En bloc petrosectomy using a Gigli saw for petroclival lesions

1995 ◽  
Vol 83 (3) ◽  
pp. 559-560 ◽  
Author(s):  
Tomio Sasaki ◽  
Makoto Taniguchi ◽  
Ichiro Suzuki ◽  
Takaaki Kirino
Keyword(s):  
Facial Nerve ◽  
Semicircular Canals ◽  
Petrous Bone ◽  
New Technique ◽  
En Bloc ◽  
Content Type ◽  
A New Technique ◽  
Transtentorial Approach ◽  
Fine Print

✓ The authors report a new technique for en bloc petrosectomy using a Gigli saw as an alternative to drilling the petrous bone in the combined supra- and infratentorial approach or the transpetrosal—transtentorial approach. It is simple and easy and avoids postoperative cosmetic deformity. This technique has been performed in 11 petroclival lesions without injuring the semicircular canals, the cochlea, or the facial nerve.

A new technique for exposure of the cervical spine laminae

2002 ◽  
Vol 96 (1) ◽  
pp. 122-126 ◽  
Author(s):  
Tateru Shiraishi
Keyword(s):  
Cervical Spine ◽  
New Technique ◽  
Diverse Range ◽  
Content Type ◽  
Spinous Processes ◽  
Technical Details ◽  
A New Technique ◽  
Fine Print

✓ The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. In contrast to conventional cervical approaches, none of the muscular attachments to the spinous processes is compromised. In this paper the author describes the technical details and discusses the applications of the procedure.

Posterior petrous meningiomas: 82 cases

2005 ◽  
Vol 102 (2) ◽  
pp. 284-289 ◽  
Author(s):  
Zhe Bao Wu ◽  
Chun Jiang Yu ◽  
Shu Sen Guan
Keyword(s):  
Facial Nerve ◽  
Clinical Manifestations ◽  
Petrous Bone ◽  
Type I ◽  
Type Ii ◽  
Posterior Surface ◽  
Total Resection ◽  
Content Type ◽  
Functional Preservation ◽  
Fine Print

Object. The aim of this study was to discuss posterior petrous meningiomas—their classification, clinical manifestations, surgical treatments, and patient outcomes. Methods. A retrospective analysis was performed in 82 patients with posterior petrous meningiomas for microsurgery. According to the anatomical relationship with the posterior surface of the petrous bone and with special reference to the internal auditory canal (IAC), posterior petrous meningiomas were classified into three types: Type I, located laterally to the IAC (28 cases); Type II, located medially to the IAC, which might extend to the cavernous sinus and clivus (32 cases); and Type III, extensively attached to the posterior surface of the petrous bone, which might envelop the seventh and eighth cranial nerves (22 cases). Sixty-eight (83%) of 82 cases involved total resection. The rate of anatomical preservation of facial nerve was 97.5%, whereas the functional preservation rate was 81%. The rate of hearing preservation was 67%. All Type I tumors were completely resected, and the rate of anatomical preservation of facial nerve was 100% and functional preservation was 93%. Regarding Type II lesions, 75% of 32 cases involved total resection; the rate of anatomical preservation of facial nerve was 97% and functional preservation was 75%. For Type III lesions, 73% of 22 cases were totally resected. The rate of anatomical preservation of facial nerve in patients with this tumor type was 95%, whereas functional preservation was 73%. Conclusions. Clinical manifestations and surgical prognoses are different among the various types of posterior petrous meningiomas. It is more difficult for Types II and III tumors to be resected radically than Type I lesions, and postoperative functional outcomes are significantly worse accordingly. The primary principles in dealing with this disease entity include preservation of vital vascular and central nervous system structures and total resection of the tumor as much as possible.

A subarachnoid screw for monitoring intracranial pressure

1973 ◽  
Vol 39 (3) ◽  
pp. 416-419 ◽  
Author(s):  
John K. Vries ◽  
Donald P. Becker ◽  
Harold F. Young
Keyword(s):  
Intracranial Pressure ◽  
Local Anesthesia ◽  
Subarachnoid Space ◽  
New Technique ◽  
Content Type ◽  
A New Technique ◽  
Fine Print

✓ A new technique for monitoring intracranial pressure is presented. It is based on a hollow screw in the skull whose tip projects through the dura into the subarachnoid space. The screw can be easily inserted under local anesthesia. Pressure is monitored isovolumetrically by connecting the screw to a transducer. The system can be calibrated in situ and has been successfully used in 56 patients during a 6-month period.

