Safer optic nerve decompression surgery



Using new technologies that make it easier to sequence the human genome, researchers at the University of Michigan Comprehensive Cancer Center have identified a series of genes that become fused when their chromosomes trade places with each other. These recurrent gene fusions are thought to be the driving mechanism that causes certain cancers to develop.

Full Post: Researchers find genes that fuse in cancer

Knowing about variations in the location of the optic nerve and ophthalmic artery can aid surgeons in performing optic nerve decompression - a delicate operation performed in patients with vision loss resulting from head injury, reports a study in the November Journal of Craniofacial Surgery.

Led by Dr. Jiping Li, a head and neck surgeon at Shanghai (China) Jiaotong University School of Medicine, the researchers performed a study in cadavers to analyze the anatomy of the optic nerve and ophthalmic artery. They present important information on useful anatomical landmarks and common variations for surgeons to be aware of when performing optic nerve decompression.

Optic nerve decompression, as first discussed in a pioneering 1976 study by the current Editors-in-Chief of LWW’s Journal of Craniofacial Surgery and Annals of Plastic Surgery, is sometimes needed in patients who have loss of vision after head injury, such as from car crashes. Swelling from head trauma can place pressure on the optic nerve, causing a decreased vision or blindness. Urgent surgery is sometimes needed to relieve the pressure on the optic nerve, in the hope of restoring vision.

In their study, Dr. Li and colleagues performed simulated optic nerve decompression surgery in eight cadaver heads. The procedure is done using a minimally invasive approach using an endoscope-a telescope-like instrument that lets the surgeon see and operate within the skull. The surgery is done through a “transsphenoidal” approach, meaning through the sphenoid sinus-one of the air spaces behind the nose.

The study provided important information on key landmarks for surgeons to follow when navigating through the sinuses to reach the location of the optic nerve. The researchers also identified the most common sites of the optic nerve within the sinus and some common variations that may be found during the procedure. For example, one key landmark that is useful in guiding surgery was absent about 40 percent of the time.

A key goal of the study was identification of the ophthalmic artery, which closely follows the optic nerve-the surgeon must take meticulous care to avoid damaging the optic nerve. The researchers found that the ophthalmic artery starts below and a little to the side (inferomedial) compared to the optic nerve, but may intersect the nerve as it runs alongside.

Dr. Li and colleagues hope the new information on the anatomic relationships between the optic nerve, ophthalmic artery, and sphenoid sinus will help to guide surgeons in planning performing this precise endoscopic surgical procedure. They write, “Understanding these relationships facilitates identification of the optic nerve, avoids ophthalmic artery injury, and prevents resulting severe complications?the key [to] achieving good surgical outcomes.”

http://www.jcraniofacialsurgery.com

Link




Simbionix USA Corp, an international company using leading edge simulation to advance clinical performance, announces the world-wide release of a breakthrough training simulation of the laparoscopic colorectal procedure. Although minimally invasive surgical (MIS) techniques provide many advantages over traditional open surgery, surgeons have been slow to adopt laparoscopic colon resection, because it is a very

Full Post: New colorectal module from Simbionix advances laparoscopic cancer treatment



Smith & Nephew’s Endoscopy Division has announced the launch of the CROSSTRAC Hip Guide System, which enables surgeons to accurately establish pathways to diagnose and repair the hip joint using arthroscopy, or minimally invasive, repair procedures. The announcement came at the Arthroscopy Association of North America Fall Course, which opened today and runs through Saturday in

Full Post: New system helps the repair of hip joint using arthroscopy



Patients whose nose has been destroyed by a tumor or injury carry a severe psychological and social burden. Esthetic reconstruction ranges among the most challenging tasks in plastic surgery. Helmut Fischer and Wolfgang Gubisch present the different options for nasal reconstruction surgery in the current issue of Deutsches ?zteblatt International ( Dtsch Arztebl Int 2008;

Full Post: 7 years without a nose



It’s time patient consent forms came back full circle to a tool for patient education, rather than the waiver of liability they have become. The original purpose of the consent forms was for a surgeon or doctor to inform the patient of common or serious risks associated with the procedure to be performed. However, the

Full Post: Informed consent process has lost its educational value



Surgeons in the United States have carried out America’s first face transplant at a clinic in Cleveland, Ohio where a woman has had 80% of her face replaced with that of a deceased female donor. The operation which was conducted by reconstructive surgeon Dr. Maria Siemionow along with a team of seven other doctors, is

Full Post: American surgeons carry out first U.S. face transplant