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Deepak K. Jha - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic Treatment of Hydrocephalus with Minimal Resources: Resource Utilization and Indigenous Innovation in Developing Countries like India.
Asian journal of neurosurgery, 2018Co-Authors: Deepak K. Jha, Mukul Jain, Ishita Pant, Rima Kumari, Renu Goyal, Arvind Arya, Suman KushwahaAbstract:Context: Neuroendoscopic surgeries need specialized equipments, unavailable in neurosurgical departments of majority of public healthcare institutions of India. Aims: Neuroendoscopic treatment of hydrocephalus in the setting of minimal resources using utilization of available resources, inter-departmental co-ordination and indigenous innovations. Methods: Study was carried out at a public sector institute of India with scarce resources. Senior author (DKJ) used indigenously designed stainless steel working sheath along with equipments of 'awake endoscopic intubation system' of department of neuroanesthesia and 18 cm, 4 mm, 0° Rigid Telescope for neuroendoscopic surgeries for various intraventricular pathologies. Results: Thirty-four neuroendoscopic surgeries in 32 patients were done over last 3 years. There were 18 males and 14 females with average age of 23 years. It included hydrocephalus due to tubercular meningitis (n = 19), neurocysticercosis (NCC) (n = 4), intra-ventricular (n = 2) and para-ventricular (n = 2) space occupying lesions, aqueduct stenosis with (n = 2) or without (n = 1) shunt malfunction and one case each of pyogenic meningitis and right cerebellar infarction. Endoscopic third ventriculostomy (ETV) (n = 28), septostomy (n = 6), removals of cystic lesions (n = 3) and biopsies of intraventricular lesions (n = 2) were done in a total of 34 neuroendoscopic surgeries. Overall there were four failures of ETVs, which were managed by ventriculo-peritoneal shunts. Two mortalities in the study group were unrelated to the surgical procedures. Conclusion: Indigenous innovations and interdisciplinary co-ordination are the way ahead to tackle resource scarcity in public sector healthcare institutions of India in the scenario of plenty of neuroendoscopic trainings opportunities for young neurosurgeons and paucity of equipments required.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiographic catheter.
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh GuptaAbstract:OBJECTIVE Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticerosis with an angiographic catheter. Commentary
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh Gupta, Gerardo Guinto, Walter A. Hall, M. Gangemi, Paolo Cappabianca, Mark M. SouweidaneAbstract:OBJECTIVE: Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS: Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS: Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION: Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
Rakesh Gupta - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiographic catheter.
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh GuptaAbstract:OBJECTIVE Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticerosis with an angiographic catheter. Commentary
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh Gupta, Gerardo Guinto, Walter A. Hall, M. Gangemi, Paolo Cappabianca, Mark M. SouweidaneAbstract:OBJECTIVE: Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS: Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS: Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION: Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
Mazhar Husain - One of the best experts on this subject based on the ideXlab platform.
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Neuro-endoscopic management of intraventricular neurocysticercosis (NCC)
Acta Neurochirurgica, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Nuzhat Husain, R. K. GuptaAbstract:Objective . Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC. Methods . Twenty-one cases, 13 females and 8 males (age range 12–50 years; mean, 25.7 years), of intraventricular NCC [lateral ( n = 6), third ( n = 6), fourth ( n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0° and 30° Rigid Telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular ( n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months. Results . Complete ( n = 18) or partial ( n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm Rigid Telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC. Conclusion . Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiographic catheter.
