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Dolas I, Unal TC, Yorukoglu AG, Ruetten S, Dolen D, Gulsever CI, Sahin D, Aydoseli A, Sencer A. Full-Endoscopic Technique for Posterior Fossa Decompression in Chiari Malformation. Oper Neurosurg (Hagerstown) 2023; 25:e345-e351. [PMID: 37820101 DOI: 10.1227/ons.0000000000000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/14/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Full-endoscopic techniques are well-described for spinal procedures. Although endoscopic-assisted techniques are reported for posterior fossa decompression (PFD) in Chiari malformation (CM), a full-endoscopic technique is yet to be reported in these patients. The aim of this study was to present and describe a full-endoscopic technique for PFD in patients with CM. CLINICAL PRESENTATION Two patients diagnosed with CM were operated on by the full-endoscopic PFD technique. The patients consented to the procedure and to the publication of their image. An endoscope with an oval shaft cross-section with a diameter of 9.3 mm, a working length of 177 mm, a viewing angle of 20°, and a working channel of 5.6 diameters were used. Operative videos were recorded. The surgical steps were easily applied after the clear anatomic landmarks, such as the C1 posterior tubercle and the rectus capitis posterior minor muscles. The patients were followed up for 6 months. Both patients were symptom-free with a significant decrease in Visual Analog Scale score and a good functional outcome assessed by Chicago Chiari Outcome Scale after surgery without any complications. CONCLUSION All the steps of the full-endoscopic technique for PFD described by the authors in their previous human cadaveric study were also feasible on patients with CM.
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Affiliation(s)
- Ilyas Dolas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ali Guven Yorukoglu
- Department of Neurosurgery, Istanbul Scoliosis and Spine Center, Florence Nightingale Hospital, Istanbul, Turkey
| | - Sebastian Ruetten
- Center for Spine Surgery and Pain Therapy, Center for Orthopedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhein-Ruhr, St. Anna Hospital Herne/Marien Hospital Herne University Hospital/Marien Hospital Witten, Herne, Germany
| | - Duygu Dolen
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cafer Ikbal Gulsever
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Duran Sahin
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Aydin Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Altay Sencer
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Unal TC, Dolas I, Sahin D, Gulsever CI, Dolen D, Aras Y, Aydoseli A, Sabanci PA, Sencer A. Intraoperative ultrasound-guided ventricular cannulation in patients with normal-sized ventricles. Neurochirurgie 2023; 69:101463. [PMID: 37393990 DOI: 10.1016/j.neuchi.2023.101463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/05/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Many pathologies require normal-sized ventricle cannulation, which may be technically challenging even with neuronavigation guidance. This study presents a series of ventricular cannulation of normal-sized ventricles using intraoperative ultrasound (iUS) guidance and the outcomes of patients treated by this technique, for the first time. METHODS The study included patients who underwent ultrasound-guided ventricular cannulation of normal-sized ventricles (either ventriculoperitoneal (VP) shunting or Ommaya reservoir) between January 2020 and June 2022. All patients underwent iUS-guided ventricular cannulation from the right Kocher's point. The inclusion criteria for normal-sized ventricles were as follows: (1) Evans index <30%, and (2) widest third ventricle diameter <6mm. Medical records and pre-, intra- and post-operative imaging were retrospectively analyzed. RESULTS Nine of the 18 included patients underwent VP shunt placement; 6 had idiopathic intracranial hypertension (IIH), 2 had resistant cerebrospinal fluid fistula following posterior fossa surgery, and 1 had iatrogenic intracranial pressure elevation following foramen magnum decompression. Nine patients underwent Ommaya reservoir implantation, 6 of whom had breast carcinoma and leptomeningeal metastases and 3 hematologic disease and leptomeningeal infiltration. All catheter tip positions were achieved in a single attempt, and none were placed suboptimally. Mean follow-up was 10 months. One IIH patient (5.5%) had early shunt infection which necessitated shunt removal. CONCLUSION iUS is a simple and safe method for accurate cannulation of normal-sized ventricles. It provides an effective real-time guidance option for challenging punctures.
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Affiliation(s)
- T C Unal
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey.
| | - I Dolas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - D Sahin
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - C I Gulsever
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - D Dolen
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - Y Aras
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - A Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - P A Sabanci
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
| | - A Sencer
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey
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Unal TC, Sencer A, Dolas I, Gulsever CI, Sahin D, Dolen D, Ozata MS, Ozturk M, Aras Y, Aydoseli A. Corrigendum: Full-endoscopic removal of third ventricular colloid cysts: technique, results, and limitations. Front Surg 2023; 10:1234433. [PMID: 37425346 PMCID: PMC10327886 DOI: 10.3389/fsurg.2023.1234433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023] Open
Abstract
[This corrects the article DOI: 10.3389/FSURG.2023.1174144.].
