >175° in 4 specimens (20%).</p><p><strong>Conclusion: </strong>Our data confirm presence of the intratentorial segment of CN IV. Transection of the FET carries the lowest risk of CN IV injury if performed < 2 mm or >10 mm posterior to the OP, or posterior to intersection of the FET and a virtual extension of a petrous ridge.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"705-711"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114762","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}
Operative NeurosurgeryPub Date : 2025-05-01Epub Date: 2024-08-20DOI: 10.1227/ons.0000000000001328
Hugo Leonardo Dória-Netto, Érico Samuel Gomes Galvão da Trindade, Mariano Teyssandier, Erica Antunes Effgen, Alexander Feliciano Vilcahuamán Paitán, Sebastián Juan Mária Giovannini, Alejandro Benjamin Romero Leguina, Bruno Loof de Amorim, Dmitriy Korotkov, Feres Chaddad-Neto
{"title":"Use of the Inferior Frontal Sulcus for Microsurgical Resection of an Arteriovenous Malformation of the Caudate Nucleus: 2-Dimensional Operative Video.","authors":"Hugo Leonardo Dória-Netto, Érico Samuel Gomes Galvão da Trindade, Mariano Teyssandier, Erica Antunes Effgen, Alexander Feliciano Vilcahuamán Paitán, Sebastián Juan Mária Giovannini, Alejandro Benjamin Romero Leguina, Bruno Loof de Amorim, Dmitriy Korotkov, Feres Chaddad-Neto","doi":"10.1227/ons.0000000000001328","DOIUrl":"10.1227/ons.0000000000001328","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"721-722"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005835","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}
Operative NeurosurgeryPub Date : 2025-05-01Epub Date: 2025-03-07DOI: 10.1227/ons.0000000000001541
Varun Kashyap, Mark Ashby, Scott Stanslaski, Kevin Nguyen, Kristin Hageman, Alexander A Khalessi
{"title":"In Reply: Feasibility of Endovascular Deep Brain Stimulation of Anterior Nucleus of the Thalamus for Refractory Epilepsy.","authors":"Varun Kashyap, Mark Ashby, Scott Stanslaski, Kevin Nguyen, Kristin Hageman, Alexander A Khalessi","doi":"10.1227/ons.0000000000001541","DOIUrl":"10.1227/ons.0000000000001541","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"745"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574682","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}
Operative NeurosurgeryPub Date : 2025-05-01Epub Date: 2024-08-26DOI: 10.1227/ons.0000000000001334
I-Sorn Phoominaonin, Andres Felipe Vargas Rosales, Garret W Choby, Eric W Wang, Georgios A Zenonos, Carl H Snyderman, Paul A Gardner
{"title":"Carotid Plexus Sympathetic Nerves as a Landmark for the Abducens Nerve Within the Cavernous Sinus During Endoscopic Endonasal Surgery: Cadaveric Anatomic Study and Surgical Consideration.","authors":"I-Sorn Phoominaonin, Andres Felipe Vargas Rosales, Garret W Choby, Eric W Wang, Georgios A Zenonos, Carl H Snyderman, Paul A Gardner","doi":"10.1227/ons.0000000000001334","DOIUrl":"10.1227/ons.0000000000001334","url":null,"abstract":"<p><strong>Background and objectives: </strong>The abducens nerve (CN VI) is vulnerable to injury during endoscopic endonasal transcavernous surgery. In this study, the authors aimed to develop the surgical anatomic landmark and explore the relationship between the sympathetic nerves (SNs) around the internal carotid artery (ICA) and CN VI within the cavernous sinus (CS).</p><p><strong>Methods: </strong>The relationship and patterns between the SNs and CN VI were investigated in 15 cadaveric specimens. The intraoperative examples of anatomic landmark were presented.</p><p><strong>Results: </strong>There were SNs around the ICA running into the CN VI, classified into ascending SNs and accessory sympathetic branches. The ascending SNs were divided into 3 types: (1) Type I had a single ascending SN. There were 2 subtypes of Type I (Type IA [17/30, 56.7%] was defined as a single ascending branch that ran into the CN VI, and Type IB [4/30, 13.3%] was defined as a single ascending branch with a terminal bifurcation before merging into the CN VI or lateral CS wall), (2) Type II (7/30, 23.3%) was defined as 2 ascending branches that ran into the CN VI and the lateral CS wall, and (3) Type III (2/30, 6.7%) was defined as 3 ascending branches that ran into the CN VIs and the lateral wall of the CS. The accessory branches of the SNs were defined by sympathetic branches from the posterior genu or horizontal ICA and found in 6/30 sides (20%).</p><p><strong>Conclusion: </strong>The authors propose a classification of the relationship between paraclival ICA SNs and the CN VI within the CS, as approached during endoscopic endonasal surgery. The consistent relationship of the ascending SN and CN VI within the CS provides a reliable anatomic landmark during the endonasal approach to the CS.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"697-704"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057232","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}
Operative NeurosurgeryPub Date : 2025-05-01Epub Date: 2024-09-20DOI: 10.1227/ons.0000000000001368
Eva M Wu, Meredith C Costello, Ahmed Abdelsalam, Robert M Starke, Jacques J Morcos
{"title":"Left Cranioorbital Approach for Trapping of Fusiform Internal Carotid Artery Aneurysm With Common Carotid Artery to Frontal M2 Bypass With Saphenous Vein Interposition Graft and Coiling of Fusiform Anterior Cerebral Artery Aneurysm: A 2-Dimensional Operative Video.","authors":"Eva M Wu, Meredith C Costello, Ahmed Abdelsalam, Robert M Starke, Jacques J Morcos","doi":"10.1227/ons.0000000000001368","DOIUrl":"10.1227/ons.0000000000001368","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"734"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985620","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}