World Neurosurg
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Case Reports
Endoscopic Transsphenoidal Resection of Cystic Third Ventricular Craniopharyngioma with Cysto-Cisternal Fenestration.
Cystic craniopharyngiomas of the third ventricle can be challenging to treat because complete resection of the cyst wall can be associated with hypothalamic dysfunction and minimal rostral displacement of the optic chiasm leads to a small endonasal operative corridor. Various methods to overcome the frequent recurrences have been described, such as intracystic bleomycin or catheter placement, with mixed results.1-12 In Video 1, we describe a simple cystocisternal fenestration technique with preservation of the rostral cyst wall via an endoscopic endonasal approach where the solid portion of the tumor is resected, and the inferior wall of the cyst is opened into the prepontine cistern and the superior wall of the cyst and adjacent third ventricle are preserved. This allows for ventricular pressure to collapse the cyst cavity in the postoperative period. In select patients where safe complete resection of a cystic craniopharyngioma is prohibitive, this may provide a durable treatment and can be performed through a small endonasal corridor below a nondisplaced optic chiasm.
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Anterior cervical discectomy and fusion (ACDF) is a common neurosurgical procedure. Portions of the procedure, such as the discectomy, foraminotomy, graft placement, and plate placement, are often performed using operating microscopes to maximize visualization and minimize neurovascular injury. Although standard operating microscopes offer superb visualization, they lack ergonomic and educational utility. ⋯ The Neck Disability Index score and visual analog scale score for neck pain improved significantly at 6 weeks postoperatively (from 59.6 [1.3] to 27.9 [3.0] and from 6.3 [1.0] to 2.5 [0.92], respectively; P < 0.001 for both). Thus, excellent clinical outcomes can be achieved using three-dimensional exoscopes with comparable operative time and blood loss compared with conventional surgical microscopes or loupes. Given the improved ergonomic and teaching potential of exoscopes, the use of three-dimensional exoscopes for neurosurgical and spine surgeries warrants further investigation.
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Virtual reality-based learning of neuroanatomy is a new feasible method to explore, visualize, and dissect interactively complex anatomic regions. We provide a new interactive photorealistic three-dimensional (3D) model of sellar region microsurgical anatomy that allows side-by-side views of exocranial and endocranial surfaces to be explored, with the aim of assisting young neurosurgery residents in learning microsurgical anatomy of this complex region. ⋯ Detailed knowledge of key surgical landmarks representing keyholes and/or anatomic structures to not violate is mandatory for safer surgery, especially for a complex region such as the skull base. Highly accurate virtual and functional neurosurgical models, such as photogrammetry, can generate a realistic appearance to further improve surgical simulators and learn neuroanatomy.
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The aim of this study is to analyze the quality, reliability, comprehensibility, and the mentioned medical concepts of traumatic brain injury (TBI) related videos on YouTube. ⋯ Results suggest the requirement for higher quality and reliability in YouTube content about TBI. Emphasis should be placed on clear and accurate language to promote comprehensibility. Continued research, guidelines, education, and platform oversight can enhance the spread of reliable health information on social media, benefiting creators, and consumers in this field.
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This study aimed to explore the clinical efficacy of metagenomic next-generation sequencing (mNGS) in diagnosing and treating suspected spinal infectious diseases. ⋯ mNGS demonstrated significantly higher detection rates for bacterial, fungal, viral, and mixed infections in cases of suspected spinal infectious diseases. The clinical implementation of mNGS could further enhance the efficiency of diagnosing and treating suspected spinal infectious diseases.