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Unal TC, Sencer A, Dolas I, Gulsever CI, Sahin D, Dolen D, Ozata MS, Ozturk M, Aras Y, Aydoseli A. Full-endoscopic removal of third ventricular colloid cysts: technique, results, and limitations. Front Surg 2023; 10:1174144. [PMID: 37334201 PMCID: PMC10272465 DOI: 10.3389/fsurg.2023.1174144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/24/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Colloid cysts (CCs) are rare benign lesions that usually arise from the roof of the third ventricle. They may present with obstructive hydrocephalus and cause sudden death. Treatment options include ventriculoperitoneal shunting, cyst aspiration, and cyst resection microscopically or endoscopically. This study aims to report and discuss the full-endoscopic technique for removing colloid cysts. Materials and methods A 25°-angled neuroendoscope with an internal working channel diameter of 3.1 mm and a length of 122 mm is used. The authors described the technique of resecting a colloid cyst by a full-endoscopic procedure and evaluated the surgical, clinical, and radiological results. Results Twenty-one consecutive patients underwent an operation with a transfrontal full-endoscopic approach. The swiveling technique (grasping the cyst wall and rotational movements) was used for CC resection. Of these patients, 11 were female, and ten were male (mean age, 41 years). The most frequent initial symptom was a headache. The mean cyst diameter was 13.9 mm. Thirteen patients had hydrocephalus at admission, and one needed shunting after cyst resection. Seventeen patients (81%) underwent total resection; 3 (14%), subtotal resection; and 1 (5%), partial resection. There was no mortality; one patient had permanent hemiplegia, and one had meningitis. The mean follow-up period was 14 months. Conclusion Even though microscopic resection of cysts has been widely used as a gold standard, successful endoscopic removal has been described recently with lower complication rates. Applying angled endoscopy with different techniques is essential for total resection. Our study is the first case series to show the outcomes of the swiveling technique with low recurrence and complication rates.
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Yildiz MZ, Peker B, Unal TC, Dolas I, Gulsever CI, Dolen D, Sonmez E, Aras Y, Aydoseli A, Sabanci PA, Sencer A, Izgi AN. The effect of halofuginone use on epidural fibrosis after spinal surgery: An animal experiment. Turk Neurosurg 2023. [PMID: 38650558 DOI: 10.5137/1019-5149.jtn.42998-22.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
AIM Epidural fibrosis (EF) can cause persistent low back pain after spinal surgery. Type I collagen is the main component of scar tissue formed after spinal surgery, and an antifibrotic agent is necessary for preventing fibrosis. Halofuginone is an antifibrotic agent that has an effect on type I collagen. Our study aimed to investigate the effectiveness of local halofuginone application for spinal EF after lumbar laminectomy in rats. MATERIAL AND METHODS Forty rats were equally divided into four groups (Groups I-IV; 10 rats in each group), and lumbar laminectomy was performed under general anesthesia. After laminectomy, Group I received saline (NaCl 0.9%) locally (control), Group II received spongostan, Group III received 0.5 mL of halofuginone-impregnated spongostan, and Group IV received 0.5 mL of halofuginone. Spongostan was used to prolong the exposure period of halofuginone. All rats were sacrificed after four weeks and evaluated according to histopathological criteria. A p-value of 0.05 was considered statistically significant. RESULTS Fibrosis was significantly lower in Group IV than in Group I (p 0.05). There was no significant difference in fibrosis between Group II/III and Group I. It was observed that spongostan increased fibrosis. CONCLUSION Halofuginone helps prevent EF after spinal surgery. However, further clinical and experimental studies are needed to assess its safety in humans.
