A new surgical approach to the treatment of coronal synostosis

1977 ◽  
Vol 46 (2) ◽  
pp. 210-214 ◽  
Author(s):  
Anthony J. Raimondi ◽  
Francisco A. Gutierrez
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Essential Elements ◽  
Content Type ◽  
Coronal Synostosis ◽  
Orbital Rim ◽  
Fine Print

✓ The authors describe a surgical technique for the treatment of unilateral coronal synostosis, which they have carried out successfully in 16 children. Frontal craniotomy, removal of the lesser wing of the sphenoid, orbital unroofing, and removal of the entire orbital rim are recommended as essential elements of cranioorbital reconstruction in the treatment of plagiocephaly.

Anterior sacral meningocele in pregnancy

2001 ◽  
Vol 94 (1) ◽  
pp. 162-164 ◽  
Author(s):  
Amgad Saddik Hanna ◽  
Xavier Morandi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Technique ◽  
Surgical Approach ◽  
Resonance Imaging ◽  
Content Type ◽  
Anterior Sacral Meningocele ◽  
Fine Print ◽  
In Pregnancy

✓ Anterior sacral meningocele was first described in 1837. Most reported cases were associated with complications, including meningitis and death, because of misdiagnosis or inappropriate surgical approach. The authors present a case of anterior sacral meningocele accidentally discovered during pregnancy and provide unique magnetic resonance imaging documentation. The pathogenesis, management, and surgical technique are discussed.

Treatment of bilateral coronal synostosis in infancy: a holistic approach

1990 ◽  
Vol 72 (2) ◽  
pp. 171-175 ◽  
Author(s):  
John A. Persing ◽  
John A. Jane ◽  
Johnny B. Delashaw
Keyword(s):  
Surgical Technique ◽  
Operative Procedure ◽  
Holistic Approach ◽  
Cerebral Function ◽  
Content Type ◽  
Therapeutic Goals ◽  
Skull Shape ◽  
Anteroposterior Axis ◽  
Coronal Synostosis ◽  
Fine Print

✓ Bilateral coronal synostosis often results in a turribrachycephalic skull shape. Reduction of skull height and elongation of the anteroposterior axis of the skull while preserving normal cerebral function are the major therapeutic goals. A surgical technique is described which can successfully accomplish these goals in a single operative procedure.

Alternative techniques in the treatment of unilateral coronal synostosis

1984 ◽  
Vol 61 (3) ◽  
pp. 550-556 ◽  
Author(s):  
John A. Jane ◽  
T. S. Park ◽  
Barry M. Zide ◽  
Phillip Lambruschi ◽  
John A. Persing ◽  
...  
Keyword(s):  
Operative Technique ◽  
Frontal Bone ◽  
Coronal Suture ◽  
Operative Techniques ◽  
Content Type ◽  
Tongue In Groove ◽  
Coronal Synostosis ◽  
Alternative Techniques ◽  
Orbital Rim ◽  
Fine Print

✓ Premature closure of one coronal suture results in bilateral abnormalities. There is always ipsilateral flatness of the orbital rim, and contralateral frontal bossing is often found. The authors have employed three operative techniques for correction of unilateral coronal synostosis: frontal bone overlay, lateral canthal advancement, and the tongue-in-groove procedure. The choice of operative technique depends upon the exact deformity to be corrected. The authors believe that altering the relations between the bone and dura by techniques such as radical remodeling and dural plication may improve the results of surgical correction of craniosynostosis.

Modified osteoplastic orbitozygomatic craniotomy

2005 ◽  
Vol 102 (5) ◽  
pp. 940-944 ◽  
Author(s):  
Vijayabalan Balasingam ◽  
Akio Noguchi ◽  
Sean O. McMenomey ◽  
Johnny B. Delashaw
Keyword(s):  
Surgical Technique ◽  
Muscle Atrophy ◽  
Bone Infection ◽  
Bone Flap ◽  
Temporalis Muscle ◽  
Content Type ◽  
Orbital Rim ◽  
Supraorbital Foramen ◽  
Fine Print

