World Neurosurg
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Review Meta Analysis Comparative Study
Endoscopic versus microsurgical resection of colloid cysts: a systematic review and meta-analysis of 1,278 patients.
Colloid cysts of the third ventricle have been successfully treated with transcranial microsurgical approaches. However, the endoscopic approach has recently been advocated as a lesser invasive technique. We conducted a systematic review and meta-analysis of published studies to compare the outcomes between the two approaches. ⋯ Microsurgical resection of colloid cysts is associated with a higher rate of complete resection, lower rate of recurrence, and fewer reoperations than with endoscopic removal. However, the rate of morbidity is higher with microsurgery than with endoscopy.
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Review
Current purpose and practice of hypertonic saline in neurosurgery: a review of the literature.
To review and summarize controversies and current concepts regarding the use of hypertonic saline during the perioperative period in neurosurgery. ⋯ We suggest that hypertonic saline will emerge as an alternative to mannitol, especially for a long-term use or multiple doses are needed and lead to a great opportunity for collaborative research.
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As interest and enthusiasm for the use of the endoscope in transsphenoidal anterior skull base and pituitary surgery increases, neurosurgeons are increasingly adopting endoscopic technology and associated novel concepts. Often this involves a transition from the standard operating microscope as the main means of visualization to the operating endoscope (2D or 3D) during surgery. ⋯ The endoscopic approach and its allied technology are here to stay. They are useful and occasionally preferable methods for treating a variety of suitable lesions involving the anterior skull base. The importance of incorporating the basic principles of skull base surgery is emphasized.
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We aim to evaluate the complications of spinal cord stimulation (SCS). ⋯ In spite of the existence of several complications, SCS may be seen as a safe technique. Furthermore, the incidence of life-threatening complications is low. The physician must be alert to recognize them during the follow-up. Complications may be avoided or at least diminished by performing a proper and strict aseptic surgical technique as well as carrying out an accurate patient selection before the implantation, according to the recommendations published in the literature.
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The current approach for the diagnosis and repair of spontaneous and traumatic anterior skull-base defects is oulined, highlighting the controversies that exist in the field and describing the strategies required to access different segments of the anterior cranial fossa. ⋯ Endoscopic endonasal repair of CSF leaks and encephaloceles has evolved significantly during the past decade. The versatility of different endoscopic approaches through the four endonasal corridors allows for the endoscopic repair of almost all skull-base defects. The use of vascularized pedicled mucosal flaps has evolved to cover these defects as part of multilayered closure strategies.