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Massimo A. Giovanelli, Enrico D. F. Motti, Alessandra Paracchi, Paolo Beck-Peccoz, Bruno Ambrosi, and Giovanni Faglia

V arious procedures both physical and surgical have been used in the treatment of acromegaly, and results are mixed. 1–3, 10, 14, 20, 21, 23, 25–28, 31, 37, 39, 43, 44, 47 The goal of the treatment is to lower plasma growth hormone to normal levels without affecting normal pituitary function, and for this transsphenoidal microsurgery represents a promising approach. 16, 18, 19 We are reporting our results in a series of 29 consecutive acromegalic patients operated on with this technique. Materials and Methods Clinical Material Twenty-nine patients

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Effectiveness of microsurgery for intracranial aneurysms

Postoperative angiographic study of 50 cases

Sidney A. Hollin and Robert E. Decker

the neck but not the fundus filled. Drake and Allcock, 4 reviewing their results in 340 postoperative angiograms, reported a 14% incidence of inadequate obliteration of the aneurysm following clip or ligature. Sato and Suzuki 12 reported that only 4% of a series of 262 aneurysms were incompletely occluded. Recently, there has been a significant increase in the use of microsurgery for intracranial aneurysms. Reports confirm that the high degree of illumination and magnification obtained by the surgical microscope has improved the postoperative mortality and

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Petter Förander, Tiit Rähn, Lars Kihlström, Elfar Ulfarsson, and Tiit Mathiesen

accelerators, 10 charged-particle irradiation, 2,5,6,29,34,35 or GKS 18,22,26,28 has been used as a complement to resection. Good results have been reported for all of these treatments, but the long-term follow-up studies that are required for these slow-growing tumors have been scarce. In this article we report our 20-year experience with combined microsurgery and GKS for the treatment of intracranial chondrosarcomas. Clinical Material and Methods Patient Population Between 1987 and 2004 nine patients, four women and five men, with intracranial chondrosarcomas were

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Garnette R. Sutherland, Sanju Lama, Liu Shi Gan, Stefan Wolfsberger, and Kourosh Zareinia

surgical integration. NeuroArm has not yet been used to obtain a biopsy specimen within the aperture of the magnet. All of the initial 35 cases were microsurgery. The current size of neuroArm allows for only one manipulator to be inserted into the magnet. While surgery is possible with only one manipulator, performance is improved with two. The next generation of neuroArm, neuroArm II, is already in development. The manipulators will be 25% smaller than neuroArm I, which will allow both manipulators to fit into the magnet aperture. The smaller manipulators will also be

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Thana Theofanis, Nohra Chalouhi, Richard Dalyai, Robert M. Starke, Pascal Jabbour, Robert H. Rosenwasser, and Stavropoula Tjoumakaris

physician on the neurosurgical team both preoperatively and each postoperative day until discharge from the hospital. Neurological outcomes are stratified according to the modified Rankin Scale (mRS) score, which was determined based on documented clinical findings upon arrival at the hospital and at the time of hospital discharge. Surgical Techniques For each patient, the process of selecting the best therapy included case review and treatment by a doctor trained in microsurgery, endovascular therapy, and radio-surgery. A treatment decision was reached based on

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A decade of pituitary microsurgery

The Herbert Olivecrona Lecture

Charles B. Wilson

and surgical microscopic technique are essential. Using transsphenoidal microsurgery, we have attained Olivecrona's prediction, successfully removing small tumors while preserving pituitary function and subjecting the patient to a very low risk. During the past 12 years (June, 1970, through September, 1982), I have removed 1000 pituitary adenomas using the transsphenoidal technique described by Hardy. 37 More than 75% of these tumors were endocrine-active, and of these, prolactin (PRL)-secreting adenomas were the most frequent; endocrine-inactive tumors accounted

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Jean Régis, William Pellet, Christine Delsanti, Henry Dufour, Pierre Hughes Roche, Jean Marc Thomassin, Michel Zanaret, and Jean Claude Peragut

D espite great advances in microsurgery, morbidity remains an issue after resection for VS. The tumors are now detected much earlier; frequently, patients with newly diagnosed unilateral VS have minimal symptoms, and they often have normal hearing. For these patients, selection of the best management option often presents a therapeutic dilemma. Gamma knife surgery may be an appealing alternative in terms of reduced morbidity. To determine if this was true, we first evaluated functional outcomes in our patients with VS in whom the microsurgical approach was

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Mark E. Linskey, Stephen A. Davis, and Vaneerat Ratanatharathorn

by patient satisfaction data, and when available 29 are usually not accompanied by the corresponding satisfaction data for microsurgery performed at the same institution or by the same surgeon(s). A retrospective analysis was made of prospectively acquired data in a treatment database that included a consecutive series of patients with meningioma treated by a single surgeon over a 4-year period by using both microsurgery and GKS as part of a consistently applied comprehensive multimodality approach. While the two modalities have been studied head-to-head to

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Cheng-Chia Lee, Hsiu-Mei Wu, Wen-Yuh Chung, Ching-Jen Chen, David Hung-Chi Pan, and Sanford P. C. Hsu

consisted of patients who did not have any microsurgical resection during the follow-up period after GKS, and Group B of patients who underwent microsurgical resection for their VS after GKS. For patients in Group B, detailed information regarding their management were collected, including the length of the time interval between GKS and microsurgery, degree of resection, and sequence of therapies. Outcomes of facial nerve and cochlear nerve functions for these patients were evaluated using the House-Brackmann score at 6 months postoperatively and the Gardner

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Mohamed A. El Beltagy and Mostafa M. E. Atteya

T he earliest neuroendoscopic procedures were performed and published by L’Espinasse, who coagulated the choroid plexus endoscopically, and by Doyen, who utilized an endoscope in posterior fossa surgery in 1917. 1–3 Those were followed by further endoscopic procedures by Dandy, Fukushima, and Prott. 4–6 Hopf and Perneczky introduced the concept of “endoscope-assisted microsurgery” (EAMS) in which the surgery is primarily performed under the operative microscope in addition to the endoscope, which serves as an adjunct to the microscopic manipulations, in