Facial nerve preservation during surgery for removal of acoustic nerve tumors

1982 ◽  
Vol 57 (6) ◽  
pp. 739-746 ◽  
Author(s):  
Richard H. Lye ◽  
John Dutton ◽  
Richard T. Ramsden ◽  
Joseph V. Occleshaw ◽  
Iain T. Ferguson ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Petrous Bone ◽  
Ct Scans ◽  
Facial Weakness ◽  
Content Type ◽  
Nerve Preservation ◽  
Increased Risk ◽  
Acoustic Nerve ◽  
Facial Function ◽  
Fine Print

✓ A series of 33 patients with 35 acoustic nerve tumors is reviewed. Tumor size was estimated from computerized tomography (CT) scans, and its influence on anatomical and functional preservation of the facial nerve was assessed. Six tumors (one invading the petrous bone, three medium and two large tumors) were not detected on CT scans. The translabyrinthine approach was used in seven instances (one small and six medium tumors) and the suboccipital transmeatal approach for 28 tumors (seven medium and 21 large tumors). Anatomical preservation of the facial nerve was achieved in 83% of operations for tumor removal, two of which were subtotal. A further two patients underwent subtotal removal, but the facial nerve was destroyed. Large tumors carried an increased risk of damage to the facial nerve, but even in this group the nerve was preserved anatomically intact in 70% of cases. Damage to the facial nerve occurred more frequently in patients with preoperative evidence of facial weakness; however, this factor did not appear to influence functional recovery of the facial nerve, provided that the nerve was intact at the end of the operation. A simple grading system for facial nerve function is described. Only 76% of anatomically intact facial nerves showed any evidence of function 1 month after surgery. Postoperatively, facial function improved with time. At the latest review, 45% of these patients had normal facial function or mild facial weakness (Grades I and II).

Neurinomas of the facial nerve

1975 ◽  
Vol 43 (5) ◽  
pp. 608-613 ◽  
Author(s):  
Fabian Isamat ◽  
Federico Bartumeus ◽  
Antonio M. Miranda ◽  
Jaime Prat ◽  
Luis C. Pons
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Petrous Bone ◽  
The Other ◽  
Bone Area ◽  
Content Type ◽  
Fine Print

✓ Three cases of neurinomas of the facial nerve are reported. Two of them originated from the labyrinthine portion of the nerve and the other from the vertical portion. Neurinomas of the first part of the facial nerve can be suspected preoperatively since they seem to give rise to specific clinical and radiological manifestations that can be distinguished from tumors of other portions of the nerve, the petrous bone area, or the cerebellopontine angle. The reported cases of neurinomas of the facial nerve are reviewed and analyzed.

Selective posterior rhizotomy for treatment of spasticity

1983 ◽  
Vol 58 (6) ◽  
pp. 895-899 ◽  
Author(s):  
Lauri V. Laitinen ◽  
Stefan Nilsson ◽  
Axel R. Fugl-Meyer
Keyword(s):  
General Anesthesia ◽  
Muscle Contractions ◽  
New Technique ◽  
Similar Technique ◽  
Good Reduction ◽  
Content Type ◽  
Tonic Muscle ◽  
A New Technique ◽  
Selective Posterior Rhizotomy ◽  
Fine Print

✓ In 1976, Fasano, et al., described a new technique of posterior rhizotomy for treatment of spasticity. They stimulated electrically fascicles of the posterior roots in spastic patients and found that some fascicles responded to stimulation with tonic muscle contractions. They cut these fascicles, preserving those with a weaker or no reaction. The present authors have used a fairly similar technique in the treatment of eight patients with spasticity of the legs and one patient with spasticity of the arm: all fascicles of the posterior roots T12-S1 and C6–8, respectively, were stimulated electrically during surgery under general anesthesia. Approximately 60% to 80% of the fascicles responded to stimulation with tonic muscle jerks, and only these fascicles were cut. All nine patients showed a good reduction of spasticity. The residual cutaneous and joint sensation remained unchanged. Motility of the limbs usually improved.

