Objectives: The aim of study was to determine the pattern and management of neural tube defects (NTD). Methodology: It was a hospital based descriptive cross-sectional retrospective study on patients who consulted and...Objectives: The aim of study was to determine the pattern and management of neural tube defects (NTD). Methodology: It was a hospital based descriptive cross-sectional retrospective study on patients who consulted and/or were admitted at the Douala General hospital for neural tube defects from January 2005 to April 2015. Results: A total of forty-nine (49) patients were enrolled. Males constituted 59.8% and females 40.2% giving a sex ratio of 1.5 in favour of males. Most of the parents of the patients (71.5%) had a low socio-economic status. Myelomeningocele was the most common type (80.4%) followed by 17.4% cases of meningocele and 2.2% cases of lipomeningocele. Three cases (3) of encephaloceles were seen during this period. The commonest site of these defects was the lumbosacral region (47.8%). Other sites included lumbar (19;41.3%), sacral (3;6.5%) and thoracolumbar (2;4.3%) ones. About half of the patients (24;48.9%) presented with ruptured lesions. Hydrocephalus was also recorded in 65.3% of patients. Talipes equinovarus and talipes calcaneovalgus were the most common associated orthopedic birth defects found. Surgical closure was done for 44 (89.9%) patients. Ventriculoperitoneal shunting was done in 78.1% of those who presented with hydrocephalus. Post-operative complications were more frequent in patients with ruptured lesions (P = 0.001). The most common post-operative complications were wound infections (22;44.9%) and wound dehiscence (20;40.8%). Conclusion: Lumbosacral Myelomeningocele was the most common type of NTD in our region. Low socio-economic status was a common risk factor.展开更多
Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an al...Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an alternative to microscopic vision.Case presentation We present a case of a 46-year-old patient with a low-grade glioma recurrence of the right gyrus cinguli removed with a contralateral transfalcine approach using an exoscope(ORBEYE 4K-three-dimensional(3D)exoscope,Sony Olympus Medical Solutions Inc.,Tokyo,Japan).The operating room setup for this approach is illustrated.During the procedure,the surgeon was seated with head and back in an upright position,while the camera was aligned with the surgical corridor.The exoscope provided detailed,high-quality 4K-3D images of the anatomical structures and optimal depth perception,making surgery accurate and precise.At the end of the resection,an intraoperative MRI scan showed complete removal of the lesion.The patient was discharged on postoperative day 4 with an excellent performance on neuropsychological examination.Conclusions In this clinical case the contralateral approach was favorable because the glioma was located close to the midline and because it offered a straight path to the tumor,minimizing retraction on the brain.The exoscope provided the surgeon with important advantages in terms of anatomical visualization and ergonomics during the entire procedure.展开更多
文摘Objectives: The aim of study was to determine the pattern and management of neural tube defects (NTD). Methodology: It was a hospital based descriptive cross-sectional retrospective study on patients who consulted and/or were admitted at the Douala General hospital for neural tube defects from January 2005 to April 2015. Results: A total of forty-nine (49) patients were enrolled. Males constituted 59.8% and females 40.2% giving a sex ratio of 1.5 in favour of males. Most of the parents of the patients (71.5%) had a low socio-economic status. Myelomeningocele was the most common type (80.4%) followed by 17.4% cases of meningocele and 2.2% cases of lipomeningocele. Three cases (3) of encephaloceles were seen during this period. The commonest site of these defects was the lumbosacral region (47.8%). Other sites included lumbar (19;41.3%), sacral (3;6.5%) and thoracolumbar (2;4.3%) ones. About half of the patients (24;48.9%) presented with ruptured lesions. Hydrocephalus was also recorded in 65.3% of patients. Talipes equinovarus and talipes calcaneovalgus were the most common associated orthopedic birth defects found. Surgical closure was done for 44 (89.9%) patients. Ventriculoperitoneal shunting was done in 78.1% of those who presented with hydrocephalus. Post-operative complications were more frequent in patients with ruptured lesions (P = 0.001). The most common post-operative complications were wound infections (22;44.9%) and wound dehiscence (20;40.8%). Conclusion: Lumbosacral Myelomeningocele was the most common type of NTD in our region. Low socio-economic status was a common risk factor.
文摘Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an alternative to microscopic vision.Case presentation We present a case of a 46-year-old patient with a low-grade glioma recurrence of the right gyrus cinguli removed with a contralateral transfalcine approach using an exoscope(ORBEYE 4K-three-dimensional(3D)exoscope,Sony Olympus Medical Solutions Inc.,Tokyo,Japan).The operating room setup for this approach is illustrated.During the procedure,the surgeon was seated with head and back in an upright position,while the camera was aligned with the surgical corridor.The exoscope provided detailed,high-quality 4K-3D images of the anatomical structures and optimal depth perception,making surgery accurate and precise.At the end of the resection,an intraoperative MRI scan showed complete removal of the lesion.The patient was discharged on postoperative day 4 with an excellent performance on neuropsychological examination.Conclusions In this clinical case the contralateral approach was favorable because the glioma was located close to the midline and because it offered a straight path to the tumor,minimizing retraction on the brain.The exoscope provided the surgeon with important advantages in terms of anatomical visualization and ergonomics during the entire procedure.
