8 results on '"Ditzel Filho, Leo F."'
Search Results
2. Retrosigmoid approach for resection of petrous apex meningioma
- Author
-
de Souza, Daniel G., primary, Ditzel Filho, Leo F. S., additional, Makonnen, Girma, additional, Zoli, Matteo, additional, Naudy, Cristian, additional, Muto, Jun, additional, and Prevedello, Daniel M., additional
- Published
- 2014
- Full Text
- View/download PDF
3. Endoscopic treatment of a third ventricle choroid plexus cyst
- Author
-
de Lara, Danielle, primary, Ditzel Filho, Leo F. S., additional, Muto, Jun, additional, and Prevedello, Daniel M., additional
- Published
- 2013
- Full Text
- View/download PDF
4. Retrosigmoid approach for resection of petrous apex meningioma
- Author
-
Girma Makonnen, Daniel G. de Souza, Leo F. S. Ditzel Filho, Daniel M. Prevedello, Matteo Zoli, Jun Muto, Cristian Naudy, de Souza, Daniel G., Ditzel Filho, Leo F. S, Makonnen, Girma, Zoli, Matteo, Naudy, Cristian, Muto, Jun, and Prevedello, Daniel M.
- Subjects
medicine.medical_specialty ,Petrous Apex Meningioma ,Cerebellopontine Angle ,Neurosurgical Procedure ,Neurosurgical Procedures ,Meningioma ,Trigeminal neuralgia ,Vertigo ,Meningeal Neoplasms ,medicine ,Humans ,Meningeal Neoplasm ,biology ,business.industry ,Petrous Apex ,Medicine (all) ,Cranial nerves ,General Medicine ,Middle Aged ,medicine.disease ,biology.organism_classification ,Cerebellopontine angle ,Magnetic Resonance Imaging ,Surgery ,Dissection ,Treatment Outcome ,Female ,Neurology (clinical) ,business ,Brain Stem ,Human - Abstract
We present the case of a 50-year-old female with a 1-year history of right-side facial numbness, as well as an electric shock-like sensation on the right-side of the face and tongue. She was previously diagnosed with vertigo and trigeminal neuralgia. MRI was obtained showing a large right cerebellopontine angle mass. A retrosigmoid approach was performed and total removal was achieved after dissection of tumor from brainstem and cranial nerves IV, V, VI, VII and VIII. Pathology confirmed the diagnosis of a meningioma (WHO Grade I). The patient was discharged neurologically intact on the third postoperative day free of complications.The video can be found here: http://youtu.be/-tR0FtMiUDg.
- Published
- 2014
5. Response.
- Author
-
Prevedello DM, de Lara D, Ditzel Filho LF, Muto J, Otto BA, and Carrau RL
- Subjects
- Female, Humans, Cerebral Ventricles surgery, Craniopharyngioma surgery, Craniotomy methods, Hypophysectomy methods, Microsurgery methods, Pituitary Neoplasms surgery, Skull Base surgery, Third Ventricle surgery
- Published
- 2014
6. Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access.
- Author
-
Oyama K, Prevedello DM, Ditzel Filho LF, Muto J, Gun R, Kerr EE, Otto BA, and Carrau RL
- Subjects
- Craniopharyngioma surgery, Humans, Pituitary Neoplasms surgery, Interpeduncular Nucleus surgery, Nose surgery, Sella Turcica surgery
- Abstract
Object: The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern., Methods: Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the interpeduncular cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. "Water balloon tumors" (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the interpeduncular cistern to compare visualization using the 2 approaches. The distances between cranial nerve (CN) III and the posterior communicating artery (PCoA) and between CN III and the edge of the tentorium were measured through a transpetrosal approach to determine the width of surgical corridors using 0- to 6-ml WBTs in the interpeduncular cistern (n = 8)., Results: Both approaches provided adequate exposure of the interpeduncular cistern. The endoscopic endonasal approach yielded a good visualization of both CN III and the PCoA when a WBT was in the interpeduncular cistern. Visualization of the contralateral anatomical structures was impaired in the transpetrosal approach. The surgical corridor to the interpeduncular cistern via the transpetrosal approach was narrow when the WBT volume was small, but its width increased as the WBT volume increased. There was a statistically significant increase in the maximum distance between CN III and the PCoA (p = 0.047) and between CN III and the tentorium (p = 0.029) when the WBT volume was 6 ml., Conclusions: Both approaches are valid surgical options for retrochiasmatic lesions such as craniopharyngiomas. The endoscopic endonasal approach via the dorsum sellae provides a direct and wide exposure of the interpeduncular cistern with negligible neurovascular manipulation. The transpetrosal approach also allows direct access to the interpeduncular cistern without pituitary manipulation; however, the surgical corridor is narrow due to the surrounding neurovascular structures and affords poor contralateral visibility. Conversely, in the presence of large or giant tumors in the interpeduncular cistern, which widen the spaces between neurovascular structures, the transpetrosal approach becomes a superior route, whereas the endoscopic endonasal approach may provide limited freedom of movement in the lateral extension.
