PubMed Central (PMC3 - NLM DTD)
(2,081,148 recursos)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
Mostrando recursos 241 - 260 de 551
241.
Virtual Reality Augmentation in Skull Base Surgery - Rosahl, Steffen K.; Gharabaghi, Alireza; Hubbe, Ulrich; Shahidi, Ramin; Samii, Madjid
Objective: Skull base anatomy is complex and subject to individual variation. Understanding the complexity of surgical anatomy is faster and easier with virtual models created from primary imaging data of the patient. This study was designed to investigate the usefulness of virtual reality in image guidance for skull base procedures. Design: Primary volumetric image data from 110 patients was acquired using magnetic resonance, computed tomography (CT), and CT angiography. Pathologies included lesions in the anterior, middle, and posterior skull base. The data were transferred to an infrared-based image-guidance system for creation of a virtual operating field (VOF) with translucent surface...
242.
Optic Nerve Decompression for Orbitofrontal Fibrous Dysplasia: Recent Development of Surgical Technique and Equipment - Abe, Takumi; Satoh, Kaneshige; Wada, Akira
Objectives: Orbitofrontal fibrous dysplasia often involves the bony orbit and optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual disturbances, optic nerve decompression in patients without clinical signs of optic neuropathy remains controversial. We describe the recent development of surgical techniques and equipment for optic nerve decompression in orbitofrontal fibrous dysplasia. Methods: Optic nerve decompression was performed prophylactically for five patients and therapeutically for one patient using the transcranial extradural route. A high-speed drill and continuous suction-irrigation system has been used in five patients since 1998, and an ultrasonic bone curette in two patients...
243.
Transmastoid Partial Labyrinthectomy for Brainstem Vascular Lesions: Clinical Outcomes and Assessment of Postoperative Cochleovestibular Function - Taplin, Michael A.; Anthony, Richard; Tymianski, Michael; Wallace, Michael C.; Rutka, John A.
Objectives: To discuss the transmastoid partial labyrinthectomy approach for brainstem vascular lesions, with respect to hearing and balance preservation. Design: Retrospective case series. Setting: Tertiary referral center (University Health Network, Toronto). Participants: Nine consecutive surgical patients between 1999 and 2004. Main outcome measures: Clinical, audiometric, and electrophysiological vestibular data. Results: Nine transmastoid partial labyrinthectomy procedures (all females) were performed. In seven patients the underlying pathology was an intra-axial brainstem cavernous malformation. Two patients were treated for a basilar artery aneurysm. All patients had progressive neurological signs. Serviceable hearing (pure tone average (PTA): ?50%) was...
244.
Esthesioneuroblastoma (Olfactory Neuroblastoma) with Hemorrhage: An Unusual Presentation - Sampath, Prakash; Park, Michael C.; Huang, Dara; Deville, Curtiland; Cortez, Selina; Chougule, Prakash
Esthesioneuroblastoma (olfactory neuroblastoma) is an uncommon neuroectodermal tumor. Its biological activity ranges from indolent growth to local recurrence and rapid widespread metastasis. Treatment options consist of surgical resection followed by radiation therapy for primary lesions and the addition of chemotherapy for advanced, recurrent, or metastatic lesions. Patients often present with nasal obstruction, rhinorrhea, recurrent epistaxis, hyposmia, or anosmia. However, we report the highly unusual case of a patient with an esthesioneuroblastoma who presented with atypical symptoms of headaches, sinus congestion, and fatigue before acutely losing consciousness. Imaging showed a large frontal skull-based tumor associated with intratumoral hemorrhage. The findings prompted...
245.
Hydroxyurea Treatment of Meningiomas: A Pilot Study - Weston, Gabriel J.; Martin, Andrew J.; Mufti, Ghulam J.; Strong, Anthony J.; Gleeson, Michael J.
