There are many kinds of unusual presentations or associations and clinical mimics of acute append... more There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.
Registration fee ENT specialist 1450 €, ENT resident in training (certificate requested) 1250 €, ... more Registration fee ENT specialist 1450 €, ENT resident in training (certificate requested) 1250 €, Lectures only 1100 €, Accompanying person 450 € Registrations/info/course secretariat
Background: Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia ... more Background: Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision of the external dura accompanied by widening the cisterna magna and making longitudinal incisions in the internal dura, without disturbing the arachnoid.
The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulococ... more The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulocochlear nerve, which consist of the cochlear nerve, the superior vestibular nerve, and the inferior vestibular nerve, run together in the IAC packaged in dura mater. Oort first described the vestibulocochlear anastomoses in 1918, which is important for the understanding of the pathogenesis and pathophysiology of otologic disorders. The current study documents the existence of vestibulofacial and vestibulocochlear neural connections and topographical relationship of the nerves as part of a radiologic evaluation of 73 human temporal bones from brainstem to the lateral portion of IAC.
or if there are atypical features of the lesion noted intraoperatively. Additionally, metastases ... more or if there are atypical features of the lesion noted intraoperatively. Additionally, metastases and adenomas may coexist. 5 Metastatic cells tend to have a high proliferative index when stained with monoclonal antibody MIB-1 or for proliferating cell nuclear antigen. 5 Further immunostaining such as with cytokeratins for adenocarcinomas and synaptophysin for small cell carcinomas should be guided by the clinical history and initial cellular appearance. 5,6 Pituitary metastases remain an important differential diagnosis for sellar tumours. Clinical and radiological features of pituitary metastases may be indistinguishable from other sellar tumours. Histopathology, with immunohistochemical assays, remain the key to the diagnosis.
We rarely use the cervical transpedicular fixation (CPF) technique in the neurosurgery department... more We rarely use the cervical transpedicular fixation (CPF) technique in the neurosurgery departments of the authors' institutions because the pedicle is thin and there is a risk of neurovascular damage. In this study we investigated postoperative neurovascular injury caused by the transpedicular screws of 210 pedicles in 45 patients on whom we performed CPF for various cervical pathologies. Fixation was performed between C3 and C7, and the iliac crest and lamina were used as autografts for fusion. In 205 of 210 pedicles (97.6%), the screws were in the correct position, while a non-critical lateral orientation was detected in three pedicles (1.4%). Two screws (one in each of two patients) were positioned inappropriately (0.9%, Grade 3), unilaterally and directly in the vertebral foramen, as shown on postoperative CT scans; blood circulation was normal on angiography. The fusion rate was 100%. The average screw length used for C3 to C7 was 32 mm. The patients were followed up for an average of 35.7 months (range: 17-60 months). There was no morbidity or mortality in our study. We concluded that CPF provides very strong cervical spine fixation but also carries a risk of pedicle perforation without neurovascular injury. However, a free-hand technique performed by an experienced surgeon is acceptable for CPF for various cervical pathologies.
The purpose of our study was to investigate the topographical relationship between these nerves a... more The purpose of our study was to investigate the topographical relationship between these nerves along their course from the brainstem through the internal acoustic canal IAC in the living human brain using MR imaging.
There are many kinds of unusual presentations or associations and clinical mimics of acute append... more There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.
Registration fee ENT specialist 1450 €, ENT resident in training (certificate requested) 1250 €, ... more Registration fee ENT specialist 1450 €, ENT resident in training (certificate requested) 1250 €, Lectures only 1100 €, Accompanying person 450 € Registrations/info/course secretariat
Background: Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia ... more Background: Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision of the external dura accompanied by widening the cisterna magna and making longitudinal incisions in the internal dura, without disturbing the arachnoid.
The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulococ... more The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulocochlear nerve, which consist of the cochlear nerve, the superior vestibular nerve, and the inferior vestibular nerve, run together in the IAC packaged in dura mater. Oort first described the vestibulocochlear anastomoses in 1918, which is important for the understanding of the pathogenesis and pathophysiology of otologic disorders. The current study documents the existence of vestibulofacial and vestibulocochlear neural connections and topographical relationship of the nerves as part of a radiologic evaluation of 73 human temporal bones from brainstem to the lateral portion of IAC.
or if there are atypical features of the lesion noted intraoperatively. Additionally, metastases ... more or if there are atypical features of the lesion noted intraoperatively. Additionally, metastases and adenomas may coexist. 5 Metastatic cells tend to have a high proliferative index when stained with monoclonal antibody MIB-1 or for proliferating cell nuclear antigen. 5 Further immunostaining such as with cytokeratins for adenocarcinomas and synaptophysin for small cell carcinomas should be guided by the clinical history and initial cellular appearance. 5,6 Pituitary metastases remain an important differential diagnosis for sellar tumours. Clinical and radiological features of pituitary metastases may be indistinguishable from other sellar tumours. Histopathology, with immunohistochemical assays, remain the key to the diagnosis.
We rarely use the cervical transpedicular fixation (CPF) technique in the neurosurgery department... more We rarely use the cervical transpedicular fixation (CPF) technique in the neurosurgery departments of the authors' institutions because the pedicle is thin and there is a risk of neurovascular damage. In this study we investigated postoperative neurovascular injury caused by the transpedicular screws of 210 pedicles in 45 patients on whom we performed CPF for various cervical pathologies. Fixation was performed between C3 and C7, and the iliac crest and lamina were used as autografts for fusion. In 205 of 210 pedicles (97.6%), the screws were in the correct position, while a non-critical lateral orientation was detected in three pedicles (1.4%). Two screws (one in each of two patients) were positioned inappropriately (0.9%, Grade 3), unilaterally and directly in the vertebral foramen, as shown on postoperative CT scans; blood circulation was normal on angiography. The fusion rate was 100%. The average screw length used for C3 to C7 was 32 mm. The patients were followed up for an average of 35.7 months (range: 17-60 months). There was no morbidity or mortality in our study. We concluded that CPF provides very strong cervical spine fixation but also carries a risk of pedicle perforation without neurovascular injury. However, a free-hand technique performed by an experienced surgeon is acceptable for CPF for various cervical pathologies.
The purpose of our study was to investigate the topographical relationship between these nerves a... more The purpose of our study was to investigate the topographical relationship between these nerves along their course from the brainstem through the internal acoustic canal IAC in the living human brain using MR imaging.
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