✓ The authors report on a surgical technique involving a one-piece osteoplastic bone flap, which incorporates the frontal, temporal, and lateral portions of the orbital rim as a technically simpler alternative to the standard orbitozygomatic (OZ) craniotomy. The orbital rim component extends just laterally from the supraorbital foramen/notch to the frontozygomatic suture. This craniotomy obviates the need for removing the zygoma and has evolved from the authors' experience in more than 200 patients with a variety of pathological lesions, both vascular and tumorous. The osteoplastic aspect of this technique was initially evaluated in 14 cadaveric sites in seven heads dissected prior to implementing this procedure clinically. The osteoplastic bone flap minimally obstructs the surgical view and provides all the advantages of a standard OZ craniotomy. Temporalis muscle atrophy leading to temporal hollowing is avoided, a bone union to the calvaria is improved, and the possibility of bone infection is decreased. The osteoplastic component of the technique adds to the improved long-term cosmesis and warrants active consideration in the art of neurosurgery.

Orbital rim and malar advancement for unilateral coronal synostosis in the older pediatric age group

1991 ◽  
Vol 74 (2) ◽  
pp. 219-223 ◽  
Author(s):  
Kost Elisevich ◽  
Uldis Bite ◽  
Robert G. Colcleugh
Keyword(s):  
Screw Fixation ◽  
Age Group ◽  
Pediatric Age ◽  
En Bloc ◽  
Content Type ◽  
Pediatric Age Group ◽  
Tongue In Groove ◽  
Coronal Synostosis ◽  
Orbital Rim ◽  
Fine Print

✓ The authors describe a technique for lateral orbital rim and malar advancement in patients in the older pediatric age group. The technique makes use of a strip craniotomy containing the supraorbital margin, greater sphenoid wing, and temporal bone, with en bloc inclusion of the lateral orbital rim, zygoma, and malar prominence. The method allows a contoured yet stable construction secured in a tongue-in-groove fashion with plate-and-screw fixation. It creates a symmetrical reconstruction of both frontal and lateral orbital aspects in the untreated or inadequately treated older plagiocephalic child with orbital dystopia. The accompanying malar recession is likewise corrected.

Trigeminal schwannoma

1988 ◽  
Vol 69 (6) ◽  
pp. 850-860 ◽  
Author(s):  
Paul C. McCormick ◽  
Jacqueline A. Bello ◽  
Kalmon D. Post
Keyword(s):  
Trigeminal Nerve ◽  
Surgical Approach ◽  
Csf Leak ◽  
Symptom Duration ◽  
Consecutive Series ◽  
Nerve Function ◽  
Content Type ◽  
Trigeminal Schwannoma ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ A consecutive series of 14 patients with trigeminal schwannoma managed surgically at the Neurological Institute of New York since 1970 is reported. Nine women and five men (mean age 40 years) were diagnosed following a mean symptom duration of 33 months. Abnormalities of trigeminal nerve function were present in 11 patients on admission examination. Facial pain was a prominent feature in eight patients. Two patients, both with schwannomas arising from the trigeminal root, presented initially with typical trigeminal neuralgia. Additional cranial nerve palsies or cerebellar or pyramidal tract signs were noted in eight patients. The surgical approach to these tumors depends on their anatomical location. Four patients had tumors confined to the middle fossa, three patients had tumors limited to the posterior fossa, and seven patients had both supratentorial and infratentorial components of their tumors. Twenty operative procedures were performed on these patients, resulting in complete extirpation in six patients, nearly complete removal in seven patients, and partial removal in one patient. Adherence of the tumor to the lateral wall of the cavernous sinus or the brain stem precluded total removal. There was one postoperative death. In the immediate postoperative period, abnormalities of cranial nerves controlling the extraocular muscles were common. In general, these deficits were transient; however, some permanent loss of trigeminal nerve function occurred in nine patients. Two patients required tarsorrhaphy for neurotropic keratitis, and two patients underwent cerebrospinal fluid (CSF) shunting procedures for hydrocephalus or for a persistent CSF leak. The follow-up period ranged from 4 to 177 months (mean 47 months). The clinical features, anatomical considerations, and surgical approach to these rare tumors are discussed. A clinical review of 106 additional cases of trigeminal schwannoma, reported in the English literature since 1935, is also presented.

Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and surgical approach on incidence and response to treatment

2001 ◽  
Vol 94 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Jeffrey W. Brennan ◽  
David W. Rowed ◽  
Julian M. Nedzelski ◽  
Joseph M. Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Acoustic Neuroma ◽  
Surgical Approach ◽  
Tumor Size ◽  
Surgical Repair ◽  
Leakage Rate ◽  
Csf Leak ◽  
Content Type ◽  
Csf Leakage ◽  
Fine Print

Object. The aims of this study were to review the incidence of cerebrospinal fluid (CSF) leakage complicating the removal of acoustic neuroma and to identify factors that influence its occurrence and treatment. Methods. Prospective information on consecutive patients who underwent operation for acoustic neuroma was supplemented by a retrospective review of the medical records in which patients with CSF leaks complicating tumor removal were identified. This paper represents a continuation of a previously published series and thus compiles the authors' continuous experience over the last 24 years of practice. In 624 cases of acoustic neuroma the authors observed an overall incidence of 10.7% for CSF leak. The rate of leakage was significantly lower in the last 9 years compared with the first 15, most likely because of the abandonment of the combined translabyrinthine (TL)—middle fossa exposure. There was no difference in the leakage rate between TL and retrosigmoid (RS) approaches, although there were differences in the site of the leak (wound leaks occurred more frequently after a TL and otorrhea after an RS approach, respectively). Tumor size (maximum extracanalicular diameter) had a significant effect on the leakage rate overall and for RS but not for TL procedures. The majority of leaks ceased with nonsurgical treatments (18% with expectant management and 49% with lumbar CSF drainage). However, TL leaks (especially rhinorrhea) required surgical repair significantly more often than RS leaks. This has not been reported previously. Conclusions. The rate of CSF leakage after TL and RS procedures has remained stable. Factors influencing its occurrence include tumor size but not surgical approach. The TL-related leaks had a significantly higher surgical repair rate than RS-related leaks, an additional factor to consider when choosing an approach. The problem of CSF leakage becomes increasingly important as nonsurgical treatments for acoustic neuroma are developed.

Excision of a congenital suboccipital vertebral arteriovenous fistula

1972 ◽  
Vol 37 (4) ◽  
pp. 452-456 ◽  
Author(s):  
Albert D. Bartal ◽  
Morris J. Levy
Keyword(s):  
Arteriovenous Malformation ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Surgical Approach ◽  
Left Ventricular ◽  
Content Type ◽  
Vertebral Arteriovenous Fistula ◽  
Cardiac Enlargement ◽  
Major Consideration ◽  
Fine Print

✓ This report describes the successful excision of a congenital vertebral arteriovenous malformation in an 8-year-old child. There was mild effort dyspnea and left ventricular cardiac enlargement; a left-to-right vertebral artery steal across the basilar trifurcation was a major consideration in planning the surgical approach.

Endoscopic treatment of colloid cysts of the third ventricle

1998 ◽  
Vol 89 (6) ◽  
pp. 1062-1068 ◽  
Author(s):  
M. Samy Abdou ◽  
Alan R. Cohen
Keyword(s):  
Surgical Technique ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Third Ventricle ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Endoscopic Evacuation ◽  
Colloid Cysts ◽  
Fine Print

✓ The surgical technique for the endoscopic evacuation of colloid cysts of the third ventricle in 13 patients is described. The authors conclude that endoscopic resection of these lesions is a useful addition to the current surgical repertoire and a viable alternative to stereotactic aspiration or open craniotomy.

Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex

1992 ◽  
Vol 76 (4) ◽  
pp. 629-634 ◽  
Author(s):  
Edgar Nathal ◽  
Nobuyuki Yasui ◽  
Takeshi Sampei ◽  
Akifumi Suzuki
Keyword(s):  
Surgical Approach ◽  
Radical Surgery ◽  
Anatomical Variations ◽  
Surgical Approaches ◽  
Anterior Communicating Artery ◽  
Anatomical Studies ◽  
Content Type ◽  
Number Of Patients ◽  
Vascular Elements ◽  
Fine Print

✓ The intraoperative anatomical findings of the anterior communicating artery (ACoA) complex in 46 patients with anatomical variations were compared to those in an equal number of patients without variations in order to determine the visualization of the elements of the vascular complex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior interhemispheric, or basal interhemispheric. Visualization of the vascular elements was similar in patients with or without anatomical variations. The differences observed were dependent on the surgical approach selected and on the projection of the aneurysm. It was found that, even when the intraoperative anatomical field and the number of vascular elements visualized are different from those obtained in autopsy studies, the vascular microanatomical characteristics can be confirmed with each surgical approach to the extent necessary to ensure safe clipping of aneurysms in patients both with and without anatomical variations.

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