Objectives: To present a pilot study of hydroxyurea chemotherapy in the management of surgically difficult meningiomas. Design: Prospective case series. Setting: Tertiary referral center. Participants: Six patients were enrolled: five had symptomatic recurrent or residual WHO Grade I meningiomas and one had an unoperated anterior clinoidal meningioma. Main outcome measures: MRI volumetry before and after treatment, hematological state, progression to surgery. Results: Hydroxyurea was administered for 1 year, starting at a dose of 15 mg/kg/day. No tumors reduced in size on treatment and one continued to grow rapidly. Three remained stable. Full volumetry was unavailable on two patients. One patient...
246.
Intracisternal Schwannoma of the Spinal Accessory Nerve: A Case Report - Jung, Tae-Young; Jung, Shin; Kim, In-Young; Kang, Sam-Suk
We report the details of a patient with an intracisternal schwannoma that developed from the spinal accessory nerve. The patient, a 70-year-old women, presented with a 5-year history of intermittent headache and neck pain. A 3.2?×?2.5 cm partially cystic mass was found in the right cervicomedullary cistern. It was removed through a far-lateral inferior suboccipital craniotomy using image-guidance. The tumor arose from one rootlet of the right accessory nerve and histological examination confirmed the diagnosis of a schwannoma. Removal of the schwannoma did not result in a significant neurological deficit.
247.
Extradural Middle Fossa Approach. Proposal of a Learning Method: The Rule of Two Fans. Technical Note - Mastronardi, Luciano; Sameshima, Tetsuro; Ducati, Alessandro; De Waele, Luc F.; Ferrante, Luigi; Fukushima, Takanori
The extradural middle fossa approach is used to access lesions of the petroclival and cavernous sinus regions. It may be included in combined petrosal and anterolateral transcavernous approaches. Technically, it is a demanding exposure that provides a wide extradural corridor between the 5th, 7th, and 8th cranial nerves. Its major advantages are that it offers extradural dissection, limits temporal lobe retraction, and avoids the transposition of nerves or vessels. Its disadvantages are primarily related to the complicated anatomy of the petrous apex from the middle fossa trajectory, which can be unfamiliar to neurosurgeons. To facilitate the first attempts with this...
248.
Vagal Paraganglioma - Zanoletti, Elisabetta; Mazzoni, Antonio
Objectives: To report the outcomes of surgical treatment of vagal paragangliomas and to define a management protocol. Design: A retrospective case series. Patients and methods: Sixteen consecutive patients with vagal paragangliomas managed by surgical resection using a cervicoparotid approach and pericapsular dissection using microsurgical techniques between 1990 and 2003. Results: All patients either had or developed a vagal palsy. Additional cranial nerve deficits were sustained in 8 patients. No patients died as a result of surgery or from their disease. Conclusions: The technique used and described in this article allowed adequate exposure of the retrostyloid parapharyngeal space for the safe...
249.
The Voice-Controlled Robotic Assist Scope Holder AESOP for the Endoscopic Approach to the Sella - Nathan, Cherie-Ann O.; Chakradeo, Vinaya; Malhotra, Kavita; D'Agostino, Horacio; Patwardhan, Ravish
Objective: To evaluate the feasibility of using a voice-controlled robot Automated Endoscopic System for Optimal Positioning (AESOP) for holding and maneuvering the endoscope in the trans-sphenoidal approach to the pituitary. Design: To compare the manual approach to the voice-activated robotic scope holder in maneuvering the endoscope and resecting pituitary lesions using a two-handed technique. Setting: Robotic laboratory at Louisiana State University Health Sciences Center, Shreveport. Cadavers: Ten fresh cadaver heads. Main Outcome Measures: To determine the feasibility, advantages, and disadvantages of a single neurosurgeon maneuvering the endoscope, visualizing key anatomical features in the sphenoid, and resecting skull base lesions after...
253.
