Transsphenoidal Surgery Microadenoma

Kampfe had the patient under general anesthesia to do this procedure. The patient T. M. is a 30-year-old male; he has mental retardation/special needs. The patient had to be in the right lateral recumbent (right-sided position) position; we transferred him to the OR table on his back (supine) first, while the CRNA could intubate him. The anesthesiologist stated that the patient had a short neck and big tongue, with a little mouth, and he said it was extremely hard to intubate him. The CRNA struggled and eventually got it, but said, if the patient wasn’t already missing the three teeth on his left upper mouth, he would’ve knocked them out while intubating him. The surgery went great as I stated a little about the procedure in the first paragraph. Dr. Kampfe cut the smaller side cyst and then did the bigger cyst next. After that was done he cauterized the areas to stop the bleeding and then did the skin

While observing the surgery, I learned that the surgeons possess a variety of techniques that can be applied in dealing with a range of otologic findings. One of the more prominent nuances required for implantation was changing the techniques to account

Chordomas of the skull base represent significant challenges due to their midline position and their ability to engulf critical neurovascular structures located around them. In addition to these location issues, their biology represents significant challenges, as notocordal rests located throughout the clivus, often remote from the visible lesion, have the propensity to grow and recur. Both of these features are critical for the skull base surgeon, the former in determining the surgical approach and trajectory and the latter in deciding on the surgical goals and intentions of treatment. For more than a decade, lateral and paramedian approaches have been traditionally the mainstay for surgical access and have provided valuable corridors. These have included transbasal (12), trans-septal trans-sphenoidal (13), transmaxillary (14), facial translocation, (15), transoral with or without mandible split (16), transcervical-transclival, and anterior cervical approaches. These anterior and lateral approaches toward a centrally located chordoma carry the potential morbidity of manipulating neurovascular structures in the way to lesion. The cited data report gross total resection rates that vary widely, ranging from 44 to 83%. The corresponding neurological morbidity rates are equally variable, ranging from 0 to 80%, and vascular injuries are reported at 9 to 12%. CSF leak rates are reported to range from 8.3 to 30% (17-19).

The efficacy of the decompressive craniectomy is a topic of debate in today’s healthcare setting. While initial studies showed no significance in the procedure’s ability to save lives when compared to conservative treatment, more recent studies that take into account time after onset of injury and age of patient make a strong case for the necessity of the craniectomy. As research continues to develop, the decompressive craniectomy continues to gain more support as the gold standard treatment for a sudden, uncontrolled increase in intracranial pressure.

It is really a great success to procedure this operation and an attempt to save a man face again to return his hope. And this prove that the science is always in permanent develop.

From a surgical point of view rather than a classroom setting, it was interesting to observe the anatomical structures we learned about in class. More specifically, before insertion of the electrode, an incision was created behind the mastoid to accommodate the receiver portion of the internal device of the cochlear implant. The mastoid was exposed during surgery and the anatomy of the middle ear space and the round window could be visualized. More importantly, any misinterpretation of the anatomy could lead to damage of the Chorda Tympani (facial nerve) and possibly incorrect insertion of the electrode. After

There was additionally no correlation with location of metastases and complication rate or readmission within 3 months (p=0.643 and p=0.105) (Table 9 and 10).

Treatment depends on the number of cysts and the symptoms you have. In some cases, no treatment is needed. When only one cyst is found, treatment is often not given.

The success of speech therapy intervention is dependent on successful surgical correction. The authors note that postsurgical complications may include stiffness due to scar tissue decreasing the flexibility of the velum, tethering of the velum, weakness of the velum, and shrinking of the velar tissues. The authors also note the risk of malocclusion as the child grows and the palate continues to grow and develop.

Endolymphatic sac surgery involves decompression of the sac and draining the endolymph. The decompression occurs while maintaining the vestibular neuroepithelium and its innervation.3 Endolymphatic sac decompression is performed by making an incision behind the affected ear and exposing the mastoid bone.4 The bone over the endolymphatic sac is exposed and sac is opened once identified.4 The procedure decreases the buildup of endolymphatic pressure by removing the petrous bone that encases the

In this case, the surgical aim was for 2cm margins. Adequate margins were achieved except for a medial margin of 5.9mm. Final histology confirmed DFSP. Further discussion in multidisciplinary team and with the patient came to a decision to continue with close observation alone, rather than re-excision. This is predicated on the slow growth pattern of DFSP and its tendency to metastasize only very rarely.

A hemispherectomy is a daunting medical procedure. It involves removing or disconnecting an entire half of someone’s brain. With a surgery as delicate as this, extreme conditions must be met before someone is considered a candidate. Being a candidate means that you have one or more of the following: progressive handicapping as a result of seizures not being able to be controlled by drugs, a lesion in one of the hemispheres of the brain, children with tuberous sclerosis, or damage in one hemisphere as a result of bacterial or viral infections, trauma, or tumors. Pediatric stroke, Rasmussen’s Encephalitis, and Sturge-Weber Syndrome are some of the common neurological disorders that can lead to requiring a hemispherectomy. Children receiving a hemispherectomy tend to benefit the most, as the functions of the removed hemisphere are maintained by the other hemisphere early on.

These tympanic membrane perforations can be repaired surgically use Temporalis fascia, perichondrium and cartilage are the most common grafts which requires a general anesthesia which is often protracted and/or hypotensive, and which can represent an unacceptable risk in older patients. (4)

PATIENTS AND METHODS: We reviewed 30 consecutive patients during the period from January 2014 to January 2016 with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients’ clinical outcomes, degrees of tumor removal, and complications were reported.

     If treatment of a cancer is to be successful, the diagnosis must be as early as possible. Though no tests have