The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Takuji Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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usefulness of extradural optic nerve decompression via trans Superior Orbital Fissure approach for treatment of traumatic optic nerve injury surgical procedures and techniques from experience with 8 consecutive patients
World Neurosurgery, 2016Co-Authors: Naoki Otani, Kojiro Wada, Kazuya Fujii, Terushige Toyooka, Kohsuke Kumagai, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Yasuaki Nakao, Takuji YamamotoAbstract:Objective To describe our experience of extradural optic nerve decompression via the trans–Superior Orbital Fissure approach for traumatic optic neuropathy (TON) and retrospectively analyze its advantages and pitfalls. Methods Between September 2009 and August 2014, 8 consecutive patients with TON underwent extradural optic canal decompression via the trans–Superior Orbital Fissure approach. We retrospectively reviewed medical charts, radiologic findings, surgical techniques, complications, and final surgical results. Results All 8 patients presented with visual disturbance caused by head injury; 2 patients had no light perception, 6 had light perception, and 2 had ophthalmoplegia. All patients underwent extradural optic canal decompression and high-dose steroid administration within 24 hours after injury. Postoperative visual acuity on discharge was improved in 6 patients and unchanged in 2. The 2 patients with ophthalmoplegia gradually recovered by 3 months after operation. The postoperative outcome was good recovery in 7 patients and moderate disability in 1 patient. There were no complications related to the surgical procedure. Conclusions Emergent optic canal release has been recommended in patients with TON. The advantage of the extradural optic canal decompression via the trans–Superior Orbital Fissure approach is easy identification of the optic canal after partial removal of the anterior clinoid process, resulting in fewer surgical complications. In addition, this procedure can achieve intraOrbital decompression if necessary. We recommend this modified approach with mini-peeling as a safe and reliable procedure in patients with TON.
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surgical simulation of extradural anterior clinoidectomy through the trans Superior Orbital Fissure approach using a dissectable three dimensional skull base model with artificial cavernous sinus
Skull Base Surgery, 2010Co-Authors: Kentaro Mori, Yasuaki Nakao, Takuji Yamamoto, Takanori EsakiAbstract:Extradural anterior clinoidectomy via the trans-Superior Orbital Fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely reproduced the dura propria of the temporal lobe, periosteal bridge, and inner reticular layer in the cavernous sinus and SOF using silicone and varnish. The cranial nerves and blood vessels were made from rubber fibers and vinyl tube. Simulation of extradural anterior clinoidectomy via the trans-SOF approach could be performed on the model using a high-speed drill under the operating microscope. The steps of reconstruction of the skull base model and dissection promote clear understanding of the 3-D anatomy and techniques of extradural anterior clinoidectomy via the trans-SOF approach.
Yuray Chen - One of the best experts on this subject based on the ideXlab platform.
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traumatic Superior Orbital Fissure syndrome assessment of cranial nerve recovery in 33 cases
Plastic and Reconstructive Surgery, 2010Co-Authors: Chientzung Chen, Theresa Y Wang, Peikwei Tsay, Faye Huang, Yuray ChenAbstract:BACKGROUND: Superior Orbital Fissure syndrome is a rare complication that occurs in association with craniofacial trauma. The characteristics of Superior Orbital Fissure syndrome are attributable to a constellation of cranial nerve III, IV, and VI palsies. This is the largest series describing traumatic Superior Orbital Fissure syndrome that assesses the recovery of individual cranial nerve function after treatment. METHODS: In a review from 1988 to 2002, 33 patients with Superior Orbital Fissure syndrome were identified from 11,284 patients (0.3 percent) with skull and facial fractures. Severity of cranial nerve injury and functional recovery were evaluated by extraocular muscle movement. Patients were evaluated on average 6 days after initial injury, and average follow-up was 11.8 months. RESULTS: There were 23 male patients. The average age was 31 years. The major mechanism of injury was motorcycle accident (67 percent). Twenty-two received conservative treatment, five were treated with steroids, and six patients underwent surgical decompression of the Superior Orbital Fissure. After initial injury, cranial nerve VI suffered the most damage, whereas cranial nerve IV sustained the least. In the first 3 months, recovery was greatest in cranial nerve VI. At 9 months, function was lowest in cranial nerve VI and highest in cranial nerve IV. Eight patients (24 percent) had complete recovery of all cranial nerves. Functional recovery of all cranial nerves reached a plateau at 6 months after trauma. CONCLUSIONS: Cranial nerve IV suffered the least injury, whereas cranial nerve VI experienced the most neurologic deficits. Cranial nerve palsies improved to their final recovery endpoints by 6 months. Surgical decompression is considered when there is evidence of bony compression of the Superior Orbital Fissure.