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh GuptaAbstract:OBJECTIVE Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
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Endoscopic transaqueductal removal of fourth ventricular neurocysticerosis with an angiographic catheter. Commentary
Neurosurgery, 2007Co-Authors: Mazhar Husain, Manu Rastogi, Deepak K. Jha, Nuzhat Husain, Rakesh Gupta, Gerardo Guinto, Walter A. Hall, M. Gangemi, Paolo Cappabianca, Mark M. SouweidaneAbstract:OBJECTIVE: Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a Rigid endoscope. METHODS: Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree Rigid Telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS: Removal of the cyst was performed in all cases. A 30-degree Rigid Telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION: Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a Rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
Şahİn, Mehmet İlhan - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of Pediatric Upper Airway Diseases with Rigid Telescope Video Laryngoscopy
'Guncel Pediatri', 2019Co-Authors: Şahİn, Mehmet İlhan, Vural Alperen, Ketencİ İbrahİm, KÖkoĞlu KeremAbstract:INTRODUCTION: It is hard to make a differential diagnosis of upper airway diseases in pediatrics. Best method is direct visualization. Flexible nasopharyngoscopy is the most performed method. Rigid Telescope-video laryngoscopy (RTVL) could be an alternative in patients who can not be performed flexible nasopharyngoscopy. It is aimed to review RTVL results of pediatric patients for the evaluation of upper airway problems
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Evaluation of pediatric upper airway diseases with Rigid Telescope video laryngoscopy
Bursa Uludağ Üniversitesi, 2019Co-Authors: Ketencİ İbrahİm, Vural Alperen, KÖkoĞlu Kerem, Şahİn, Mehmet İlhanAbstract:GİRİŞ ve AMAÇ: Pediatrik üst solunum yolu problemlerinin ayrıcı tanısı zordur. En iyi method direkt görüntülemektir. Fleksibl nazofaingoskopi en sık uygulanan yöntemdir. Rijit teleskop video laringoskopi (RTVL), fleksible nazofaringoskopi uygulanamayan hastalarda bir alternatif olabilir. Bu çalışmada RTLV ile üst solunum yolu değerlendirilen hasta sonuçlarının değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Üst solunum yolu problemi nedeniyle RTVL uygulanan hastalar retrospektif olarak çalışmaya dahil edildi. Hastaların semptomları, ek hastalıkları ve bulguları kaydedildi. Uygulamalar 30 derece rijit teleskop video laringoskop ile aynı tecrübeli KBB uzmanınca gerçekleştirildi. Hastalar fleksibl nazofaringoskopi yapılamayan ya da cerrahi planlanan hastalara yapıldı. Bulgular ve cerrah işlemler kaydedildi. BULGULAR: 332 hastaya 427 işlem uygulandı. Stridor en sık endikasyondu. En sık bulgu laringomalaziydi. 73 hastada endikasyon ekstübasyon başarısızlığıydı. Bu hastaların 59'unda entübasyon granülomu en sık bulguydu. 67 hastaya trakeotomi işlemi yapıldı. Trakeotomi için en sık endikasyon uzamış entübasyondu. Tüm işlemler içinde tek ciddi komplikasyon bir hastada gelişen bradikardiydi ve uygun müdahale ile normale döndü. TARTIŞMA ve SONUÇ: Stridor ve uzamış entübasyon pediatrik üst havayolu için en sık semptomdu. Gastro-özefageal reflü ile birlikte olan ya da olmayan laringomalazi en sık bulguydu. Rijit teleskop - video laringoskopi uygulaması, fleksibl nazofaingoskopi yapılamayan hastalarda yararlı bir metoddur.INTRODUCTION: It is hard to make a differential diagnosis of upper airway diseases in pediatrics. Best method is direct visualization. Flexible nasopharyngoscopy is the most performed method. Rigid Telescope-video laryngoscopy (RTVL) could be an alternative in patients who can not be performed flexible nasopharyngoscopy. It is aimed to review RTVL results of pediatric patients for the evaluation of upper airway problems. METHODS: A retrospective analysis of patients who underwent RTVL because of upper airway problems were conducted in the study. The patients’ symptoms, additional diseases and examination findings were recorded. The examinations were performed with a 30 degree Rigid Telescope – video laryngoscopy by a same, experienced physician. The procedures were performed when flexible video nasopharyngolaryngoscopy was unsuccesfull or when any kind of surgical intervention was planned. Examination findings as well as the surgical procedures performed were recorded. RESULTS: Total of 427 procedures were performed to 332 patients. Stridor was the most common indication for the procedure. The most common examination finding was laryngomalacia. There were 73 patients who had extubation failure and were applied Rigid Telescope – video laryngoscopy for this reason. Fifty-nine patients had intubation granuloma and this was the most common finding in patients with extubation failure. Tracheotomy was applied to 67 patients. The most common indication for tracheotomy was prolonged intubation. One patient experienced bradycardia during all procedures who recovered with appropriate intervention. DISCUSSION and CONCLUSION: Stridor and prolonged intubation were the most common symptoms of pediatric upper airway diseases. Laryngomalacia with or without gastro-esophageal reflux were the most common causes. Rigid Telescope – video laryngoscopy may be a useful method to evaluate pediatric upper airway diseases when flexible laryngoscopy can not be performed