Anchoring of deep brain stimulation electrodes using a microplate

1996 ◽  
Vol 85 (6) ◽  
pp. 1181-1183 ◽  
Author(s):  
Jacques Favre ◽  
Jamal M. Taha ◽  
Timothy Steel ◽  
Kim J. Burchiel
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
New Technique ◽  
Content Type ◽  
A New Technique ◽  
Fine Print ◽  
Deep Brain

✓ The authors report a new technique to anchor deep brain stimulation electrodes using a titanium microplate. This technique has been safely used to secure 20 quadripolar deep brain stimulation electrodes implanted for movement disorders (18 electrodes) and pain (two electrodes). Twelve electrodes were implanted in the thalamus, four in the subthalamic nucleus, and four in the pallidum. No electrode migration or rupture occurred, and all electrodes have been shown to work properly after internalization of the system.

Ventriculofiberscope: a new technique for endoscopic diagnosis and operation

1973 ◽  
Vol 38 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Takanori Fukushima ◽  
Buichi Ishijima ◽  
Kimiyoshi Hirakawa ◽  
Norio Nakamura ◽  
Keiji Sano
Keyword(s):  
Ventricular System ◽  
Endoscopic Diagnosis ◽  
New Technique ◽  
Content Type ◽  
A New Technique ◽  
Fine Print

✓ The authors report a new ventriculofiberscope useful in both diagnosing and operating on lesions of the ventricular system. The technique and its advantages are illustrated in representative cases.

New technique of side-to-end hypoglossal—facial nerve attachment with translocation of the infratemporal facial nerve

1999 ◽  
Vol 90 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Vincent Darrouzet ◽  
Jean Guerin ◽  
Jean-Pierre Bébéar
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Functional Results ◽  
Clinical Results ◽  
New Technique ◽  
Complete Disappearance ◽  
Content Type ◽  
Analytic Scoring ◽  
Grade Iii ◽  
Fine Print

Object. The goal of this study was to assess the clinical results of hypoglossal-facial nerve attachment (HFA), which was primarily performed in patients following excision of tumors of the cerebellopontine angle. In six of the patients a new side-to-end procedure was used.Methods. The authors have performed a retrospective study of 33 patients who underwent HFA, including 24 classic end-to-end, three May, and six side-to-end procedures. For the latter procedure, a hemihypoglossal—facial nerve attachment was performed by rerouting the intratemporal facial nerve; this avoided the jump-cable graft used in May's technique. The goal of the new procedure is to reduce the incidence of morbidity due to hemilingual paralysis (difficulty in chewing, speaking, and swallowing). The incidence of hemilingual paralysis was evaluated based on the findings of a questionnaire that was completed by the patients. The patient's facial mobility was assessed using the House and Brackmann grading system and the author's analytic scoring system.Conclusions. The HFA offers good functional results. Of the 28 cases evaluated, nine had House and Brackmann Grade III, 17 Grade IV, and only two Grade V at 18 months. When the new technique of side-to-end hemihypoglossal—facial nerve attachment was used, there was considerable reduction, if not complete disappearance, of lingual morbidity and the facial functional results were constant and satisfactory: there were five patients with House and Brackmann Grade III and one with Grade IV, and their mean percentage of facial mobility was 43.3%.

Intraparenchymal embolization for obliteration of an intramedullary AVM of the spinal cord

1977 ◽  
Vol 47 (1) ◽  
pp. 119-125 ◽  
Author(s):  
James I. Ausman ◽  
Lawrence H. Gold ◽  
S. Murthy Tadavarthy ◽  
Kurt Amplatz ◽  
Shelley N. Chou
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformation ◽  
New Technique ◽  
Content Type ◽  
A New Technique ◽  
Fine Print

✓ A new technique is presented in which expandable compressed Ivalon sponge emboli were used to obliterate an intramedullary arteriovenous malformation of the spinal cord by intraparenchymal embolization. A case is described in which this method was used.

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