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traumatic Superior Orbital Fissure syndrome current management
Craniomaxillofacial Trauma and Reconstruction, 2010Co-Authors: Chientzung Chen, Yuray ChenAbstract:Traumatic Superior Orbital Fissure syndrome is an uncommon complication of craniomaxillofacial trauma with an incidence of less than 1%. The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. This article describes a detailed anatomy of the Superior Orbital Fissure as it related to pathophysiology and clinical findings. Etiology and diagnosis are established after detailed physical and radiographic examination. On the basis of our clinical experience in the management of Superior Orbital Fissure syndrome and from the data reported previously in the literature, an algorithm for treatment of traumatic Superior Orbital Fissure syndrome including use of steroid, surgical decompression of Superior Orbital Fissure, and reduction of concomitant facial fracture is presented and its rationale discussed.
Naoki Otani - One of the best experts on this subject based on the ideXlab platform.
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usefulness of extradural optic nerve decompression via trans Superior Orbital Fissure approach for treatment of traumatic optic nerve injury surgical procedures and techniques from experience with 8 consecutive patients
World Neurosurgery, 2016Co-Authors: Naoki Otani, Kojiro Wada, Kazuya Fujii, Terushige Toyooka, Kohsuke Kumagai, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Yasuaki Nakao, Takuji YamamotoAbstract:Objective To describe our experience of extradural optic nerve decompression via the trans–Superior Orbital Fissure approach for traumatic optic neuropathy (TON) and retrospectively analyze its advantages and pitfalls. Methods Between September 2009 and August 2014, 8 consecutive patients with TON underwent extradural optic canal decompression via the trans–Superior Orbital Fissure approach. We retrospectively reviewed medical charts, radiologic findings, surgical techniques, complications, and final surgical results. Results All 8 patients presented with visual disturbance caused by head injury; 2 patients had no light perception, 6 had light perception, and 2 had ophthalmoplegia. All patients underwent extradural optic canal decompression and high-dose steroid administration within 24 hours after injury. Postoperative visual acuity on discharge was improved in 6 patients and unchanged in 2. The 2 patients with ophthalmoplegia gradually recovered by 3 months after operation. The postoperative outcome was good recovery in 7 patients and moderate disability in 1 patient. There were no complications related to the surgical procedure. Conclusions Emergent optic canal release has been recommended in patients with TON. The advantage of the extradural optic canal decompression via the trans–Superior Orbital Fissure approach is easy identification of the optic canal after partial removal of the anterior clinoid process, resulting in fewer surgical complications. In addition, this procedure can achieve intraOrbital decompression if necessary. We recommend this modified approach with mini-peeling as a safe and reliable procedure in patients with TON.
Yasuaki Nakao - One of the best experts on this subject based on the ideXlab platform.
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usefulness of extradural optic nerve decompression via trans Superior Orbital Fissure approach for treatment of traumatic optic nerve injury surgical procedures and techniques from experience with 8 consecutive patients
World Neurosurgery, 2016Co-Authors: Naoki Otani, Kojiro Wada, Kazuya Fujii, Terushige Toyooka, Kohsuke Kumagai, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Yasuaki Nakao, Takuji YamamotoAbstract:Objective To describe our experience of extradural optic nerve decompression via the trans–Superior Orbital Fissure approach for traumatic optic neuropathy (TON) and retrospectively analyze its advantages and pitfalls. Methods Between September 2009 and August 2014, 8 consecutive patients with TON underwent extradural optic canal decompression via the trans–Superior Orbital Fissure approach. We retrospectively reviewed medical charts, radiologic findings, surgical techniques, complications, and final surgical results. Results All 8 patients presented with visual disturbance caused by head injury; 2 patients had no light perception, 6 had light perception, and 2 had ophthalmoplegia. All patients underwent extradural optic canal decompression and high-dose steroid administration within 24 hours after injury. Postoperative visual acuity on discharge was improved in 6 patients and unchanged in 2. The 2 patients with ophthalmoplegia gradually recovered by 3 months after operation. The postoperative outcome was good recovery in 7 patients and moderate disability in 1 patient. There were no complications related to the surgical procedure. Conclusions Emergent optic canal release has been recommended in patients with TON. The advantage of the extradural optic canal decompression via the trans–Superior Orbital Fissure approach is easy identification of the optic canal after partial removal of the anterior clinoid process, resulting in fewer surgical complications. In addition, this procedure can achieve intraOrbital decompression if necessary. We recommend this modified approach with mini-peeling as a safe and reliable procedure in patients with TON.
