BACKGROUND: Meningiomas are the type of central nervous system tumours, derived from the cells of the arachnoid membrane that are well constrained from surrounding tissues, mainly no infiltrating neoplasm with benign features. Meningiomas consist about 15-20% of all primary intracranial neoplasms. AIM: The evaluation of the outcome of the operatively treated meningiomas in relation with the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion METHODS: In this article 40 operatively treated patients are reviewed for the outcome of the operation about the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion. RESULTS: Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been established. CONCLUSION: Gender, age and Karnofsky performance score have predictive value in the treatment of different types of meningiomas. The magnitude of surgical resection is associated with the regrowth of a tumour. The mitotic count in different types of meningiomas presents significant feature in the appearance of meningioma recurrence. The surgical resection and the quality and quantity of patient’s survival have a significant relation to the mitotic count of the meningiomas. There is no connection between the size and the localisation of a tumour related to different values of the mitotic count.
BACKGROUND:Premature fusion of the metopic suture results in a type of craniosynostosis known as trigonocephaly. The treatment of trigonocephaly is surgical and is likely to remain so. Surgical methods and techniques for correction of craniosynostosis-related skull deformities have evolved, and a single best procedure is yet to be presented.CASE REPORT:Here we present a technical remark in a case of open cranial vault reconstruction.CONCLUSION:Although the literature, in general, prefers barrel stave (radial) frontal bone osteotomies, a technique with longitudinal frontal bone osteotomies were performed, without fixation of the bony flaps, frontal bone or supraorbital arch, with a quite satisfactory result.
BACKGROUND: Neurophthalmologic examination is part of the baseline evaluation of patients with pituitary lesions. The neuro-ophthalmologist quantifies and evaluates the impact that the sellar lesion has on afferent and efferent visual pathways, contributes to the determination of tumor growth dynamics, and monitors the success and possible complications. In cases of vision loss, blurring, damage, or double vision as symptoms of a clinical presentation, the neuro-ophthalmologist is often the first to recognize and define the pituitary lesion. AIM: The aims of this study are as follows: First, to determine the comparative difference and value of the axis/width of the field of vision in the comparable resection technologies, i.e. fully endoscopic and microscopic/microscopic-assisted hypophysectomy; and second, the extend of resection in both technologies compared with post-operative outcome analysis. METHODS: The study was designed as a retrospective-prospective clinical trial in the period of 2011–2017. This study enrolled 85 patients, 46 of whom were treated with a microscopic resection, and 39 patients treated only with endoscopic transsphenoidal resection of pituitary adenomas as the subject of this study. RESULTS: The results of our analysis showed that the achievement of complete, radical, and subtotal resection is significantly higher in the endoscopic technique compared to the microscopic technique. Essentially, better lighting, better viewing angle with no “blind spots,” and a perfected toolkit of instruments are the objective factors for progress. CONCLUSION: The results of our study, comparing the endoscopic version of the microscopic transnasal, transsphenoidal resection of pituitary adenomas, during the period 2010–2018, have unequivocally shown that the endoscopic transnasal transsphenoidal procedure is rational, effective, efficient, and above all safe technique, with a number of favorable advantages that allow for a higher degree of surgical radicality.
BACKGROUND: The transnasal transsphenoidal endoscopic approach to the sella turcica is an overwhelming alternative to the microscopic approach for the past few decades assuming into prominence as a new technique, reaching nearly gold standard for this pathology. The endoscopic approach to the pituitary has redefined accurate visualization of the sella. The panoramic view afforded by the endoscope is unparalleled as compared with the traditional conical view of the microscope. AIMS: This study aims to compare both endoscopic and microscopic technologies, including advantages and disadvantages through the results of endocrine outcome. SETTINGS AND DESIGN: Our retrospective/prospective study included 46 microscopically and 39 endoscopically treated patients during the period of 2010–2018. Tumors were classified according to the diameter and clinical outcomes were evaluated. RESULTS: Our retrospective/prospective study included 46 microscopically and 39 endoscopically treated patients during the period of 2010–2018. Tumors were classified according to the diameter, hormone activity and clinical outcomes were evaluated. Comparison results revealed more efficacious and effective endocrine control and reestablishing the endocrine homeostasis utilizing the endoscopic technique, especially in secretory active macroadenomas. Further, the extension of the resection, which was better in endoscopic approach undouptedly contributed to better endocrine control of the disease. Complication rate, including endocrine, was lower following endoscopy compared with microsurgery. CONCLUSION: This technique evidenced to have a statistically significant reduction in operative time and length of hospital stay, as well as more radical safe resection and complication control. There is also a trend toward improved endocrine outcomes and rate of return of visual defects. These two approaches are still comparable with eloquent advantages and disadvantages, formulated as balanced dialectics. In addition, the use of endoscopes, including multilocular polifilament 3D endoscope, facilitates extended approaches, reaching a delicate skull base lesions that are suprasellar, retrosellar, and parasellar, which permits visualization beyond the abilities of the microscope.
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