World Neurosurg
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Case Reports
Percutaneous balloon rhizotomy for trigeminal neuralgia using three-dimensional fluoroscopy.
Percutaneous balloon rhizotomy is one of the standard techniques for the treatment of trigeminal neuralgia. However, there have been well-reported complications from cannulating the foramen ovale (FO). We describe a novel technique for cannulating the FO using 3-dimensional (3D) rotational fluoroscopy. ⋯ Three-dimensional rotational fluoroscopy allows real-time visual guidance to cannulate the FO and determine the optimal position of the inflated balloon. We believe that this is an important adjunct for treating trigeminal neuralgia via percutaneous techniques.
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To evaluate risk factors for the development of dysphagia after anterior cervical surgery. ⋯ In our patients, the incidence of dysphagia was low, and it had completely resolved at 12 months in all cases. Risk factors for dysphagia were multilevel procedures, involvement of C4-5 and C5-6, and age.
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Review Historical Article
"Through the looking glass": optical physics, issues, and the evolution of neuroendoscopy.
Although the concept of endoscopy has existed for centuries, a practical, working neuroendoscopic system did not emerge until last century, as a result of numerous contributions and refinements in optical technology, illumination sources, and instrumentation. Modern neuroendoscopy would not be a flourishing field, as it is today, without the dedication, innovation, and implementation of emerging technology by key contributors including Maximilian Nitze, Walter Dandy, and Harold Hopkins. ⋯ In this review, the history of neuroendoscopy, key players who envisioned how the inner workings of the human body could be visualized "through the looking glass," and current state and future potential for neuroendoscopic surgery are discussed. Future directions of neuroendoscopic surgery will likely be guided by further miniaturization in camera and optical technology, innovations in surgical instrumentation design, the introduction of robotics, multi-port minimally invasive surgery, and an enhanced ability to perform bimanual microdissection.
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Comparative Study
Direct percutaneous puncture approach versus surgical cutdown technique for intracranial neuroendovascular procedures: technical aspects.
To present the authors' experience with a direct transcervical or transbrachial puncture approach in neuroendovascular procedures in which cranial access via the commonly used percutaneous transfemoral route was impossible because of tortuous upstream angioarchitecture. ⋯ Transcervical or transbrachial direct puncture accomplished with PP or by SCD is an effective and safe access route in patients in whom neuroendovascular interventions cannot be done transfemorally. In cases where extensive perioperative anticoagulation is mandatory, bleeding at the puncture site may be a serious problem and can be controlled more effectively through an open surgical approach than by percutaneous maneuvers.