Endoscope-Assisted Middle Fossa Approach: Optimizing the Surgical Corridor for the Resection of Multicompartmental Chordomas.

 Skull base chordomas are a major therapeutic challenge. The surgical management involves selecting an approach that will offer the patient the best chance of largest/complete removal while minimizing morbidity and mortality.  Medical records and imaging review of two skull base chordomas involving the middle fossa and posterior fossa that were successfully treated with an endoscope-assisted middle fossa approach.

A Primary Clival Defect: Endoscopic Binostril Approach With Nasal Septal Flap Closure and Preservation of Septal Integrity.

Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea is an unusual phenomenon that may occur anywhere along the skull base. However, CSF leaks originating from clival defects are rarely reported in the literature. The majority of reported cases were managed with microscopic techniques, using free grafts.

Zika Virus Infection in Pregnant Women and Microcephaly.

From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damage to the central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection's devastating process on the central nervous system of embryos and fetuses.

Management of infection by the Zika virus.

A panel of national experts was convened by the Brazilian Infectious Diseases Society in order to organize the national recommendations for the management of zika virus infection. The focus of this document is the diagnosis, both clinical and laboratorial, and appropriate treatment of the diverse manifestations of this infection, ranging from acute mild disease to Guillain-Barré syndrome and also microcephaly and congenital malformations.

Endoscopic endonasal management of cerebrospinal fluid rhinorrhea after anterior clinoidectomy for aneurysm surgery: changing the paradigm of complication management.

Resection of the anterior clinoid process results in the creation of the clinoid space, an important surgical step in the exposure and clipping of clinoidal and supraclinoidal internal carotid artery aneurysms. Cerebrospinal fluid rhinorrhea is an undesired and potentially serious complication. Conservative measures may be unsuccesful, and there is no consensus on the most appropriate surgical treatment.

Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study).

Objective: The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil.

Methods: Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy.

Endoscopic sinus surgery dissection courses using a real simulator: the benefits of this training.

Introduction: Endonasal surgeries are among the most common procedures performed in otolaryngology. Due to difficulty in cadaver acquisition and the intrinsic risks of training residents during operations on real patients, nasosinusal endoscopic dissection courses utilizing real simulators, such as the Sinus Model Otorhino Neuro Trainer are being developed as a new technique to facilitate the acquisition of better anatomical knowledge and surgical skill.

Objective: To evaluate the efficacy of nasosinusal endoscopic dissection courses with the Sinus Model Otorhino Neuro Trainer simulator in the training of otolaryngology surgeons.

Chemical and cytological analysis of cerebral spinal fluid after intrathecal injection of hypodense fluorescein.

Introduction: Intrathecal fluorescein has been effective for topographic diagnosis of rhinoliquorrhea. Nonetheless, there are no reports on the study of cerebral spinal fluid (CSF) after use of intrathecal fluorescein.

Objective: A prospective study attempting to evaluate CSF through chemical and cytological analysis, after injection of fluorescein.

Is the information available on the Web influencing the way parents see ENT surgical procedures?

Introduction And Aims: the Internet is the world's fastest growing source of health related information. Parents and guardians are increasingly turning to the Internet for information about their children's medical conditions and treatments. This paper has the following objectives 1) determine the prevalence of web searches for medical information performed by parents/guardians of children undergoing ENT surgery in a private hospital of Sao Paulo, Brazil.

Feasibility of balloon dilatation in endoscopic sinus surgery simulator.

Objective: Assess the feasibility of the use of a life-size model for ESS to perform balloon catheter dilatation of the paranasal sinus ostia.

Study Design And Setting: Four validated sinus models were enrolled in this study. One experienced endoscopic surgeon performed all the dilatations of the paranasal sinus ostia.

Novel compact laptop-based image-guidance system: preliminary study.

Objectives: To describe a novel portable laptop-based image-guidance system and its preliminary navigational results.

Methods: An optic-based, specially developed navigational system and a life-size endoscopic sinus anatomic model were used. The model was submitted to computer tomography (CT), and predefined anatomic landmarks were used to test the image-guidance accuracy according to the real model.

Primary mucinous adenocarcinoma of the bladder with signet-ring cells: case report.

Context: Primary adenocarcinomas of the bladder are uncommon and usually occur by contiguity with or hematogenic dissemination of other adenocarcinomas such as colorectal, prostate and gynecological tract carcinomas. Mucinous and signet-ring cell histological patterns are even rarer and it is often difficult to morphologically distinguish them from metastatic colorectal adenocarcinoma.

Case Report: We present and discuss a rare case of primary mucinous adenocarcinoma of the bladder with signet-ring cells in a 57-year-old male patient.

Quantitative and qualitative analysis of collagen types in the fascia transversalis of inguinal hernia patients.

Background: Inguinal hernia is the second most common surgical case in our field. The anatomical factors alone are not enough to explain the inguinal hernia. Studies show changes in the proportion and quantity of collagen fibers in the developing of inguinal hernia.

[Giant intracranial aneurysm in three years old boy: case report].

Cerebral aneurysms are rare in the pediatric age group and differ from adults' aneurysms in size, localization and incidence. We report a 3-year-old boy with giant middle cerebral artery aneurysms who presented with subarachnoid hemorrhage. The patient was submitted to surgical treatment and the postoperative period was uneventful.

[Anterior and lateral foramen magnum meningiomas].

We report our experience with 11 cases of foramen magnum meningiomas, eight originating inside the posterior fossa and three in the caudal region. The mean age of the patients was 50.8 years and the main complaint was cervical headache for at least 18.

Transnasal endoscopic surgical approaches to the clivus.

Transnasal endoscopic-assisted techniques to the clivus region can be safe and effective. Endoscopic-assisted approaches provide improved visualization and are a superior alternative to open surgical approaches in most cases. Nevertheless, problems such as infection, CSF leakage, and difficulty controlling intradural bleeding still remain.

[Posterior longitudinal ligament ossification: case report].

Posterior longitudinal ligament ossification of cervical spine is a rare condition among caucasians. A 42 years old japanese patient with progressive walking difficulty was diagnosed with this pathology by CT scan and MRI and treated surgically by an anterior approach with arthrodesis. Pathophysiology, racial prevalence, clinical picture, radiological characteristics and surgical approaches options are revised.

[Olfactory groove meningioma].

Olfactory groove meningiomas compromise approximately 8-18% of intracranial meningiomas and harbor frequently large sizes when diagnosticated. We report 13 consecutive cases operated on Hospital São Paulo and Hospital Professor Edmundo Vasconcelos between 1995 and 2003. These patients were retrospectively studied regarding clinical preservation, surgical results and complications.

[Size and proliferative index correlation in acoustic neuromas].

Acoustic neuromas are the most common tumors in the cerebellopontine angle. The molecular mechanisms involved in generation and growth of these tumors are not completely elucidated. Many radiological, clinic and immunohistochemistry data were correlated to tumor growth.