Metastatic Alveolar Soft-Part Sarcoma of the Intracranial Skull Base: Case Report - Cohen, David B.; Jones, David M.; Fergus, Allan H.; Qian, Jiang; Schwartz, Marc S.
A patient with an intracranial skull base alveolar soft-part sarcoma, thought on preoperative imaging to be a meningioma, is presented. The mass was removed and identified by pathological evaluation to be an alveolar soft-part sarcoma. Postoperative investigation revealed widespread systemic disease. The histologic and clinical characteristics of this unusual tumor and the implications for prognosis and treatment are discussed.
255.
Resection of Giant Olfactory Groove Meningioma with Extradural Devascularization - Wei, Chih-Peng; Wang, Alexander D.; Tsai, Ming-Dar
A 55-year-old male patient presented with a giant olfactory groove meningioma supplied by both ophthalmic arteries. The tumor was debulked through a bifrontal craniotomy, but the surgery was discontinued because of extensive blood loss. During a second operation, the dura of the frontal base was dissected extradurally before the tumor was removed. The meningeal blood supply was occluded with bipolar coagulation of the epidural meningeal vessels around the crista galli. The highly vascular tumor then was totally removed with considerably less blood loss. The patient's postoperative course was uneventful. Because the ophthalmic artery cannot be embolized preoperatively, the direct extradural...
256.
Recurrent Giant Cell Reparative Granuloma of the Skull Base and the Paranasal Sinuses Presenting with Acute One-Sided Blindness - Plontke, Stefan K.-R.; Adler, Claus-Peter; Gawlowski, Jan; Ernemann, Ulrike; Friese, Sigrid A.; Plinkert, Peter K.
The etiology, pathogenesis, histopathologic diagnosis, prognosis, and treatment of giant cell reparative granulomas of the skull are controversial. We report a 14-year-old girl with an advanced recurrent giant cell reparative granuloma of the skull base and paranasal sinuses whose only clinical manifestation was a loss of vision. After undergoing endovascular catheter embolization, the patient underwent repeated surgical resections of the mass via a combined frontobasal and modified infratemporal approach followed by radiation therapy. Histopathologic examination confirmed the diagnosis of giant cell reparative granuloma. A traumatic event in the patient's historya fossa canina abscess followed by tooth extraction 14 months before...
257.
Meningiomas of the Internal Auditory Canal: Two Case Reports - Magliulo, Giuseppe; Zardo, Francesco; Bertin, Serena; D'Amico, Raffaello; Savastano, Vincenzo
Meningiomas represent 3 to 12% of the tumors that involve the cerebellopontine angle and internal auditory canal (IAC). Intracanalicular meningiomas, however, are rare. Only 10 well-documented cases have been reported in the English literature. The differential diagnosis includes acoustic neuromas, facial nerve neuromas, hemangiomas, lipomas, and meningiomas. We report two new cases of intracanalicular meningioma. Both patients had unilateral tinnitus. In case 1, the patient also experienced sensorineural hearing loss with unilateral tinnitus. In case 1, the lesion appeared hyperintense on T1-weighted and hypointense on T2-weighted magnetic resonance images. In case 2, the patient had an enhancing lesion in the...
258.
Lateral Orbital Rim Osteotomy in the Treatment of Certain Skull Base Lesions - Pritz, Michael B.
Quantitative data from a recent human cadaveric study suggested that removal of the lateral orbital rim alone may be sufficient to reach many targets for which the orbitozygomatic craniotomy has been used. Consequently, a lateral orbital rim osteotomy was substituted for an orbitozygomatic craniotomy in seven patients with a variety of pathologies located in the anterior, middle, and interpeduncular fossae. In each case, lateral orbitotomy provided a satisfactory surgical corridor for diagnosis and treatment. Compared with the orbitozygomatic craniotomy, the lateral orbital rim osteotomy offers several advantages: technical simplicity, shorter operating time, and a low risk of postoperative malocclusion. If,...
241.
