Object: The authors present their experience in the surgical treatment of metopic synostosis by orbital bandeau remodeling and frontal bone rotation. The pitfalls and advantages of the surgical technique are discussed, along with the long-term clinical results in 48 consecutive cases.
Methods: Forty-eight consecutive patients in whom trigonocephaly was diagnosed between 1990 and 2009 were treated with frontal bone rotation and frontoorbital bandeau remodeling. Of these patients, 38 (79%) were boys and 10 (21%) were girls. The age at the time of surgical treatment ranged between 4 and 42 months (mean ± SD 11.4 ± 8.7 months). The average follow-up period was 5.5 ± 4.2 years (range 5 months-19 years). The preoperative and latest postoperative photographs of the patients were evaluated for the following features: 1) shape of the forehead; 2) hypotelorism; and 3) temporal depression. Scores of 0, 1, or 2 were assigned for each item: 0 was normal, 1 meant moderate deformity, and 2 denoted severe deformity.
Results: In the early postoperative period, no complications were documented. The average hospitalization period was 4 days. Follow-up radiographs or 3D CT scans were obtained at regular intervals. The mean preoperative scores for the evaluated items were 1.38 ± 0.49 for the shape of the forehead, 1.33 ± 0.48 for hypotelorism, and 1.7 ± 0.46 for the temporal depression. The mean postoperative scores were 0.06 ± 0.24 for the shape of the forehead, 0.21 ± 0.4 for hypotelorism, and 0.67 ± 0.48 for the temporal depression. Overall, the total preoperative score dropped from 4.4 to 0.93 postoperatively (p < 0.05). All the patients were contented with the cosmetic results.
Conclusions: Early detection and treatment of metopic suture synostosis has a significant, favorable influence on the outcomes. Good understanding of the structural abnormality and the pathophysiological mechanisms of the possible complications is very important for performing proper surgical reconstruction.
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http://dx.doi.org/10.3171/2010.12.PEDS10359 | DOI Listing |
J Neurosurg Spine
January 2025
2Department of Neurosurgery, University of Alabama at Birmingham, Alabama.
Objective: The aim of this study was to evaluate the association of neighborhood-level and individual-level measures of socioeconomic status with readmission, complication rates, and postoperative length of stay of patients with cervical spondylotic myelopathy (CSM) in the Deep South.
Methods: The authors identified all patients undergoing surgical intervention for the treatment of CSM from November 2010 to February 2022 using Current Procedural Terminology and ICD-9/ICD-10 codes. Patient demographic, socioeconomic, perioperative, and postoperative data for each patient were collected via review of the electronic medical record.
J Neurosurg Pediatr
January 2025
2Neurology, UT Southwestern, Dallas, Texas.
Objective: Patients with drug-resistant epilepsy (DRE) are often referred for phase II evaluation with stereo-electroencephalography (SEEG) to identify a seizure onset zone for guiding definitive treatment. For patients without a focal seizure onset zone, neuromodulation targeting the thalamic nuclei-specifically the centromedian nucleus, anterior nucleus of the thalamus, and pulvinar nucleus-may be considered. Currently, thalamic nuclei selection is based mainly on the location of seizure onset, without a detailed evaluation of their network involvement.
View Article and Find Full Text PDFJ Neurosurg Spine
January 2025
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
Objective: Mixed-reality (MR) applications provide opportunities for technical rehearsal, education, and estimation of surgical performance without the risk of patient harm. In this study, the authors provide a structured literature review on the current state of MR applications and their effects on neurosurgery training. They also introduce an MR prototype for neurosurgical spine training.
View Article and Find Full Text PDFUrogynecology (Phila)
October 2024
Aava Medical Center, Hämeenlinna, Finland.
Importance: Although surgery for pelvic organ prolapse (POP) is generally associated with an improvement in sexual function, knowledge on specific changes is limited.
Objectives: The aim of this study was to describe and compare changes in sexual activity and function during a 5-year follow-up period after POP surgery.
Study Design: This was a nationwide cohort study of 3,515 women operated on for POP in 2015 in Finland.
Urogynecology (Phila)
October 2024
Atrium Wake Forest Baptist Health, Winston-Salem, NC.
Importance: Limited data exist comparing total laparoscopic hysterectomy (TLH) versus laparoscopic supracervical hysterectomy (LSCH) at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse.
Objectives: The objective of this study was to compare TLH versus LSCH at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse, hypothesizing that LSCH would demonstrate a higher proportion of recurrent prolapse, but a lower proportion of mesh exposures.
Study Design: This was a retrospective, secondary analysis comparing a prospective cohort of patients undergoing TLH sacrocolpopexy versus a retrospective cohort of patients who had undergone LSCH sacrocolpopexy.
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