World Neurosurg
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Case Reports
Four-Level Vertebrectomy For En Bloc Resection of a Cervical Chordoma: Technical Case Report.
Chordomas are locally aggressive tumors that can involve multiple levels of the spine and are difficult to resect. We present our technique for 4-level en bloc cervical spondylectomy for a locally aggressive chordoma. ⋯ En bloc resection as part of a multidisciplinary team approach remains the mainstay of spinal chordoma treatment. Modern instrumentation and careful dissection can provide good results even in locally advanced cases.
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Chiari III malformation is an extremely rare congenital anomaly. At present, its primary and associated pathognomonic factors remain poorly understood. The authors report a case of a male neonate born with an occipital encephalocoele with herniation of posterior fossa contents associated with bilateral postaxial polydactyly. ⋯ Owing to the uniqueness of this patient's presentation, the concurrent diagnoses of Chiari III malformation and polydactyly are discussed in concordance with updated literature.
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The authors present cases of childhood moyamoya disease successfully treated with bilateral superficial temporal artery to anterior cerebral artery (ACA) direct anastomoses and describe the surgical techniques used in this vascular reconstruction method. ⋯ The described technique can be considered an effective and uncomplicated revascularization procedure for the ACA regions, which are crucial for normal intellectual growth in the pediatric population.
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Hypoglossal nerve injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the hypoglossal-facial nerve anastomosis bilaterally, a technique that includes partial splitting of the hypoglossal nerve and skeletonization of the facial nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and hypoglossal nerves after the procedure. ⋯ HHFA is an effective technique for facial nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods.
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To investigate prognostic factors of clival chordoma using the largest patient set to date. ⋯ GTR rates were comparable in different surgical approaches. GTR was a significant predictor of longer PFS and OS in clival chordoma.