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Affiliation(s)
- Mehmet Zeki Yildiz
- Bahcesehir University, Pendik Medical Park Hospital, Department of Neurosurgery, Istanbul, Türkiye
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Aras Y, Dolas I, Dolen D, Unal TC, Sahin D, Gulsever CI, Sabanci PA, Sencer A. Pediatric Cerebral Cavernous Malformation: A Single-Centered Experience of 23 Cases. Turk Neurosurg 2023; 33:63-69. [PMID: 36924006 DOI: 10.5137/1019-5149.jtn.36915-21.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIM To describe, and to evaluate the clinical and radiological characteristics of pediatric cavernous malformations (CMs) and the surgical approaches and their outcomes in a single center. MATERIAL AND METHODS We retrospectively reviewed pediatric patients with CMs that were treated in our center between 2010 and 2020. Radiological, clinical, and demographic features, as well as treatment details were evaluated. RESULTS Of 23 patients, 12 were male, and 11 were female. Two patients with multiple CMs had a family history. The most common symptoms were headaches (9/23, 39.1%) and seizures (9/23, 39.1%). Twenty patients had single lesions and three patients had multiple lesions. According to Zabramski classification, eight (34.7%) patients had type 1, 11 (47.8%) had type 2 and four (17.3%) had type 3 lesions. Thirteen patients had recurrent preoperative hemorrhages and nine had increased lesion size. Seven patients (30.4%) had coexisting deep venous anomalies in the CM vicinity. Twenty-one patients underwent microsurgical resection (5/23 simple lesionectomy, 16/23 lesionectomy + resection of the surrounding hemosiderin ring). All lesions were completely resected. No surgical mortalities or major complications occurred. CONCLUSION Since pediatric CMs are more aggressive than adult CMs, they should not be underestimated. Microsurgical total resection should be the first treatment choice where possible. We concluded that early surgical treatment and resection of perilesional hemosiderin-stained tissue, when feasible, yield the most favorable results at long-term follow-up including seizure outcomes.
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Affiliation(s)
- Yavuz Aras
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
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Dolen D, Ahmadov T, Dolas I, Unal TC, Aydoseli A, Ozturk M, Sabanci PA, Aras Y, Bilgic MB, Sencer A. Analysis of the prognosis of high-grade gliomas in the view of new immunohistochemistry markers and 2016 who classification. Turk Neurosurg 2022; 32:500-507. [DOI: 10.5137/1019-5149.jtn.40005-22.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sabanci PA, Unal TC, Ozturk O, Dolen D, Dolas I, Peker B, Saka E, Ali A, Aydoseli A, Aras Y, Sencer A, Hepgul K, Izgi N, Barlas O. Effect of Intraoperative Computed Tomography on Ventriculoperitoneal Shunt Survival. World Neurosurg 2021; 153:e373-e379. [PMID: 34217860 DOI: 10.1016/j.wneu.2021.06.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND In patients with hydrocephalus who undergo ventriculoperitoneal shunt placement, the ventricular catheter tip position is one of the most important prognostic factors influencing shunt survival. The aim of this study was to present our findings of ventriculoperitoneal shunt placement performed with intraoperative computed tomography (CT) and to evaluate the effect of intraoperative CT-based image guidance on optimal catheter positioning and overall shunt survival. METHODS Of the study enrolled 345 patients with hydrocephalus who underwent ventriculoperitoneal shunt placement for the first time between 2008 and 2018. Ventricular catheters were inserted freehand via the Kocher point into the lateral ventricle in all patients. In 163 patients, intraoperative CT was performed to confirm the tip position. In this group of patients, if the tip position was nonoptimal, the catheter was ejected and reinserted during the surgery. In the remaining 182 patients, the tip position was assessed with routine postoperative CT. The effect of performing intraoperative CT on catheter tip positioning and shunt failure was investigated. RESULTS Nonoptimal tip position was significantly correlated with shunt dysfunction even when excluding nonobstructive causes (P < 0.001). In the intraoperative CT group, 11 ventricular catheters (6.7%) were intraoperatively repositioned. The repositioning significantly improved the optimal tip position rate from 54% to 58.3% (P = 0.007). Intraoperative CT usage also showed direct correlation with shunt survival (P = 0.006). CONCLUSIONS Intraoperative CT is an effective tool for increasing the rate of optimal tip positioning and thereby overall shunt survival.
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Affiliation(s)
- Pulat Akin Sabanci
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Onur Ozturk
- Department of Neurosurgery, Cerkezkoy State Hospital, Tekirdag, Turkey
| | - Duygu Dolen
- Department of Neurosurgery, Yuksekova State Hospital, Hakkari, Turkey
| | - Ilyas Dolas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Baris Peker
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Esra Saka
- Department of Neurosurgery, Cerkezkoy State Hospital, Tekirdag, Turkey
| | - Achmet Ali
- Department of Anesthesiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Aydin Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yavuz Aras
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Altay Sencer
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Kemal Hepgul
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Nail Izgi
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Orhan Barlas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Unal TC, Aktoklu M, Gel MS, Dolen D, Dolas I. Spontaneous fusion several years after undiagnosed cervical distractive flexion injury: a report of 3 cases. Br J Neurosurg 2020:1-3. [PMID: 32436447 DOI: 10.1080/02688697.2020.1767283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report three cases of spontaneously fused distractive flexion injury (DFI) in the cervical spine detected several years after the trauma. This is the first report in the literature that describes such late presentation of healed DFI. Although injuries are considered highly unstable requiring fusion surgery, all three healed spontaneously without intervention or immobilization. Despite significant misalignment, stability was confirmed with flexion-extension radiographs. All the three patients had no neurologic deficits. The possibility of healed old DFI should be kept in mind for patients who present with neck pain and a history of high-energy trauma.
