World Neurosurg
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To search for texture features of routine magnetic resonance imaging to predict tumor volume reduction and transient versus permanent tumor progression of vestibular schwannomas treated by Gamma Knife stereotactic radiosurgery. ⋯ Texture feature analysis helps to predict permanent versus transient enlargement and final volume reduction of schwannomas after SRS. Thus, alternative treatment strategies might be considered, mainly in large tumors, where further clinical deterioration cannot be excluded. To confirm these results, a prospective study including more cases and a longer follow-up period is necessary.
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To evaluate whether use of partial nondepolarizing neuromuscular blocking agents, at a train-of-four level 1, compromise facial nerve monitoring during vestibular schwannoma (VS) resection. ⋯ Although mean stimulation threshold to elicit a response amplitude was higher in the peripheral neuromuscular blockade group than in the free of neuromuscular blockade group at the proximal site, the stimulation thresholds in both groups were sufficient for facial nerve monitoring in VS surgery, indicating no clinical difference in both groups.
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Surgical site infection (SSI) remains a complication of spine deformity surgery. Although fusion/instrumentation failure in the setting of SSI has been reported, few studies have investigated the relationship between these entities. We examine the relationship between early SSI and fusion/instrumentation failure after instrumented fusion in patients with thoracolumbar scoliosis. ⋯ Early SSI significantly increases the risk of fusion/instrumentation failure in patients with thoracolumbar scoliotic deformity, and it significantly shortens the time to failure. Patients with early SSI have a significantly higher likelihood of requiring revision surgery and after a significantly shorter time interval.
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To investigate whether the behavior of disc arthroplasty in 2-level hybrid surgery (HS) was affected by adjacent fusion in vivo compared with cervical disc arthroplasty (CDA) alone. ⋯ Although the fusion in 2-level HS partially affected the behavior of adjacent disc arthroplasty compared with CDA alone, it did not cause severe complications and adverse clinical outcomes. However, large-scale and long follow-up trials are warranted.
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Intracranial epidermoid cysts are developmental central nervous system abnormalities that arise from erroneous ectodermal inclusion during neural tube closure. Epidermoids are relatively common, representing 1% of all intracranial masses, and are particularly predominant in the cerebellopontine angle (CPA), where they are the third most prevalent diagnosis after schwannomas and meningiomas. ⋯ By use of a 2-surgeon 4-hands technique, the mass was dissected from the surrounding neurovascular structures, and a gross total removal was achieved with no postoperative neurologic deficits. Our video highlights the critical nuances pertinent to the fully endoscopic resection technique, with special attention to the relative restrictions of a small working corridor parallel to the tentorium and the petrous bone.