Hydrogen Peroxide Head Preparation: Enabling Cuttings and Anatomic Studies of Skull Base Dura Mater and Arachnoid Without Use of Drilling

INTRODUCTION: Anatomic pieces that are preserved using formaldehyde allow us to undertake high-quality skull base studies. However, extensive drilling is often necessary, which can lead to damages to the dura mater and thus arachnoid. Formaldehyde and hydrogen peroxide can soften the bone, which, in turn, can be easily cut with a scalpel or removed with a curette. After having discovered this technique by chance, our aim was to establish a study protocol of the skull base dura mater without the use of the drill. METHODS: Ten heads were set with a 10% formalin solution and then injected with colored latex. Five heads were then subsequently bleached with 20% hydrogen peroxide solution (HPS). The following were studied weekly: 1) macroscopic modification of the bone, dura mater, arachnoid and brain; 2) histology; 3) computed tomography scans; and 4) calcium concentration screenings were studied weekly. RESULTS: After several weeks (mean 6.1, range 5-8 weeks), all HPS specimens were flexible, similar to rubber in consistence. Geometrical bone cuts could be made while preserving all the surrounding anatomic structure (cranial nerves, dura mater, and vascular elements). Histologically, the dural and bone structure are preserved. The HPS cadavers appear to be radiologically demineralized. We note a significant calcium concentration augmentation in HPS solution after 1 month, 6 weeks, and 2 months compared with day 0. CONCLUSIONS: The softening of the bone, probably caused by decalcification from the use of corrosive chemicals present in hydrogen peroxide solution, can ease the cutting of the skull base geometrically, which is useful for anatomic and workshop studies

The interperiosteodural concept applied to the jugular foramen and its compartmentalization

OBJECTIVE The dura mater is made of 2 layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain and spinal cord. These 2 dural layers join together in most parts of the skull base and cranial convexity, and separate into the orbital and perisellar compartments or into the spinal epidural space to form the extradural neural axis compartment (EDNAC). The EDNAC contains fat and/or venous blood. The aim of this dissection study was to anatomically verify the concept of the EDNAC by focusing on the dural layers surrounding the jugular foramen area. METHODS The authors injected 10 cadaveric heads (20 jugular foramina) with colored latex and fixed them in formalin. The brainstem and cerebellum of 7 specimens were cautiously removed to allow a superior approach to the jugular foramen. Special attention was paid to the meningeal architecture of the jugular foramen, the petrosal inferior sinus and its venous confluence with the sigmoid sinus, and the glossopharyngeal, vagus, and accessory nerves. The 3 remaining heads were bleached with a 20% hydrogen peroxide solution. This procedure produced softening of the bone without modifying the fixed soft tissues, thus permitting coronal and axial dissections. RESULTS The EDNAC of the jugular foramen was limited by the endosteal and meningeal layers and contained venous blood. These 2 dural layers joined together at the level of the petrous and occipital bones and separated at the inferior petrosal sinus and the sigmoid sinus, and around the lower cranial nerves, to form the EDNAC. Study of the dural sheaths allowed the authors to describe an original compartmentalization of the jugular foramen in 3 parts: 2 neural compartments-glossopharyngeal and vagal-and the interperiosteodural compartment. CONCLUSIONS In this dissection study, the existence of the EDNAC concept in the jugular foramen was demonstrated, leading to the proposal of a novel 3-part compartmentalization, challenging the classical 2-part compartmentalization, of the jugular foramen

Long term surgical results of 154 petroclival meningiomas: A retrospective multicenter study

BACKGROUND: Outcomes of petroclival meningiomas (PCM) (morbidity, permanent cranial nerves deficit, tumor removal and recurrence) are inconsistent in the literature, making it a challenge to predict surgical morbidity. METHODS: A multicenter study of patients with PCMs larger than 2.5cm between 1984 and 2017 was conducted. The authors retrospectively reviewed the patients\u27 medical records, imaging studies and pathology reports to analyze presentation, surgical approach, neurological outcomes, complications, recurrence rates and predictive factors. RESULTS: There were 154 patients. The follow-up was 76.8 months on average (range 8-380 months). Gross total resection (GTR) was achieved in 40 (26.0%) patients, subtotal resection (STR) in 101 (65.6%), and partial resection in 13 (8.3%). Six (2.6%) perioperative deaths occurred. The 5-year, 10-year and 15-year progression-free survival (PFS) of GTR and STR with radiation therapy (RT) was similar (100%, 90% and 75%). PFS of STR without adjuvant radiation was associated with progression in 71%, 51% and 31%, respectively. Anterior petrosectomy and combined petrosectomy were associated with higher postoperative CN V and CN VI deficits compared to the retrosigmoid approach. The latter had a significantly higher risk of CN VII, CN VIII and LCN deficit. Temporal lobe dysfunction (seizure and aphasia) were significantly associated with the anterior petrosectomy approach. CONCLUSIONS: Our study shows that optimal subtotal resection of PCMs associated with postoperative RT or stereotactic radiosurgery results in long-term tumor control to equivalent radical surgery. Case selection and appropriate intraoperative judgement are required to reduce the morbidity

Effects of Multisensory Context on Tofu and Soy Sauce Evaluation and Consumption

We examined the effects of an informative pitch and multisensory contexts as potential factors influencing individuals’ experience of tofu with soy sauce and the amount consumed outside the lab. Two hundred and sixteen participants watched one of two pitches (promoting either vegetarian diets or exercise) and were guided into one of three multisensory contexts (‘sustainable’, ‘meat’, or ‘neutral’ theme). Participants rated the aroma and appearance of soy sauce and the taste of tofu dipped in it using the intuitive ‘one touch’ EmojiGrid valence and arousal measuring tool. Our results showed that the ‘meat’ context increased arousal ratings for soy sauce and the tendency to consume more tofu relative to the other contexts. Pitch did not influence affective ratings or amounts consumed. We conclude that the multisensory context has the potential to positively affect peoples’ choices and perceptions of plant-based and sustainable food and promote its consumption

A biosphere reserve in the metropolitan region of Santiago-Valparaiso: Zoning stakes [Une réserve de biosphère dans la région centrale du Chili: les enjeux du zonage]

info:eu-repo/semantics/publishe