Journal of neurosurgery
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Journal of neurosurgery · Dec 2001
Chordomas of the craniocervical junction: follow-up review and prognostic factors.
Chordomas are rare tumors that arise from the remnants of the notochord. Because of their deep location, local infiltrative nature, and involvement of surrounding bone, treatment of chordomas is a challenge. In this study the authors analyze the data and prognostic factors obtained during the follow-up period (range 1-150 months, median 38 months) in 53 patients with craniocervical junction chordomas and 10 patients with chondrosarcomas. ⋯ A better prognosis was observed in patients with chondrosarcoma compared with those harboring chordoma. Histological pattern and patient age at symptom onset were not factors that influenced prognosis in cases of chordoma. Extensive resection and possibly adjuvant proton-beam therapy provided better prognoses for these patients.
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Journal of neurosurgery · Dec 2001
Historical ArticleThe history and evolution of transsphenoidal surgery.
Initial attempts at transcranial approaches to the pituitary gland in the late 1800s and early 1900s resulted in a mortality rate that was generally considered prohibitive. Schloffer suggested the use of a transsphenoidal route as a safer, alternative approach to the sella turcica. He reported the first successful removal of a pituitary tumor via the transsphenoidal approach in 1906. ⋯ Jules Hardy, who used intraoperative fluoroscopy while learning the transsphenoidal approach from Guiot, then introduced the operating microscope to further refine the procedure; he thereby significantly improved its efficacy and decreased surgical morbidity. With the development of antibiotic drugs and modern microinstrumentation, the transsphenoidal approach became the preferred route for the removal of lesions that were confined to the sella turcica. The evolution of the transsphenoidal approaches and their current applications and modifications are discussed.
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Journal of neurosurgery · Dec 2001
Biography Historical ArticlePioneers in the development of transsphenoidal surgery: Theodor Kocher, Oskar Hirsch, and Norman Dott.
The development of new scientific concepts and techniques is usually the result of a progressive evolution. The transsphenoidal approach to pituitary lesions is no exception. ⋯ In this historical vignette, the contributions of three master surgeons. Theodor Kocher, Oskar Hirsch, and Norman Dott, are reviewed.
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Journal of neurosurgery · Dec 2001
Anaglyphic three-dimensional stereoscopic printing: revival of an old method for anatomical and surgical teaching and reporting.
The authors describe how to use the three-dimensional (3D) anaglyphic method to produce stereoscopic prints for anatomical and surgical teaching and reports preparation by using currently available nonprofessional photographic and computer methods. As with any other method of producing stereoscopic images, the anaglyphic procedure is based on the superimposition of two slightly different images of the object to be reproduced, one seen more from a left-sided point of view and the other seen more from a right-sided point of view. ⋯ To be seen stereoscopically, glasses with colored lenses, normally one red and one blue, have to be used. Stereoscopic 3D anaglyphic prints can be produced using standard photographic and PC equipment; after some training, the prints can be easily reproduced without significant cost and are particularly helpful to disclose the 3D character of anatomical structures.