Endoscopic assisted microneurosurgery for gasserian portion of trigeminal neuroma: two cases

Faleiro, Luiz Carlos Mendes; Faleiro, Rodrigo Moreira; Barroso, Luiz Fernando Vilar; Gripp, Daniel Andrade

doi:10.1590/s0004-282x2006000400025

Cited by 8 publications

(7 citation statements)

References 9 publications

(23 reference statements)

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“…The deep location and the surrounding neurovascular structures make accessing the Meckel cave challenging. 2,11,13,15 The possibility of damaging surrounding tissue is high, and attempts to operate in the Meckel cave have been associated with cranial nerve morbidity. 18,19 Consequently, an approach to surgery was required that allowed adequate visualization and a sufficiently open corridor to perform tumor resection.…”

Section: Discussionmentioning

confidence: 99%

“…With the improvement in endoscopic technology, endoscopic-assisted surgery has been utilized with a reasonable degree of success. 11 This has allowed increased visualization and limited unintended disruption of sensitive tissue. The endonasal endoscopic approach has evolved to become an innovative method of accessing the entire ventral skull base.…”

Section: Discussionmentioning

confidence: 99%

“…These endoscopic-assisted procedures are able to maintain oncologic principles and minimize neurovascular damage. 10,11 However, brain manipulation is still required in some cases to access the tumor.…”

Section: Introductionmentioning

confidence: 99%

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What is the Best Route to the Meckel Cave? Anatomical Comparison between the Endoscopic Endonasal Approach and a Lateral Approach

et al. 2013

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Background?Traditionally, a pterional approach is utilized to access the Meckel cave. Depending on the tumor location, extradural dissection of the Gasserian ganglion can be performed. An endoscopic endonasal access could potentially avoid a craniotomy in these cases. Methods?We performed an endoscopic endonasal approach as well as a lateral approach to the Meckel cave on six anatomic specimens. To access the Meckel cave endoscopically, a complete sphenoethmoidectomy and maxillary antrostomy followed by a transpterygoid approach was performed. For lateral access, a pterional craniotomy with extradural dissection was performed. Results?The endoscopic endonasal approach allowed adequate access to the Gasserian ganglion. All the relevant anatomy was identified without difficulty. Both approaches allowed for a similar exposure, but the endonasal approach avoided brain retraction and improved anteromedial exposure of the Gasserian ganglion. The lateral approach provided improved access posterolaterally and to the superior portion. Conclusion?The endoscopic endonasal approach to the Meckel cave is anatomically feasible. The morbidity associated with brain retraction from the open approaches can be avoided. Further understanding of the endoscopic anatomy within this region can facilitate continued advancement in endoscopic endonasal surgery and improvement in the safety and efficacy of these procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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What is the Best Route to the Meckel Cave? Anatomical Comparison between the Endoscopic Endonasal Approach and a Lateral Approach

et al. 2013

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“…The use of endoscopy in order to minimize the dimensions of a given approach is not usual, but it is usual to assist in the identification of anatomical structures. Very small ports are adequate when a microscope is substituted from a standard endoscope (6,7). Furthermore, the use of the endoscope minimizes the retraction of structures and widens the lateral angle of vision.…”

Section: Discussionmentioning

confidence: 99%

Middle cranial fossa endoscopy using a rigid endoscope

Mourgela

Sakellaropoulos²,

Anagnostopoulou

2007

Minimally Invasive Therapy & Allied Technologies

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Trigeminal neuralgia (TN), also known as tic douloureaux, is a craniofacial pain disorder which is typically associated with acute-onset severe pain on one side of the face usually. The condition is characterized by intermittent unilateral pain affecting the lower face and jaw. Although many potential causes have been implicated, in many patients the etiology remains obscure. Initially, patients with trigeminal neuralgia should be offered conservative medical management. If surgery is necessary, the simplest and least hazardous procedure should be chosen. The goals of modern surgical therapy are: Long-term pain control, minimal to no morbidity, and as low a mortality risk as possible. In this study, we attempted to perform middle cranial fossa endoscopic exploration in four adult phenol-formalin embalmed cadavers, using a rigid endoscope with 3.8 mm external diameter and two working channels of 1 mm in diameter each (Karl Storz, Tuttlingen, Germany), inserted through a burr-hole centered at the base of the middle cranial fossa, 1 cm in front and 1 cm upwards of the tragus. Our objective was to determine if this approach provides adequate access to the trigeminal ganglion for possible dissection of V2 and V3 trigeminal roots, the two typically radiating sites of TN. In all four cadavers, middle cranial fossa exploration was possible without difficulties. We offer this approach as a minimally invasive surgical procedure to access the trigeminal ganglion, for potential use as another alternative for the surgical management of medically refractory trigeminal neuralgia.

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“…Alternatives to the common 115V three-phase grid are a 230V three-phase supply [3], high voltage DC bus (350V DC [1], 540V DC [2]) or a DC-bus with central energy storage for regenerative loads [4]. Another possible topology divides the whole network into subnets with active power filter maintaining power quality at the connection to the main bus [5].…”

Section: Introductionmentioning

confidence: 99%

Design and implementation of control algorithm for an active power filter in aviation

Liebig

Engstler

Engler

2012

2012 15th International Power Electronics and Motion Control Conference (EPE/PEMC)

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Over the past years, the number of electrical systems in airplanes, and thus their power ratings have been rising. Therefore, the optimization of devices and actuators regarding efficiency and power density has become increasingly important. Besides the large topic of weight reduction at component level, aircraft manufacturers and several research projects have focused on the topology of the entire electrical grid. One possible topology may divide the whole network into subnets and an active power filter maintains the power quality at the connection to the main bus. This solution allows the use of simple diode bridge rectifiers in all power electronic devices within the subnet, which results in increased reliability, power density and reduced costs. Since most of the actuators e.g. in a wing are not driven permanently and not simultaneously, the power rating of this active power filter is significantly smaller than the power rating of the entire subnet. This paper presents the control algorithm for an active power filter for aerospace application, which requires robust behaviour towards frequency transients and high compensation accuracy in steady state operation.

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Endoscopic assisted microneurosurgery for gasserian portion of trigeminal neuroma: two cases

Cited by 8 publications

References 9 publications

What is the Best Route to the Meckel Cave? Anatomical Comparison between the Endoscopic Endonasal Approach and a Lateral Approach

What is the Best Route to the Meckel Cave? Anatomical Comparison between the Endoscopic Endonasal Approach and a Lateral Approach

Middle cranial fossa endoscopy using a rigid endoscope

Design and implementation of control algorithm for an active power filter in aviation

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