World Neurosurg
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This study aims to evaluate the clinical and surgical outcomes with suprasellar Rathke's cleft cysts(RCCs) treated using the extended endoscopic transnasal(EET) approach. It emphasizes surgical strategies, nuances of the technique, and the importance of cyst wall resection in optimizing outcomes while preserving postoperative pituitary function. ⋯ Surgical intervention is essential for suprasellar RCCs due to their proximity to vital structures. Tailored strategies and gentle resection with minimal stalk manipulation are key to effective treatment and preserving endocrine function.
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To describe in detail the characteristics of the travels and relationship of splanchnic nerves, and to provide an anatomical basis for splanchnic nerve block. ⋯ Anatomy: 90% of the GSN and LSN intersect. The point was (18.69±3.52) mm from the median sagittal plane, (7.99±4.43) mm from the anterior aspect of the vertebral body, (8.2±7.9) mm from the cranial aspect of the superior endplate of the T12 vertebral body, and (7.03±12.41) mm from the caudal aspect of the inferior endplate of the T12 vertebral body. Clinical validation: All patients exhibited a decrease in VAS and an increase in QS compared to preoperative levels (P < 0.0001) CONCLUSIONS: The intersection of the GSN and LSN exists in the downward course, and its position is relatively fixed, located on the anterior side of the T11-L1 vertebral body, and the point where the GSN crosses the diaphragm is searched for anteriorly and upwardly, and the block is performed according to the position of the intersection of the GSN and LSN in the clinic, which is safe and effective.
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In adults, the conus medullaris (CM) tip usually terminates at the mid aspect of the L1 vertebra. However, variations exist. Beside the location, differences in the CM's shape are believed to be closely related to neurological conditions. ⋯ The majority of participants had the CM at the caudal level of L1. We did not observe any highly positioned CM above T12. There is good reliability of interobserver agreement of the current methods for description of the location and shape of CM.
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Minimally invasive keyhole approaches to the anterior skull base and circle of Willis require small incisions near distal branches of the temporal division (TD) of the facial nerve. Few studies have focused on planning the incision to avoid the TD branches and maximize exposure in these approaches. This study aimed to define a safe zone away from the TD branches for skin incision during minimally invasive keyhole approaches using reliable and practical skin landmarks. ⋯ Identifying a safe zone for preserving TD branches is crucial for surgical incisions planned in the superolateral region of the orbit. This study provides a clinically applicable and reproducible landmark for planning incisions commonly used during minimally invasive keyhole approaches.