Feasibility and accuracy of a voxel-based neuronavigation system with 3D image rendering in preoperative planning and as a learning tool for young neurosurgeons, exemplified by the anatomical localization of the superior sagittal sinus.

It is essential for a neurosurgeon to know individual anatomy and the corresponding anatomical landmarks before starting a surgery. Continuous training, especially of young neurosurgeons, is crucial for understanding complex neuroanatomy. In this study, we used a neuronavigation system with 3D volumetric image rendering to determine the anatomical relationship between the sagittal suture and the superior sagittal sinus (SSS) in patients with intracranial lesions.

Endoscopic approach-routes in the posterior fossa cisterns through the retrosigmoid keyhole craniotomy: an anatomical study.

Endoscopy in cerebellopontine angle surgery is an increasingly used technique. Despite of its advantages, the shortcomings arising from the complex anatomy of the posterior fossa are still preventing its widespread use. To overcome these drawbacks, the goal of this study was to define the anatomy of different endoscopic approaches through the retrosigmoid craniotomy and their limitations by surgical windows.

Supraorbital Keyhole Approach to the Skull Base: Evaluation of Complications Related to CSF Fistulas and Opened Frontal Sinus.

Aim: Cerebrospinal fluid (CSF) rhinorrhea due to a breach in the frontal sinus (FS) presents one of the main postoperative complications of the supraorbital keyhole approach. The goal of this study was to further analyze the actual surgical morbidity and potential risk for patients due to an opened FS after a surgery via a supraorbital craniotomy and compare the results with data published in the current literature.

Methods And Patients: A total of 350 consecutive patients who underwent surgeries via the supraorbital keyhole approach for various lesions were included in this retrospective study.

Endoscopic surgery for tumors of the pineal region via a paramedian infratentorial supracerebellar keyhole approach (PISKA).

The tumors of the pineal region represent a significant challenge in terms of patient selection and surgical approach. Traditional surgical options were commonly used to approach this area causing considerable surgical morbidity and mortality. We report for the first time on a series of endoscopic procedures for lesions of the pineal region performed via an infratentorial supracerebellar keyhole approach (PISKA) in the prone position using endoscope-assisted and endoscope-controlled technique.

Evaluation of a 3-dimensional voxel-based neuronavigation system with perspective image rendering for keyhole approaches to the skull base: an anatomical study.

Background: Keeping track of the endoscope tip in 3 planes (axial, coronal, and sagittal) while performing skull base surgeries can be difficult because the surgeon is focused most on the live video images of the endoscope. For that reason, it was the aim of this anatomical cadaver study to evaluate the usefulness of a voxel-based neuronavigation system with 3-dimensional (3D) perspective image rendering for endoscopic procedures through keyhole approaches to the skull base.

Methods: On 5 whole-body fixed cadavers, frontolateral and retrosigmoid approaches were performed bilaterally using a neuronavigation system with 3D perspective image rendering (Cbyon, Med-Surgical Services Inc.

Differential effects of the tumor necrosis factor alpha-blocker infliximab and etanercept on immunocompetent cells in vitro.

The tumor necrosis factor-alpha (TNFα) antagonists infliximab or etanercept are used in the management of chronic inflammatory disorders but have differences in clinical activity. Here we show that both have different effects on immunocompetent cells in vitro. Peripheral blood mononuclear cells (PBMC) from 20 healthy donors were incubated with infliximab or etanercept alone and in a co-culture with recall-antigens (BCG, tetanus toxoid [TT]).