World Neurosurg
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Hypertrophic neuropathy is a rare entity commonly associated with peripheral nerve, characterized by onion bulb formations. Its cranial nerve involvement is very rare; only 7 cases have been found in the literature. ⋯ Here, we report a first case of isolated hypertrophic neuropathy involving the oculomotor nerve.
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Tinnitus is a common entity that may lead to severe impairment in quality of life. An adequate treatment modality for severe tinnitus is currently lacking. Neurostimulation of the auditory tract may serve as a promising adjunct in tinnitus treatment. The aim is to investigate the effect of direct stimulation on the cochleovestibular nerve for intractable tinnitus. ⋯ Direct neurostimulation resulted in treatment success in a small majority of the patients, with a significant decrease in THI score. However, because of a high risk of additional hearing damage, this technique seems not viable for patients with moderate hearing loss.
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Choroid plexus papillomas (CPPs) are rare benign intracranial tumors. We report a rare case of CPP manifesting with typical symptoms of normal-pressure hydrocephalus rather than obstructive hydrocephalus. ⋯ The hydrocephalus was of a communicating type and caused by CSF overproduction. The lateral route of the trans-CMF approach is useful for the dissection of tumors that extend into the unilateral cerebellomedullary cistern through the CMF. This approach not only enables sufficient exposure for resection but also avoids damage to the surrounding structures.
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Comparative Study
Comparison of consecutive, interval, and skipped pedicle screw techniques in moderate Lenke type 1 adolescent idiopathic scoliosis.
To compare perioperative, radiographic, and Scoliosis Research Society-22 (SRS-22) outcomes of consecutive, interval, and skipped pedicle screw techniques in patients with moderate Lenke type 1 adolescent idiopathic scoliosis (AIS). ⋯ Consecutive, interval, and skipped pedicle screw techniques all provide satisfactory deformity correction and SRS-22 outcomes with few complications. With better perioperative outcomes, interval and skipped pedicle screw techniques are the more cost-effective options for patients with moderate Lenke type 1 AIS.
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Advances in the oncologic and functional results of insular surgery have been reported recently. Such successes have been made possible by the advent of the transopercular approach under awake monitoring and by improved anatomic and functional knowledge of white matter pathways surrounding the insula. Nonetheless, given the rarity of insular tumors, it is difficult to get familiar with the complex 3-dimensional anatomy of the different neuronal and vascular structures encountered during a transopercular insular resection. We thus propose to develop a laboratory model allowing to train transopercular approaches of the insula. ⋯ In this paper, we show that Klinger dissection with preservation of pial membranes provides a realistic model of insular surgery, allowing surgeons to learn and train on this highly specialized surgery.