Operative Neurosurgery最新文献

{"title":"Synovial Cyst Resection Using Biportal Endoscopic Technique: 2-Dimensional Operative Video.","authors":"Ryan W Turlip, Yohannes Ghenbot, Daksh Chauhan, Richard J Chung, Stephen Miranda, Mert Marcel Dagli, Hasan S Ahmad, Jang W Yoon","doi":"10.1227/ons.0000000000001620","DOIUrl":"https://doi.org/10.1227/ons.0000000000001620","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053625","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":"Comparative Cadaveric Study and Anatomic Limitations of the Nasofrontal Trephination: A Novel Endoscopic Corridor for Enhanced Exposure of The Odontoid and Occipital Condyle Regions.","authors":"Mohammad Bilal Alsavaf, Moataz D Abouammo, Jaskaran Singh Gosal, Maithrea S Narayanan, Govind S Bhuskute, Chandrima Biswas, Guilherme Mansur, Kyle K VanKoevering, Kathleen Kelly, Kyle C Wu, Ricardo L Carrau, Daniel M Prevedello","doi":"10.1227/ons.0000000000001590","DOIUrl":"https://doi.org/10.1227/ons.0000000000001590","url":null,"abstract":"<p><strong>Background and objectives: </strong>The endoscopic endonasal approach (EEA) serves as the primary minimally invasive route to the ventral craniovertebral junction (CVJ). However, anatomic constraints limit its caudal reach. Multiport endoscopic approaches may complement a standard EEA providing additional reach. This anatomic study evaluates the EEA's anatomic limitations in accessing the CVJ and examines how contralateral nasofrontal trephination (CNT) port may overcome these constraints.</p><p><strong>Methods: </strong>Thirty-two cadaveric specimens underwent EEA and CNT dissections. Key measurements included the nasoaxial line (NAxL) angle, anteroposterior frontal sinus distance, interorbital distance, and distance of odontoid process from the hard palate line. Area of exposure and surgical freedom were quantified using a surgical navigation. A clinical case treated using the CNT approach has been included to demonstrate the technique, instrument utilization, successful healing, and absence of complications.</p><p><strong>Results: </strong>CNT significantly enhanced area of exposure of both odontoid (1720.41 vs 1086.62 mm2, P = <.001) and occipital condyle targets (613.32 vs 446.15 mm2, P = <.001), while EEA provided significant greater surgical freedom for both odontoid (1121.91 vs 1030.58 mm3, P = <.001) and occipital condyle (888.25 vs 827.74 mm3, P = <.001). Frontal sinus anteroposterior distance strongly correlated with CNT odontoid exposure (r = 0.889, P < .001) but not with the occipital condyle (r = -0.009, P = .966). CNT offered a wider angle of attack compared with EEA (49.8° vs 16.5°, P = <.001). NAxL angle inversely correlated with the distance of the odontoid process from the hard palate line level (r = -0.757, P < .001), while showing no significant correlation with EEA exposure area.</p><p><strong>Conclusion: </strong>CNT augments traditional EEA by enhancing inferior access during the management of complex CVJ pathologies. Although NAxL angle may provide guidance in determining the inferior extent of the EEA, anatomic variability and its poor correlation with exposure area limit its standalone utility in surgical planning.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057693","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":"Cranial Reconstruction for Infiltrative Meningioma Using 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography and Individual Patient Solutions CaseDesigner®: A Case Series.","authors":"Connor C Jacob, Ludovica Pasquini, Kerry-Ann S Mitchell, Lucas P Carlstrom, Daniel M Prevedello","doi":"10.1227/ons.0000000000001596","DOIUrl":"https://doi.org/10.1227/ons.0000000000001596","url":null,"abstract":"<p><strong>Background and objectives: </strong>Meningioma with bone involvement presents challenges for complete resection and cranial reconstruction. 68Ga-dodecanetetreaacetic acid tyrosine-3-octreotide (DOTATATE) positron emission tomography (PET)/computed tomography (CT) has emerged as an excellent modality for localizing invasive meningiomas because of molecular interaction with somatostatin receptor-2. We present a novel technique to design 3-dimensional-printed artificial cranioplasty, using combined fine-slice CT, MRI, and 68Ga-DOTATATE PET/CT with Individual Patient Solutions (IPS) CaseDesigner® software. This study's objective was to generate proof-of-concept work for a novel artificial cranioplasty protocol that combines customized cranial implant software and DOTATATE PET/CT.</p><p><strong>Methods: </strong>Three patients with invasive bone meningiomas were retrospectively identified. For each patient, the proposed protocol combines CT, MRI, and 68Ga-DOTATATE PET/CT imaging to generate a 3-dimensional cranial reconstruction within the Karl Leibinger Surgical (KLS) Martin-IPS CaseDesigner® software. Subsequently, the virtual rendering is used to manufacture a customized polyetheretherketone (PEEK) implant, along with a guiding component, which ensures precise delineation of surgical borders before craniectomy. Finally, cranioplasty with the customized implant is performed using standard techniques.</p><p><strong>Results: </strong>The described preoperative cranioplasty design protocol was performed for each patient. Tumor invasion was visualized using 68Ga-DOTATATE PET/CT. Patient 1 presented with a recurrent right frontal meningioma with invasion into anterior skull base. In this case, IPS CaseDesigner® was used to create a mirror image PEEK implant for the left orbit and affected cranium. Patients 2 and 3 had intraosseous meningiomas invading the frontal bone; customized PEEK implants were tailored to the side of the planned craniectomy for both patients and were successfully placed without complication. Postoperatively, all patients remained neurologically intact and were discharged without complications. In all patients, the PEEK implants exhibited appropriate cranial continuity and integrity.</p><p><strong>Conclusion: </strong>68Ga-DOTATATE PET/CT has high sensitivity and specificity for detecting meningiomas during preoperative planning, particularly when the tumor involves bone. IPS CaseDesigner® demonstrates excellent utility for planning and constructing customized cranioplasties tailored to each patient for skull reconstruction.</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":"144049050","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":"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":"10.1227/ons.0000000000001618","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"162"},"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":"10.1227/ons.0000000000001617","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"160-161"},"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}

{"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}

{"title":"Retrograde Suction Decompression for Clipping of Kissing Intracranial Aneurysms: 2-Dimensional Operative Video.","authors":"Juan Kevan Sham, Fozia Saeed, Yosuke Suzuki, Kosumo Noda, Rokuya Tanikawa","doi":"10.1227/ons.0000000000001338","DOIUrl":"10.1227/ons.0000000000001338","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"731-732"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156610","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":"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}

{"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}

{"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}