Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2014
Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma.
Endoscopic endonasal (EE) transsphenoidal surgery is an important surgical approach to the treatment of sellar pathology, particularly for pituitary adenomas. Risk factors for the radiographic recurrence of pituitary adenomas resected using a purely endoscopic approach have not been established. This study investigates outcomes and identifies risk factors for recurrence following EE transsphenoidal surgery for pituitary adenoma. ⋯ Only 20% of patients with residual tumor developed recurrent disease over a median follow up of 23.1 months. This recurrence rate may be an important consideration in cases where gross total resection is not feasible. Preferentially operating from the right does not seem to influence the location of residual tumor.
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Clin Neurol Neurosurg · Apr 2014
Marking wire placement for improved accuracy in thoracic spinal surgery.
To present an innovative approach that does not rely on intraoperative X-ray imaging for identifying thoracic target levels and critically appraise its value in reducing the risk of wrong-level surgery and radiation exposure. ⋯ This is a safe and practical approach to identify the level of interest in thoracic spinal surgery employing a marking wire. Its application merits consideration in any spinal case where X-ray localization could prove unsafe, particularly in cases lacking bony pathologies such as intradural tumors.
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Clin Neurol Neurosurg · Apr 2014
Endoscope-assisted retrosigmoid resection of a medium size vestibular schwannoma tumor model: a cadaveric study.
To demonstrate a flexible endoscope assisted technique to perform microsurgical resection using a retrosigmoid approach of an artificial polymer tumor model that mimics a medium size (15-20mm diameter) vestibular schwannoma. ⋯ The endoscopic-assisted microsurgical removal of a tumor model simulating a medium size vestibular schwannoma was feasible in our tumor model study emulating real surgery. Visualization of the acousticofacial bundle at the early stage of the surgical removal should theoretically decrease the risk of its inadvertent injuries as well as facilitate complete removal of the tumor. Clinical studies to validate this laboratory study are necessary.
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Clin Neurol Neurosurg · Mar 2014
Complications and outcomes of surgery for spinal meningioma: a Nationwide Inpatient Sample analysis from 2003 to 2010.
The aim of the present study was to analyze the practice patterns, complications and outcome following surgery for spinal meningioma in the United States. ⋯ Caucasian patients with private insurance without co-morbidity had significantly lower complication rate and good outcome. Occurrence of spinal meningioma in the pediatric and adult age groups does not carry worse prognosis.