- Published
- 2014
- Full Text
- View/download PDF
7. Endoscopic endonasal surgical management of chondrosarcomas with cerebellopontine angle extension.
- Author
-
Mesquita Filho PM, Ditzel Filho LF, Prevedello DM, Martinez CA, Fiore ME, Dolci RL, Otto BA, and Carrau RL
- Subjects
- Adult, Aged, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurosurgical Procedures methods, Retrospective Studies, Cerebellopontine Angle pathology, Chondrosarcoma surgery, Endoscopy methods, Nose surgery, Skull Base Neoplasms surgery
- Abstract
Object: Skull base chondrosarcomas are slow-growing, locally invasive tumors that arise from the petroclival synchondrosis. These characteristics allow them to erode the clivus and petrous bone and slowly compress the contents of the posterior fossa progressively until the patient becomes symptomatic, typically from cranial neuropathies. Given the site of their genesis, surrounded by the petrous apex and the clival recess, these tumors can project to the middle fossa, cervical area, and posteriorly, toward the cerebellopontine angle (CPA). Expanded endoscopic endonasal approaches are versatile techniques that grant access to the petroclival synchondrosis, the core of these lesions. The ability to access multiple compartments, remove infiltrated bone, and achieve tumor resection without the need for neural retraction makes these techniques particularly appealing in the management of these complex lesions., Methods: Analysis of the authors' database yielded 19 cases of skull base chondrosarcomas; among these were 5 cases with predominant CPA involvement. The electronic medical records of the 5 patients were retrospectively reviewed for age, sex, presentation, pre- and postoperative imaging, surgical technique, pathology, and follow-up. These cases were used to illustrate the surgical nuances involved in the endonasal resection of CPA chondrosarcomas., Results: The male/female ratio was 1:4, and the patients' mean age was 55.2 ±11.2 years. All cases involved petrous bone and apex, with variable extensions to the posterior fossa and parapharyngeal space. The main clinical scenario was cranial nerve (CN) palsy, evidenced by diplopia (20%), ptosis (20%), CN VI palsy (20%), dysphagia (40%), impaired phonation (40%), hearing loss (20%), tinnitus (20%), and vertigo/dizziness (40%). Gross-total resection of the CPA component of the tumor was achieved in 4 cases (80%); near-total resection of the CPA component was performed in 1 case (20%). Two patients (40%) harbored high-grade chondrosarcomas. No patient experienced worsening neurological symptoms postoperatively. In 2 cases (40%), the symptoms were completely normalized after surgery., Conclusions: Expanded endoscopic endonasal approaches appear to be safe and effective in the resection of select skull base chondrosarcomas; those with predominant CPA involvement seem particularly amenable to resection through this technique. Further studies with larger cohorts are necessary to test these preliminary impressions and to compare their effectiveness with the results obtained with open approaches.
- Published
- 2014
- Full Text
- View/download PDF
8. Surgical management of craniopharyngioma with third ventricle involvement.
- Author
-
de Lara D, Ditzel Filho LF, Muto J, Otto BA, Carrau RL, and Prevedello DM
- Subjects
- Aged, Craniopharyngioma complications, Diabetes Insipidus etiology, Female, Humans, Neoplasm Invasiveness, Pituitary Neoplasms complications, Surgical Flaps, Third Ventricle pathology, Vision Disorders etiology, Vision Disorders surgery, Craniopharyngioma surgery, Hypophysectomy methods, Pituitary Neoplasms surgery, Third Ventricle surgery
- Abstract
Craniopharyngiomas are notorious for their ability to invade the hypothalamus and third ventricle. Although several transcranial approaches have been proposed for their treatment, the endonasal route provides direct access to the tumor with no need for cerebral retraction or manipulation of the optic apparatus. After the lesion is debulked, the unique angle of approach achieved with this technique enables the surgeon to perform an extra-capsular dissection and visualize the walls of the third ventricle, the foramina of Monro, and the anterior comissure. Moreover, the enhanced magnification and lighting afforded by the endoscope facilitate safe tumor removal, particularly in areas where there is loss of clear lesion delimitation and greater infiltration of the surrounding structures. Herein we present the case of a 68-year-old female patient with a 3-month history of visual deterioration accompanied by worsening headaches. Investigation with magnetic resonance imaging revealed a heterogeneous mass in the suprasellar region, extending into the third ventricle and displacing the pituitary gland and stalk inferiorly. Hormonal profile was within expected range for her age. An endonasal, fully endoscopic, transplanum transtuberculum approach was performed. Gross-total removal was achieved and pathology confirmed the diagnosis of craniopharyngioma. Postoperative recovery was marked by transient diabetes insipidus. Closure was achieved with a pedicled nasoseptal flap; despite exploration of the third ventricle, there was no cerebrospinal fluid leakage. Pituitary function was preserved. Visual function has fully recovered and the patient has been uneventfully followed since surgery. The video can be found here: http://youtu.be/it5mpofZl0Q. (http://thejns.org/doi/abs/10.3171/2013.V1.FOCUS12330)
- Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.