Search results for "skull base"

Neural conservation in skull base surgery

2002

Surgical treatment of lesions of the skull base carries significant risk to the functioning of the cerebral hemispheres, brainstem, and cranial nerves. This risk is due to both (1) problems associated with maintaining an adequate blood flow while exposing and removing the tumor and (2) direct or indirect trauma to the brain, perineural tissues, and cranial nerves. These risks may be reduced if information about possible implications of surgical maneuvers on the cerebral blood flow and on the function of the patient’s CNS and cranial nerves is available and can be monitored during surgery of the skull base. The use of EMG neuromonitoring for the facial nerve and of brainstem evoked response …

Modifications of a nerve integrity monitor useful in skull base surgery.

1993

Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling

2019

Facial nerve damage has a detrimental effect on a patient's life, therefore safety mechanisms to ensure its preservation are essential during lateral skull base surgery. During robotic cochlear implantation a trajectory passing the facial nerve at <0.5 mm is needed. Recently a stimulation probe and nerve monitoring approach were developed and introduced clinically, however for patient safety no trajectory was drilled closer than 0.4 mm. Here we assess the performance of the nerve monitoring system at closer distances. In a sheep model eight trajectories were drilled to test the setup followed by 12 trajectories during which the ENT surgeon relied solely on the nerve monitoring system and…

The craniovertebral junction in rheumatoid arthritis: State of the art

2019

Rheumatoid arthritis (RA) is a chronic inflammatory disorder, characterized by polyarticular inflammation causing progressive joint damage and disability. The mechanisms underlying its pathogenesis involve activation of innate and adaptive immunity, microvascular endothelial cell activation, and inflammatory infiltration of lymphocytes and monocytes into the synovium. Spinal involvement in RA is not typical; when it occurs, the main radiological features are (1) atlantoaxial subluxation (AAS), which is the most typical form of cervical spine involvement; (2) cranial settling—also known as basilar impression, atlantoaxial impaction or superior migration of the odontoid—which is the most seve…