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surgical simulation of extradural anterior clinoidectomy through the trans Superior Orbital Fissure approach using a dissectable three dimensional skull base model with artificial cavernous sinus
Skull Base Surgery, 2010Co-Authors: Kentaro Mori, Yasuaki Nakao, Takuji Yamamoto, Takanori EsakiAbstract:Extradural anterior clinoidectomy via the trans-Superior Orbital Fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely reproduced the dura propria of the temporal lobe, periosteal bridge, and inner reticular layer in the cavernous sinus and SOF using silicone and varnish. The cranial nerves and blood vessels were made from rubber fibers and vinyl tube. Simulation of extradural anterior clinoidectomy via the trans-SOF approach could be performed on the model using a high-speed drill under the operating microscope. The steps of reconstruction of the skull base model and dissection promote clear understanding of the 3-D anatomy and techniques of extradural anterior clinoidectomy via the trans-SOF approach.
Chientzung Chen - One of the best experts on this subject based on the ideXlab platform.
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traumatic Superior Orbital Fissure syndrome assessment of cranial nerve recovery in 33 cases
Plastic and Reconstructive Surgery, 2010Co-Authors: Chientzung Chen, Theresa Y Wang, Peikwei Tsay, Faye Huang, Yuray ChenAbstract:BACKGROUND: Superior Orbital Fissure syndrome is a rare complication that occurs in association with craniofacial trauma. The characteristics of Superior Orbital Fissure syndrome are attributable to a constellation of cranial nerve III, IV, and VI palsies. This is the largest series describing traumatic Superior Orbital Fissure syndrome that assesses the recovery of individual cranial nerve function after treatment. METHODS: In a review from 1988 to 2002, 33 patients with Superior Orbital Fissure syndrome were identified from 11,284 patients (0.3 percent) with skull and facial fractures. Severity of cranial nerve injury and functional recovery were evaluated by extraocular muscle movement. Patients were evaluated on average 6 days after initial injury, and average follow-up was 11.8 months. RESULTS: There were 23 male patients. The average age was 31 years. The major mechanism of injury was motorcycle accident (67 percent). Twenty-two received conservative treatment, five were treated with steroids, and six patients underwent surgical decompression of the Superior Orbital Fissure. After initial injury, cranial nerve VI suffered the most damage, whereas cranial nerve IV sustained the least. In the first 3 months, recovery was greatest in cranial nerve VI. At 9 months, function was lowest in cranial nerve VI and highest in cranial nerve IV. Eight patients (24 percent) had complete recovery of all cranial nerves. Functional recovery of all cranial nerves reached a plateau at 6 months after trauma. CONCLUSIONS: Cranial nerve IV suffered the least injury, whereas cranial nerve VI experienced the most neurologic deficits. Cranial nerve palsies improved to their final recovery endpoints by 6 months. Surgical decompression is considered when there is evidence of bony compression of the Superior Orbital Fissure.
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traumatic Superior Orbital Fissure syndrome current management
Craniomaxillofacial Trauma and Reconstruction, 2010Co-Authors: Chientzung Chen, Yuray ChenAbstract:Traumatic Superior Orbital Fissure syndrome is an uncommon complication of craniomaxillofacial trauma with an incidence of less than 1%. The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. This article describes a detailed anatomy of the Superior Orbital Fissure as it related to pathophysiology and clinical findings. Etiology and diagnosis are established after detailed physical and radiographic examination. On the basis of our clinical experience in the management of Superior Orbital Fissure syndrome and from the data reported previously in the literature, an algorithm for treatment of traumatic Superior Orbital Fissure syndrome including use of steroid, surgical decompression of Superior Orbital Fissure, and reduction of concomitant facial fracture is presented and its rationale discussed.
