Endoscopic Endonasal Transclival Approaches: Case Series & Outcomes for Different Clival Regions

Objective Transclival endoscopic endonasal approaches to the skull base are novel with few published cases.We report our institution’s experience with this technique and discuss outcomes according to the clival region involved. Design Retrospective case series. Setting Tertiary care academic medical center Participants All patients who underwent endoscopic endonasal transclival approaches for skull base lesions from 2008 to 2012. Main Outcome Measures Pathologies encountered, mean intraoperative time, intraoperative complications, gross total resection, intraoperative cerebrospinal fluid (CSF) leak, postoperative CSF leak, postoperative complications, and postoperative clinical course. Results A total of 49 patients underwent 55 endoscopic endonasal transclival approaches. Pathology included 43 benign and 12 malignant lesions. Mean follow-up was 15.4 months. Mean operative time was 167.9 minutes, with one patient experiencing an intraoperative internal carotid artery injury. Of the 15 cases with intraoperative cerebrospinal fluid (CSF) leaks, 1 developed postoperative CSF leak (6.7%). There were six other postoperative complications: four systemic complications, one case of meningitis, and one retropharyngeal abscess. Gross total resection was achieved for all malignancies approached with curative intent. Conclusions This study provides evidence that endoscopic endonasal transclival approaches are a safe and effective strategy for the surgical management of a variety of benign and malignant lesions

Technology and Simulation to Improve Patient Safety.

Improving the quality and efficiency of surgical techniques, reducing technical errors in the operating suite, and ultimately improving patient safety and outcomes through education are common goals in all surgical specialties. Current surgical simulation programs represent an effort to enhance and optimize the training experience, to overcome the training limitations of a mandated 80-hour work week, and have the overall goal of providing a well-balanced resident education in a society with a decreasing level of tolerance for medical errors

Sacroiliac dysfunction - Diagnosis and treatment approaches: a clinical study

The present work entails all the activities performed and assisted during the externships at Lingehoeve Diergeneeskunde, under the guidance of Peter Wiemer, and at Paardenkliniek Venlo, under the guidance of Liana Peters. The first part of this report partakes a descriptive statistic of the caseload. It is divided into different areas of the equine medicine and a small theoretical background is included for contextualization of a representative case chosen for each area of practice. The second part consists of a monography, involving a bibliographic revision of sacroiliac dysfunction associated with poor performance in sports horses, followed by a clinical study on the diagnostic and treatment approaches to this condition, based on the caseload assisted during the externship at De Lingehoeve, to provide a synthesis of the signs associated with this condition and assess the validity and success of the treatments instated; Disfunção Sacroilíaca – Abordagens diagnósticas e terapêuticas: um estudo clínico Resumo: Este trabalho relata as atividades realizadas e assistidas ao longo dos estágios curriculares realizados no hospital De Lingehoeve Diergeneeskunde, sob orientação do Dr. Peter Wiemer, e na clínica Paardenkliniek Venlo, sob orientação da Dr.ª. Liana Peters. A primeira parte deste relatório apresenta uma estatística descritiva da casuística. Foi incluído um breve resumo teórico para cada área da medicina de equinos, para contextualização dos casos selecionados considerados relevantes para cada uma destas áreas. A segunda parte é composta por uma monografia de revisão bibliográfica acerca da disfunção sacroilíaca associada com perda de performance em cavalos de desporto, seguida um estudo clínico das abordagens diagnósticas e de tratamento desta condição, tendo como base de dados a casuística acompanhada durante o estágio em De Lingehoeve, e que pretende, para além de providenciar uma síntese dos sinais clínicos e imagiológicos associados a esta condição, avaliar a validade e sucesso dos tratamentos instituídos

Worldwide research productivity in the field of full-endoscopic spine surgery: a bibliometric study.

PURPOSE(#br)To investigate the quantity and quality of articles in the field of full-endoscopic spine surgery (FESS) from different countries and assess characteristics of worldwide research productivity.(#br)METHODS(#br)Articles published from 1997 to July 23, 2018, were screened using the Web of Science database. All studies were assessed for the following parameters: the number of total publications, h-index, contribution of countries, authors, journals, and institutions.(#br)RESULTS(#br)A total of 408 articles were identified between 1997 and 2018. Between 1997 and 2017, the number of published articles tended to increase by 41 times. The largest number of articles was from China (30.15%), followed by South Korea (28.68%), the USA (13.97%), Germany (9.31%), and Japan (4.90%). The highest h-index was found for articles from South Korea (23), followed by the USA (18), Germany (16), China (11), and Japan (7). The highest number of articles was published in World Neurosurgery (12.50%), followed by Pain Physician (10.29%), Spine (6.62%), European Spine Journal (4.66%), and Journal of Neurosurgery: Spine (4.17%). Wooridul Spine Hospital published the largest number of articles (10.29%), followed by Tongji University (5.88%), University of Witten/Herdecke (5.39%), Brown University (5.15%), and Third Military Medical University (3.43%).(#br)CONCLUSIONS(#br)The number of articles published in the field of FESS has increased rapidly in the past 20 years. In terms of quantity, China is the most contributive country based on the number of publications. High-quality papers as measured by h-index and the large quantity is from South Korea (second only to China). These slides can be retrieved under Electronic Supplementary Material