Publications by authors named "Erasmo Barros da Silva"

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis.

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Purpose: Glioblastoma is a malignant and aggressive brain tumour that, although there have been improvements in the first line treatment, there is still no consensus regarding the best standard of care (SOC) upon its inevitable recurrence. There are novel adjuvant therapies that aim to improve local disease control. Nowadays, the association of intraoperative photodynamic therapy (PDT) immediately after a 5-aminolevulinic acid (5-ALA) fluorescence-guided resection (FGR) in malignant gliomas surgery has emerged as a potential and feasible strategy to increase the extent of safe resection and destroy residual tumour in the surgical cavity borders, respectively.

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Purpose: 5-aminolevulinic acid (5-ALA) fluorescence-guided resection (FGR) has been an essential tool in the 'standard of care' of malignant gliomas. Over the last two decades, its indications have been extended to other neoplasms, such as metastases and meningiomas. However, its availability and cost-benefit still pose a challenge for widespread use.

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Objective: The objective was to evaluate whether the position of the nerves within the internal auditory canal (IAC) has any effect on preoperative and postoperative cochlear and facial nerve function in patients with intracanalicular vestibular schwannoma (VS) resected through the retrosigmoid transmeatal approach.

Methods: Forty-four patients with sporadic intracanalicular VS, from a series of 710 patients with VS who underwent operations from January 1993 to April 2022, were retrospectively reviewed. The pattern of displacement of the cranial nerves and tumor within the IAC was recorded.

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Fluorescence-guided surgery with 5-aminolevulinic acid (5-ALA) is used to assist brain tumor resection, especially for high-grade gliomas but also for low-grade gliomas, metastasis, and meningiomas. With the increasing use of this technique, even to assist biopsies, high-grade glioma-mimicking lesions had misled diagnosis by showing 5-ALA fluorescence in non-neoplastic lesions such as radiation necrosis and inflammatory or infectious disease. Since only isolated reports have been published, we systematically review papers reporting non-neoplastic lesion cases with 5-ALA according with the PRISMA guidelines, present our series, and discuss its pathophysiology.

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Background: Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty.

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 Vestibular schwannomas are the most common lesions occupying the internal auditory canal (IAC); however, almost in 4 to 5% of meningiomas, metastases, cysts, lipomas, and cavernous malformations have been found in this location, mimicking schwannomas. Even though cerebellopontine angle (CPA) meningiomas with the involvement of the IAC are frequently encountered, the presence of a primary intracanalicular meningioma is rare.  To show the technical nuances of the retrosigmoid-transmeatal approach to successfully achieve gross total resection (GTR) with preservation of facial and auditory function.

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Background: According to our research, just few studies described 5-Aminolevulinic acid (5-ALA) use for spinal injuries resection. 5-ALA is known to be especially useful in certain spinal tumor entities such as meningiomas, ependymomas, hemangiopericytomas, and metastasis of central nervous system primary tumors. In contrast, 5-ALA has limited value in other histopathological tumoral entities, as neurinomas and carcinoma metastasis.

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Objective: Evaluate the feasibility of an adequate exposure with anatomical preservation of labyrinth structures through retrosigmoid transmeatal approach (RSA) in surgeries for resection of acoustic neuromas/vestibular schwannomas (VS).

Method: Thirty patients underwent surgical resection and were preoperatively evaluated with fine slice high definition CT scans and 3D-MRI volumetric reconstructions. Extension of internal auditory canal (IAC) opening during surgery was measured using 3 mm right-angle calibrated hook and neuronavigation parameters.

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Objective: The suboccipital lateral or retrosigmoid approach is the main neurosurgical approach to the cerebellopontine angle (CPA). It is mainly used in the treatment of CPA tumors and vascular decompression of cranial nerves. A prospective study using navigation registered with anatomical landmarks in order to identify the transverse and sigmoid sinuses junction (TSSJ) was carried out in a series of 30 retrosigmoid craniotomies.

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