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Affiliation(s)
- Tugrul Cem Unal
- Department of Neurosurgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aktoklu
- Department of Neurosurgery, Tunceli State Hospital, Tunceli, Turkey
| | - Mehmet Selim Gel
- Department of Neurosurgery, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Duygu Dolen
- Department of Neurosurgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilyas Dolas
- Department of Neurosurgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Can H, Unal TC, Dolas I, Guclu G, Diren F, Dolen D, Gomleksiz C, Aydoseli A, Civelek E, Sencer A. Comprehensive Anatomic and Morphometric Analyses of Triangular Working Zone for Transforaminal Endoscopic Approach in Lumbar Spine: A Fresh Cadaveric Study. World Neurosurg 2020; 138:e486-e491. [PMID: 32147551 DOI: 10.1016/j.wneu.2020.02.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The aim of this study is to provide essential information for endoscopic transforaminal approach by performing morphometric analysis of the triangular working zone (TWZ) in fresh cadavers. METHODS Fifteen fresh human cadavers (9 women and 6 men) with no history of spinal surgery were used in this study. Anatomic dissection of 150 foraminal levels were performed. Significant surgical landmarks constructing TWZ were measured bilaterally from L1-2 to L5-S1 on 15 fresh cadavers. The relationship between traversing roots and intervertebral discs was defined. RESULTS Base, height, and hypotenuse measurements of TWZ were longer as the level lowered. Mean base height and hypotenuse of TWZ were 12.15 mm, 11.29 mm, and 16.69 mm (L1-2); 17.94 mm, 17.18 mm, and 28.03 mm (L5-S1), respectively. TWZ was triangular shaped at the upper lumbar levels (L1-2, L2-3, and L3-4), and trapezoid at the lower lumbar levels (L4-5 and L5-S1). Going down the levels, the exiting root angle was narrower, the mean exiting angle of the L5 root being 28.23°. All L2 and L3 traversing roots and nearly all L4 traversing roots (86.7%) originated from below the disc level. Forty percent of L5 traversing roots originated above the disc level, and 53.3% originated at the disc level. Most S1 traversing roots originated at the proximal margin of the disc level (80%). CONCLUSIONS Our study reveals a detailed morphometric analysis of TWZ. Understanding the foraminal anatomy is crucial for safely performing transforaminal endoscopic surgery. The learning curve of transforaminal surgery can be reduced by garnering knowledge of TWZ anatomy.
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Affiliation(s)
- Halil Can
- Department of Neurosurgery, Biruni University Faculty of Medicine, Istanbul, Turkey; Department of Neurosurgery, Medicine Hospital, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Ilyas Dolas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Gucluhan Guclu
- Department of Neurosurgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Furkan Diren
- Department of Neurosurgery, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
| | - Duygu Dolen
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cengiz Gomleksiz
- Department of Neurosurgery, Silivri State Hospital, Istanbul, Turkey
| | - Aydin Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Erdinc Civelek
- Department of Neurosurgery, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
| | - Altay Sencer
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Sabanci PA, Aras Y, Ali A, Unal TC, Dolen D, Sencer S, Izgi N, Unal F, Barlas O. Transcortical Removal of Third Ventricular Colloid Cysts: Comparison of Conventional, Guided Microsurgical and Endoscopic Approaches and Review of the Literature. Turk Neurosurg 2018; 27:546-557. [PMID: 27337241 DOI: 10.5137/1019-5149.jtn.17142-16.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To compare the clinical results of different transcortical approaches for the removal of third ventricular colloid cysts (CC). MATERIAL AND METHODS Records of 41 colloid cyst patients who underwent transcortical conventional microsurgical, microsurgical with the aid of stereotactically guided cylindrical retractor (minitubular), and endoscopic removal between 1999 and 2015 were retrospectively analyzed. The clinical results of these three different transcortical surgical approaches were compared and a literature review of published series was conducted. RESULTS Ages ranged between 16 and 66 years (mean: 36.8). There were 18 female and 23 male patients. Headache was the main presenting symptom. The mean CC diameter was 15.5 mm. Intraventricular hemorrhage was encountered in 2 patients. Three patients needed postoperative ventriculoperitoneal shunt surgery. Postoperative seizures were seen in 3, postoperative neurological deficit in 3 and residual tumor in 2 patients. The conventional approach resulted in significantly higher rates of postoperative seizure compared to the minitubular and endoscopic approaches (p=0.012). The rate of residual cyst was significantly higher in endoscopic approach compared to conventional and minitubular approaches (p=0.024). Conventional approach led to significantly higher rates of neurological deficit compared to the two other approaches (p < 0.05). CONCLUSION With respect to complication rates, the stereotactic and endoscopic approaches are both safe and reliable compared to conventional microsurgical approach that has unacceptably high rates of seizures and neurological deficit. Concerning completeness of removal, both microsurgical approaches are by far superior to neuroendoscopy. The stereotactic microsurgical approach compares favorably in both respects with endoscopic and conventional microsurgical approaches.