KÖkoĞlu Kerem - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of Pediatric Upper Airway Diseases with Rigid Telescope Video Laryngoscopy
'Guncel Pediatri', 2019Co-Authors: Şahİn, Mehmet İlhan, Vural Alperen, Ketencİ İbrahİm, KÖkoĞlu KeremAbstract:INTRODUCTION: It is hard to make a differential diagnosis of upper airway diseases in pediatrics. Best method is direct visualization. Flexible nasopharyngoscopy is the most performed method. Rigid Telescope-video laryngoscopy (RTVL) could be an alternative in patients who can not be performed flexible nasopharyngoscopy. It is aimed to review RTVL results of pediatric patients for the evaluation of upper airway problems
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Evaluation of pediatric upper airway diseases with Rigid Telescope video laryngoscopy
Bursa Uludağ Üniversitesi, 2019Co-Authors: Ketencİ İbrahİm, Vural Alperen, KÖkoĞlu Kerem, Şahİn, Mehmet İlhanAbstract:GİRİŞ ve AMAÇ: Pediatrik üst solunum yolu problemlerinin ayrıcı tanısı zordur. En iyi method direkt görüntülemektir. Fleksibl nazofaingoskopi en sık uygulanan yöntemdir. Rijit teleskop video laringoskopi (RTVL), fleksible nazofaringoskopi uygulanamayan hastalarda bir alternatif olabilir. Bu çalışmada RTLV ile üst solunum yolu değerlendirilen hasta sonuçlarının değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Üst solunum yolu problemi nedeniyle RTVL uygulanan hastalar retrospektif olarak çalışmaya dahil edildi. Hastaların semptomları, ek hastalıkları ve bulguları kaydedildi. Uygulamalar 30 derece rijit teleskop video laringoskop ile aynı tecrübeli KBB uzmanınca gerçekleştirildi. Hastalar fleksibl nazofaringoskopi yapılamayan ya da cerrahi planlanan hastalara yapıldı. Bulgular ve cerrah işlemler kaydedildi. BULGULAR: 332 hastaya 427 işlem uygulandı. Stridor en sık endikasyondu. En sık bulgu laringomalaziydi. 73 hastada endikasyon ekstübasyon başarısızlığıydı. Bu hastaların 59'unda entübasyon granülomu en sık bulguydu. 67 hastaya trakeotomi işlemi yapıldı. Trakeotomi için en sık endikasyon uzamış entübasyondu. Tüm işlemler içinde tek ciddi komplikasyon bir hastada gelişen bradikardiydi ve uygun müdahale ile normale döndü. TARTIŞMA ve SONUÇ: Stridor ve uzamış entübasyon pediatrik üst havayolu için en sık semptomdu. Gastro-özefageal reflü ile birlikte olan ya da olmayan laringomalazi en sık bulguydu. Rijit teleskop - video laringoskopi uygulaması, fleksibl nazofaingoskopi yapılamayan hastalarda yararlı bir metoddur.INTRODUCTION: It is hard to make a differential diagnosis of upper airway diseases in pediatrics. Best method is direct visualization. Flexible nasopharyngoscopy is the most performed method. Rigid Telescope-video laryngoscopy (RTVL) could be an alternative in patients who can not be performed flexible nasopharyngoscopy. It is aimed to review RTVL results of pediatric patients for the evaluation of upper airway problems. METHODS: A retrospective analysis of patients who underwent RTVL because of upper airway problems were conducted in the study. The patients’ symptoms, additional diseases and examination findings were recorded. The examinations were performed with a 30 degree Rigid Telescope – video laryngoscopy by a same, experienced physician. The procedures were performed when flexible video nasopharyngolaryngoscopy was unsuccesfull or when any kind of surgical intervention was planned. Examination findings as well as the surgical procedures performed were recorded. RESULTS: Total of 427 procedures were performed to 332 patients. Stridor was the most common indication for the procedure. The most common examination finding was laryngomalacia. There were 73 patients who had extubation failure and were applied Rigid Telescope – video laryngoscopy for this reason. Fifty-nine patients had intubation granuloma and this was the most common finding in patients with extubation failure. Tracheotomy was applied to 67 patients. The most common indication for tracheotomy was prolonged intubation. One patient experienced bradycardia during all procedures who recovered with appropriate intervention. DISCUSSION and CONCLUSION: Stridor and prolonged intubation were the most common symptoms of pediatric upper airway diseases. Laryngomalacia with or without gastro-esophageal reflux were the most common causes. Rigid Telescope – video laryngoscopy may be a useful method to evaluate pediatric upper airway diseases when flexible laryngoscopy can not be performed
