World Neurosurg
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In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. ⋯ In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance.
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Case Reports
Endoscopic endonasal resection of a mixedlesion of gangliocytoma and non-functioning pituitary adenoma.
The coexistence of a gangliocytoma and a pituitary adenoma is a rare event that has been reported in only case reports. The knowledge of its diagnosis and treatment is extremely limited. ⋯ Our finding of the heterogeneous texture in the lesion of gangliocytoma associated with pituitary adenoma may help to uncover the pathogenesis of this rare disorder. This finding also supports the examination of intraoperative frozen sections to aid in diagnosis. We recommend maximized safe resection as a surgical strategy for the coexistent lesion of gangliocytoma and pituitary adenoma.
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We sought to simply demonstrate how levels of soluble human epoxide hydrolase-2 show changes in both temporal the cortex and hippocampal complex in patients with temporal lobe epilepsy. ⋯ Soluble human epoxy hydrolase enzyme-2 is increased in both lateral and medial temporal tissues in temporal lobe epilepsy. Further studies should be conducted as inhibition of this enzyme has resulted in a significant decrease in or stopping of seizures and attenuated neuroinflammation in experimental epilepsy models in the current literature.
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Surgery of the craniocervical junction (CCJ) and clivus is technically demanding. For many years, we have used the submandibular retropharyngeal approach for surgery of the upper cervical spine, especially hangman fracture. We hypothesized that submandibular gland resection could offer a significant cranial enlargement of the operative field, up to the clivus. Our aim in this work was to assess the feasibility of an endoscope-assisted retropharyngeal approach to the CCJ and clivus. ⋯ An endoscopic submandibular retropharyngeal approach provides a simple and straightforward access to the CCJ. It also conveniently exposes the clivus. This technique could be added to the techniques used for this difficult surgery.
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A retrospective cohort study of patients with tuberculum sellae meningioma (TSM)-associated sphenoidal pneumosinus dilatans (PSD) over a recent epoch was evaluated using a propensity-matched morphometric analysis. ⋯ This study suggests that TSM-associated sphenoidal PSD leads to more selective splaying of the tuberculum sellae region rather than cumulative increase in sinus volume. This may lead to operative corridor expansion for endonasal access to TSM associated with sphenoidal PSD. A radiologic classification scheme for sphenoidal PSD associated with TSM is suggested that may aid surgical decision-making.