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Affiliation(s)
- Pulat Akin Sabanci
- Istanbul University, Istanbul School of Medicine, Department of Neurosurgery, Istanbul, Turkey
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Caglayan AO, Comu S, Baranoski JF, Parman Y, Kaymakçalan H, Akgumus GT, Caglar C, Dolen D, Erson-Omay EZ, Harmanci AS, Mishra-Gorur K, Freeze HH, Yasuno K, Bilguvar K, Gunel M. NGLY1 mutation causes neuromotor impairment, intellectual disability, and neuropathy. Eur J Med Genet 2014; 58:39-43. [PMID: 25220016 DOI: 10.1016/j.ejmg.2014.08.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/18/2014] [Indexed: 11/26/2022]
Abstract
N-glycanase 1 (NGLY1) is a conserved enzyme that is responsible for the deglycosylation of misfolded N-glycosylated proteins in the cytoplasm prior to their proteasome-mediated degradation. Disruption of this degradation process has been associated with various neurologic diseases including amyotrophic lateral sclerosis and Parkinson's disease. Here, we describe two siblings with neuromotor impairment, apparent intellectual disability, corneal opacities, and neuropathy who were found to possess a novel homozygous frame-shift mutation due to a 4 base pair deletion in NGLY1 (c.1533_1536delTCAA, p.Asn511LysfsX51). We hypothesize that this mutation likely limits the capability of neuronal cells to respond to stress due to accumulation of misfolded proteins, thereby impairing their survival and resulting in progressive loss of neurological function.
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Affiliation(s)
- Ahmet Okay Caglayan
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA.
| | - Sinan Comu
- Department of Pediatrics, Division of Pediatric Neurology, Sisli, Memorial Hospital, Istanbul 34385, Turkey
| | - Jacob F Baranoski
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Yesim Parman
- Department of Neurology, Istanbul University, Faculty of Medicine, Istanbul 34098, Turkey
| | - Hande Kaymakçalan
- Department of Genetics and Bioinformatics, Faculty of Engineering, Bahcesehir University, Istanbul 34353, Turkey
| | - Gozde Tugce Akgumus
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Caner Caglar
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Duygu Dolen
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Emine Zeynep Erson-Omay
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Akdes Serin Harmanci
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Ketu Mishra-Gorur
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Hudson H Freeze
- Genetic Disease Program, Sanford-Burnham Medical Research Institute, La Jolla 92037, CA, USA
| | - Katsuhito Yasuno
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Kaya Bilguvar
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA
| | - Murat Gunel
- Departments of Neurosurgery, Neurobiology and Genetics, Yale Program in Neurogenetics, Yale School of Medicine, New Haven 06510, CT, USA.
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Aras Y, Dolas I, Dolen D, Unal TC, Sahin D, Gulsever CI, Sabanci PA, Sencer A. Retraction: Primary cerebellopontine angle Rathke's cleft cyst: case report. Turk Neurosurg 2014; 24:63-69. [PMID: 24848188 DOI: 10.5137/1019-5149.jtn.33800-21.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
On behalf of all authors, I respectfully request the retraction of our article, “Primary Cerebellopontine Angle Rathke’s Cleft Cyst: Case Report” (Turk Neurosurg, published online 2014, Vol: 24, No: 3; DOI: DOI: 10.5137/1019-5149. JTN.8084-13.1). This request is based on multiple problems with our study.
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Affiliation(s)
- Yavuz Aras
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
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