By F. Heppner, P. W. Ascher (auth.), Prof. Dr. Wendelin Walter, Prof. Dr. Mathias Brandt, Prof. Dr. Margareta Klinger, Prof. Dr. Mario Brock (eds.)
This sixteenth quantity of Advances in Neurosurgery features a collection of pa pers awarded on the thirty eighth Annual assembly of the German Society of Neurosurgery, held in Munster on 3-6 may possibly 1987. this system committee needed to opt for those contributions from a complete of 161 displays. i'm greatly obliged to the participants of the committee who contributed their adventure and energy to the association of the clinical professional gram: Prof. Dr. R.A. Frowein, Prof. Dr. W.J. Bock, Prof. Dr. E. Kazner, Prof. Dr. G. Lausberg, Prof. Dr. M. Klinger, and Prof. Dr. M. Brandt. the purpose of the assembly was once to switch stories relating to glossy diagnostic and healing achievements. the 1st major subject used to be new technical equipment in neurosurgery. Refinements in laser know-how have been brought; diverse laser units were famous as use ful instruments in microsurgery and a few peripheral nerve difficulties. The Ca vitron ultrasonic aspirator has confirmed its price in a good number of intracranial and spinal tumors inside of many years. Its technical strengthen is impressively verified by way of a few of the papers during this publication. With turning out to be adventure now we have famous the good worth of those extra tools in constrained surgical fields and discovered to not overestimate them within the palms of a talented neurosurgeon.
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Toluidine blue, x 340 Fig. 3. Cross section of distal nerve branch, 3 months' survival. Endoneurial fiber density is variable, and there are a number of aberrating fibers. Toluidine blue, x 150 Fig. 4. Longitudinal section of anastomosis, 3 months' survival. Proximal stump and suture material are marked by arrows. Congested blood vessels are also stained black by this method. Methacrylate, Sudan black, x 20 33 laser-treated nerves, none were present in 3, occasional ones in 4, and abundant ones in 5; in the 6 controls, none were present in 2, occasional ones in 3, and abundant ones in 1.
Reliability Both systems were used for 2 years and during this time there was no need for repair. New Developments Both instruments have been altered since this investigation. There is a compact lightweight version of the Sonotec (Sonotec MIC II). A new improved version of the CUSA has also been developed in which a lot of the above-mentioned disadvantages have been resolved (CUSA System 200) • 43 Surgical Ultrasonic Aspiration of Brain Tumors A. Zieger, P. Blanckenberg, 1. Pozo, U. Sander, and R Smedema Neurochirurgische Klinik, Evangelisches Krankenhaus, Steinweg 13-17, D-2900 Oldenburg Introduction In the last 10 years surgical ultrasonic aspiration has become established as a modern neurosurgical technique (2, 6, 7, 9, 13).
C,d Skeletonizing the vertebral artery ( arrow ), PICA, and brain stem ( double arrow ) after partial tUmor resection. f Resection of a lar~e suprasellar pituitary adenoma (right subfrontal route). Chiasm ( ). ~ Evacuation of a metastatic brain tumor. h Intracapsular removal of an acoustic neurinoma . i Layer -by-layer dissection of a medulloblastoma . Floor of the fourth ventricle (*) 49 Table 4. ) n 48 Equal use of CUSA and other techniques n 16 Little use of CUSA n = 11 b) Application time No more than 10 min n Between 10 and 20 min n More than 20 min n 69 (83%) = = 9 (11 %) 5 ( 6%) bleeding problems and disastrous neurological deficits seemed to be prevented by CUSA.