A Prospective Comparison Between Soft Tissue Dissection Techniques in Pterional Craniotomy: Functional, Radiological, and Aesthetic Outcomes.

BACKGROUND AND OBJECTIVES: Given the complex anatomy of the operative region and individual surgeon preferences, some techniques for soft tissue dissection before pterional craniotomy have gained more popularity than others. This prospective study used subjective and objective measurements to compare the functional, radiological, and aesthetic outcomes of 3 such dissection techniques. METHODS: This multicenter prospective cohort study included all patients who underwent elective pterional craniotomy between 2018 and 2020 at 3 centers in Riyadh, Saudi Arabia. All patients underwent 1 of 3 soft tissue dissection techniques: myocutaneous flap, interfascial, and subfascial dissection techniques. Clinical and radiological assessments were performed upon discharge and at the 3- and 6-month follow-ups. RESULTS: We included 78 patients, with a mean age of 44.9 ± 16.3 years. Myocutaneous flap, interfascial, and subfascial dissections were performed in 34 (43%), 24 (30%), and 20 patients (25%), respectively. The myocutaneous flap method had the shortest opening ( P = .001) and closure ( P = .005) times; tenderness was more evident in this group than in the others ( P = .05). The frontalis muscle was most affected in the interfascial dissection group ( P = .05). The frontalis nerve function was similar in all groups after 6 months ( P = .54). The incidence of temporomandibular joint dysfunction was highest in the myocutaneous flap group (29%). Decreased temporalis muscle thickness at the 6-month postoperative follow-up was most severe in the subfascial dissection group (12.6%), followed by the myocutaneous flap (11.9%) and interfascial dissection (9.9%) groups, with no significant difference ( P = .85). Temporal hollowing was more prominent in the myocutaneous flap group ( P = .03). Cosmetic satisfaction was highest in the interfascial dissection group, with no significant difference ( P = .4). CONCLUSION: This study provides important information for neurosurgeons in weighing the benefits and risks of each technique for their patients.

Outcomes and complications of microscopic transcallosal colloid cyst resection: A single institution experience.

Background: Colloid cysts have always provoked the interest of neurosurgeons due to their benign histology, wide variety of clinical presentations, and differences in reported surgical outcomes. Although recent studies have reported favorable outcomes with different surgical resection approaches, the transcallosal approach remains the most popular approach to date. In this series, we report the clinical and radiological outcomes of the transcallosal approach for the resection of third ventricle colloid cysts in 12 patients. Methods: We present a case series of 12 patients who were radiologically diagnosed with a third ventricle colloid cyst who underwent transcallosal resection by a single surgeon in one center over a 6-year period. Clinical, radiological, and surgical data were collected, and surgical outcomes and complications were analyzed. Results: Of the 12 patients diagnosed with colloid cysts, 10 (83%) presented with headache, and five (41%) presented with memory disturbance. All 12 patients showed improvement or resolution of their symptoms following resection. Nine patients (75%) presented with hydrocephalus on radiology. All the patients required preoperative or intraoperative external ventricular drain insertion. Four patients (33%) experienced transient postoperative complications. None of the patients required long-term cerebrospinal fluids shunting. One (8%) of 12 patients experienced transient memory loss. No mortality was recorded during the follow-up. Conclusion: Transcallosal resection of colloid cysts has a favorable prognosis. It allows for complete resection of the cyst with minimal transient postoperative complications. Most patients with postoperative complications show complete resolution of symptoms, with no long-term morbidity.

Performance of Children With Johanson-Blizzard Syndrome After Cochlear Implantation.

Johanson-Blizzard syndrome (JBS) is a rare autosomal recessive hereditary disorder characterized by multi-system involvement and facial dysmorphic features. One of the most common symptoms in JBS patients is bilateral severe to profound sensorineural hearing loss. The objective of this report is to highlight the performance of those patients after receiving cochlear implants (CI) as a management for their hearing loss. In this study, we reviewed the medical records of one female child diagnosed with JBS before and after cochlear implantation, with a particular focus on their auditory and language performance. After receiving the cochlear implant, our patient showed substantial improvement in her hearing threshold and communication abilities when compared to the preoperative condition. In conclusion, although cochlear implantation is considered a good approach for the management of JBS patients, the development of spoken language is not always achieved.