World Neurosurg
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Skull base surgery needs advanced equipment and is performed at few public sector hospitals in India. For financial and infrastructure reasons, the facilities available are insufficient for the large number of poor patients who need this surgery. ⋯ The facilities available in low-income countries such as India are insufficient to take care of poor patients who need skull base surgery. Indigenous innovations, use of the available resources, and interdisciplinary coordination help overcome the challenges of resource scarcity to a reasonable extent in many ill-equipped public sector hospitals for the safe and efficient management of many patients who need skull base surgery.
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Ideal tumor resection requires brain/spinal cord tumor interface separation in perfect and precise surgical planes within a few micrometers for radical tumor resection and maximum normal tissue preservation. Despite the availability of several dissection techniques, the search for additional alternatives and an ideal technique continues. We evaluated the feasibility and advantages of dissection using a No. 15-blade scalpel in special brain tumor surgery situations. We developed a leaf model wherein its outer layer is progressively dissected from its inner skeleton using a scalpel. An additional model used was a tomato wherein its skin was peeled off its pulp using the same technique. ⋯ A scalpel with a sharp edge could be used to perform precise and fine dissection. The scalpel deserves to occupy a place of pride as a dissecting tool in neurosurgery.
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To define the maxillary artery (MaxA) anatomy and present a novel technique for exposing and preparing this vessel as a bypass donor. ⋯ The MaxA can be exposed without zygomatic osteotomies or resection of the middle fossa floor. Anatomic landmarks for exposing the MaxA include the anterior and posterior deep temporal arteries and the pterygomaxillary fissure.
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To investigate the efficacy of antibiotic prophylaxis (AP) and the risk factors for postoperative infections in clean neurosurgery. ⋯ Our results show that in our data set, AP had no preventive effect on postoperative infections in clean neurosurgery. In addition, AP appeared to decrease the positive bacterial culture rate and to promote the emergence of multidrug-resistant bacteria. Cerebrospinal fluid leakage and surgery time were the risk factors for postoperative infection.
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Traumatic brain injury (TBI) constitutes a critical public health and socioeconomic problem. As one of the leading causes of mortality and disability from road traffic crashes, the incidence of TBIs is increasing with increasing motor vehicle usage. Understanding the prevalence and describing the characteristics of TBI are crucial for successful implementation of prevention and treatment efforts to reduce the mortality and morbidity caused by TBIs. ⋯ This preliminary analysis highlights the need to address road safety, especially with respect to helmet use and drink driving, to reduce the burden of TBIs in Bandung.