Transsylvian Insular Glioma Surgery: New Classification System, Clinical Outcome in a Consecutive Series of 79 Cases

Abstract BACKGROUND Surgery of insular glial tumors remains a challenge because of high incidence of postoperative neurological deterioration and the complex anatomy of the insular region. OBJECTIVE To explore the prognostic role of our and Berger-Sanai classifications on the extent of resection (EOR) and clinical outcome. METHODS From 2012 to 2017, a transsylvian removal of insular glial tumors was performed in 79 patients. The EOR was assessed depending on magnetic resonance imaging scans performed in the first 48 h after surgery. RESULTS The EOR ≥90% was achieved in 30 (38%) cases and <90% in 49 (62.0%) cases. In the early postoperative period, the new neurological deficit was observed in 31 (39.2%) patients, and in 5 patients (6.3%), it persisted up to 3 mo. We proposed a classification of insular gliomas based on its volumetric and anatomical characteristics. A statistically significant differences were found between proposed classes in tumor volume before and after surgery (P < .001), EOR (P = .02), rate of epileptic seizures before the surgical treatment (P = .04), and the incidence of persistent postoperative complications (P = .03). In the logistic regression model, tumor location in zone II (Berger-Sanai classification) was the predictor significantly related to less likely EOR of ≥90% and the maximum rate of residual tumor detection (P = .02). CONCLUSION The proposed classification of the insular gliomas was an independent predictor of the EOR and persistent postoperative neurological deficit. According to Berger-Sanai classification, zone II was a predictor of less EOR through the transsylvian approach.

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An Analysis of the Correlation between Temporal Bone Fracture and Potential Complications: Is There a Need for a New Classification System?

Skull Base ◽

10.1055/s-2009-1224479 ◽

2009 ◽

Vol 19 (S 02) ◽

Author(s):

D. Kikidis ◽

J. Thrasyvoulou ◽

P. Vlastarakos ◽

J. Xenelis ◽

A. Bibas

Keyword(s):

Temporal Bone ◽

Bone Fracture ◽

Classification System ◽

New Classification ◽

Temporal Bone Fracture

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Correlation between New Classification System for Reflux Laryngopharyngitis and Los Angeles Classification System for Reflux Esophagitis

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.60.268 ◽

2009 ◽

Vol 60 (3) ◽

pp. 268-275

Author(s):

Kohei Nishimura ◽

Hiromasa Fujita ◽

Toshiaki Tanaka ◽

Yuichi Tanaka ◽

Satoru Matono ◽

...

Keyword(s):

Los Angeles ◽

Reflux Esophagitis ◽

Classification System ◽

New Classification ◽

Los Angeles Classification

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Faculty Opinions recommendation of Proposal of a new classification system for melanocytic naevi.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.715898063.791452859 ◽

2012 ◽

Author(s):

Cesare Massone

Keyword(s):

Classification System ◽

New Classification ◽

Melanocytic Naevi

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Management strategies of pediatric ipsilateral olecranon with associated radial neck fractures based on multicenter experience

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02373-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jin Li ◽

◽

Sheng Ping Tang ◽

Guo Xin Nan ◽

Ming Li ◽

...

Keyword(s):

Clinical Outcome ◽

Classification System ◽

Forearm Fracture ◽

Pediatric Trauma ◽

Treatment Strategies ◽

Treatment Result ◽

Level Of Evidence ◽

Radial Neck ◽

Radial Neck Fractures

Abstract Background The ipsilateral olecranon with associated radial neck fractures does not include in the Bado classification of Monteggia fractures and equivalent lesions. The primary aims of this retrospective multicenter study were to characterize this type of injury and, noting its unique properties, evaluate the results of the treatment, determine the prognostic factors that influence the radiological and clinical outcome, and also give treatment strategies. Methods Between July 2011 and July 2016, forearm fracture patient charts were retrospectively reviewed from seven pediatric trauma centers. Patients diagnosed with ipsilateral olecranon with associated radial neck fractures and followed up for at least 24 months were included. Fracture characteristics, treatment, outcome, and complications were assessed. The clinical outcome of treatments was evaluated by the Mayo Elbow Performance Score (MEPS) and the Flynn criteria. Fisher’s exact test and ANOVA test were used; significance was defined as P < 0.05. Results One hundred thirty-seven consecutive patients (54 girls and 83 boys) from 8292 forearm fractures patients, the mean age of 7.5 years (1.5 to 14.8), with fractures of the ipsilateral olecranon with associated radial neck fractures were identified. One hundred twenty-five patients had radiologic and clinical follow-up. According to a simplified classification system with “operate” and “don’t operate” groups, including five subtypes proposed in this study, ipsilateral olecranon with associated radial neck fractures subtypes could be classified with significantly different characteristics and outcome in treatment and complications. Conclusions Fractures of the ipsilateral olecranon associated with the radial neck are not so rare as previously reported. Complications and poor outcomes were easy to encounter without knowing this type of fracture. Appropriate treatment strategies could be made according to a simple classification system based on the treatment result of follow-up. Level of evidence Retrospective comparative study; Level III

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