World Neurosurg
-
Case Reports
Postoperative Ptosis and Diplopia Induced by the Intraoperative Application of Bone Wax.
Bone wax is a hemostatic agent well used by neurosurgeons to prevent bleeding from bone. However, several complications involving bone wax have been reported, such as ptosis, infection, paraplegia, osteohypertrophy, edema, pain, granuloma formation, allergic reaction, and thrombosis. ⋯ The authors report a case with complications of ptosis and diplopia after the use of bone wax. Bone wax should be used minimally to the extent possible to avoid an unexpected harmful event.
-
Tethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear. ⋯ In adults with a repaired MMC, lumbar canal stenosis should be investigated as a possible cause of late neurologic decline. Clinical manifestations may be complicated by the coexistence of both the original and subsequent neurologic disorders. Because these additional disorders result from compressive myelopathy, early surgical decompression is indicated to avoid irreversible spinal cord dysfunction.
-
Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care. ⋯ Our study represents the first application of 7-T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7-T MRI compared with 3- and 1.5-T MRI, and found that integration of 7 T into surgical planning and guidance was feasible. These results suggest a potential for 7-T MRI to reduce surgical complications. Future studies comparing standardized 7-, 3-, and 1.5-T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7-T MRI for endonasal endoscopic surgical efficacy.
-
Multicenter Study
Clinical Outcome after Extended Endoscopic Endonasal Resection of Craniopharyngiomas: Two-institution Experience.
The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. ⋯ EEA is effective for the surgical resection of craniopharyngiomas, resulting in high rates of visual improvement and low complication rates. Adjuvant radiotherapy is a useful method for tumor control after incomplete resection.