World Neurosurg
-
With only 4 active certified neurosurgeons for a population of 50 million, neurosurgical care was seriously underdeveloped in Myanmar in 2012. Together with the local neurosurgical community, Swiss Neurosurgeons International started a program of assisted education with the aim of increasing the neurosurgical capacity to 60 active neurosurgeons by 2023. ⋯ Since the start of our project in 2013, a series of contemporary neurosurgical technologies and procedures have been introduced to Myanmar with the help of Swiss Neurosurgeons International. Our survey results have shown the strong points of the ongoing educational program and the weaknesses to be addressed. Midway through our 10-year project, with an expanded and improved education program, our goal of 60 active neurosurgeons in Myanmar by 2023 seems well within reach.
-
Pure endoscopic surgery via subtemporal extradural keyhole approach for middle cranial fossa tumors.
Extradural subtemporal keyhole approach could provide adequate removal for some specific middle skull base tumors. The combination of endoscopy and keyhole technique might further help to minimize the complications and provide optimal surgical visualization. Here, a series of attempts with endoscopy by mini-invasive subtemporal extradural approach for 5 middle skull base tumors were successfully achieved. ⋯ This exploratory series demonstrated the safety and effectiveness of pure endoscopic surgery via subtemporal extradural route for satisfactory middle cranial base tumor resection.
-
The transfemoral approach is a common technique for carotid artery stenting (CAS) but is sometimes limited by aortic or peripheral arterial conditions. The purpose of this study is to report the initial experiences with CAS using a novel sheath guide for transradial carotid cannulation. ⋯ The herein-described sheath guide specifically designed for transradial carotid cannulation was useful for CAS.
-
Two-dimensional radiologic images of computed tomography (CT) and magnetic resonance imaging (MRI) examinations are insufficient to provide three-dimensional conception of intracranial or spinal lesions, especially for an inexperienced neurosurgeon. We share our experience of applications of volume rendering (VR) images of CT and MRI studies of brain and spine for the purpose of training and surgical planning in neurosurgery. ⋯ VR is underused in neurosurgery. It enables inexperienced neurosurgeons to understand morphologic details of a lesion and important osteoneurovascular structures around it. It is also helpful for training and preoperative planning in selected patients in neurosurgery.
-
Maximal safe resection prolongs the survival of patients with glioblastoma (GB). However, whether total resection of the enhanced lesion is pursued or abandoned depends on preoperative judgments based on the findings of magnetic resonance imaging (MRI). Anatomically, medial temporal tumor tends to invade toward the temporal stem, insula, and basal ganglia, representing tumor with high surgical risk. In the present study, we describe the key radiologic features of medial temporal GB to achieve extent of resection. ⋯ Medial tGB is a challenging tumor for maximal safe resection, so our classification will help to identify cases of removable medial tGB.