Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Neurosurgical Review
Erschienen in: Neurosurgical Review 1/2024

01.12.2024 | Review

Temporal lobe injury with middle fossa approach to intracanalicular vestibular schwannomas: a systematic review

verfasst von: Gabriel Flores-Milan, Gersham J. Rainone, Keaton Piper, Ivo Peto, Christopher Danner, Kyle P. Allen, Shih Sing Liu, Harry van Loveren, Siviero Agazzi

Erschienen in: Neurosurgical Review | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

There are several surgical approaches for vestibular schwannoma (VS) resection. However, management has gradually shifted from microsurgical resection, toward surveillance and radiosurgery. One of the arguments against microsurgery via the middle fossa approach (MFA) is the risk of temporal lobe retraction injury or sequelae. Here, we sought to evaluate the incidence of temporal lobe retraction injury or sequela from a MFA via a systematic review of the existing literature. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Relevant studies reporting temporal lobe injury or sequela during MFA for VS were identified. Data was aggregated and subsequently analyzed to evaluate the incidence of temporal lobe injury. 22 studies were included for statistical analysis, encompassing 1522 patients that underwent VS resection via MFA. The overall rate of temporal lobe sequelae from this approach was 0.7%. The rate of CSF leak was 5.9%. The rate of wound infection was 0.6%. Meningitis occurred in 1.6% of patients. With the MFA, 92% of patients had good facial outcomes, and 54.9% had hearing preservation. Our series and literature review support that temporal lobe retraction injury or sequelae is an infrequent complication from an MFA for intracanalicular VS resection.
Literatur
1.
Stangerup SE, Caye-Thomasen P (2012) Epidemiology and natural history of vestibular schwannomas. Otolaryngol Clin North Am 45(2):257–268, vii
2.
Kosty JA, Stevens SM, Gozal YM et al (2019) Middle Fossa Approach for Resection of Vestibular Schwannomas: A Decade of Experience. Oper Neurosurg (Hagerstown) 16(2):147–158PubMedCrossRef
3.
Marinelli JP, Lohse CM, Carlson ML (2018) Incidence of Vestibular Schwannoma over the Past Half-Century: A Population-Based Study of Olmsted County. Minnesota Otolaryngol Head Neck Surg 159(4):717–723PubMedCrossRef
4.
Cioffi G, Yeboa DN, Kelly M, et al. (2020) Epidemiology of vestibular schwannoma in the United States, 2004–2016. Neurooncol Adv 2(1):vdaa135
5.
Marinelli JP, Beeler CJ, Carlson ML, Caye-Thomasen P, Spear SA, Erbele ID (2022) Global Incidence of Sporadic Vestibular Schwannoma: A Systematic Review. Otolaryngol Head Neck Surg 167(2):209–214PubMedCrossRef
6.
Koo M, Lai JT, Yang EY, Liu TC, Hwang JH (2018) Incidence of Vestibular Schwannoma in Taiwan from 2001 to 2012: A Population-Based National Health Insurance Study. Ann Otol Rhinol Laryngol 127(10):694–697PubMedCrossRef
7.
Waterval J, Kania R, Somers T (2018) EAONO Position Statement on Vestibular Schwannoma: Imaging Assessment. What are the Indications for Performing a Screening MRI Scan for a Potential Vestibular Schwannoma? J Int Adv Otol 14(1):95–99
8.
Marinelli JP, Nassiri AM, Habermann EB, Lohse CM, Holton SJ, Carlson ML (2021) Underreporting of Vestibular Schwannoma Incidence Within National Brain Tumor and Cancer Registries in the United States. Otol Neurotol 42(6):e758–e763PubMedPubMedCentralCrossRef
9.
Neves Cavada M, Fook-Ho Lee M, Jufas NE, Harvey RJ, Patel NP (2021) Intracanalicular Vestibular Schwannoma: A Systematic Review and Meta-analysis of Therapeutics Outcomes. Otol Neurotol 42(3):351–362PubMedCrossRef
10.
Dang L, Tu NC, Chan EY (2020) Current imaging tools for vestibular schwannoma. Curr Opin Otolaryngol Head Neck Surg 28(5):302–307PubMedCrossRef
11.
Lees KA, Tombers NM, Link MJ et al (2018) Natural History of Sporadic Vestibular Schwannoma: A Volumetric Study of Tumor Growth. Otolaryngol Head Neck Surg 159(3):535–542PubMedCrossRef
12.
Salem N, Galal A, Mastronardi V, Talaat M, Sobhy O, Sanna M (2019) Audiological Evaluation of Vestibular Schwannoma Patients with Normal Hearing. Audiol Neurootol 24(3):117–126PubMedCrossRef
13.
Marinelli JP, Schnurman Z, Killeen DE et al (2022) Long-term natural history and patterns of sporadic vestibular schwannoma growth: A multi-institutional volumetric analysis of 952 patients. Neuro Oncol 24(8):1298–1306PubMedCrossRef
14.
Chan SA, Marinelli JP, Hahs-Vaughn DL, Nye C, Link MJ, Carlson ML (2021) Evolution in Management Trends of Sporadic Vestibular Schwannoma in the United States Over the Last Half-century. Otol Neurotol 42(2):300–305PubMedCrossRef
15.
Reznitsky M, Petersen M, West N, Stangerup SE, Caye-Thomasen P (2021) The natural history of vestibular schwannoma growth-prospective 40-year data from an unselected national cohort. Neuro Oncol 23(5):827–836PubMedCrossRef
16.
Khandalavala KR, Saba ES, Kocharyan A et al (2022) Hearing Preservation in Observed Sporadic Vestibular Schwannoma: A Systematic Review. Otol Neurotol 43(6):604–610PubMedCrossRef
17.
Noudel R, Gomis P, Duntze J, Marnet D, Bazin A, Roche PH (2009) Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches. Acta Neurochir (Wien) 151(8):935–944; discussion 944–935
18.
Ogino A, Lunsford LD, Long H et al (2021) Stereotactic radiosurgery as the first-line treatment for intracanalicular vestibular schwannomas. J Neurosurg 135(4):1051–1057PubMedCrossRef
19.
Dzierzecki S, Turek G, Czapski B et al (2020) Gamma knife surgery in the treatment of intracanalicular vestibular schwannomas. Acta Neurol Scand 141(5):415–422PubMedCrossRef
20.
Balossier A, Tuleasca C, Delsanti C et al (2023) Long-Term Hearing Outcome After Radiosurgery for Vestibular Schwannoma: A Systematic Review and Meta-Analysis. Neurosurgery 92(6):1130–1141PubMedPubMedCentralCrossRef
21.
Jakubeit T, Sturtz S, Sow D et al (2022) Single-fraction stereotactic radiosurgery versus microsurgical resection for the treatment of vestibular schwannoma: a systematic review and meta-analysis. Syst Rev 11(1):265PubMedPubMedCentralCrossRef
22.
Zhang Z, Nguyen Y, De Seta D et al (2016) Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients. Acta Otorhinolaryngol Ital 36(5):408–414PubMedPubMedCentralCrossRef
23.
Fík Z, Zverina E, Lisy J et al (2023) Hearing After Vestibular Schwannoma Surgery: Is It Preserved Forever? Otol Neurotol 44(3):260–265PubMedCrossRef
24.
Peker S, Samanci Y, Ozdemir IE, Kunst HPM, Eekers DBP, Temel Y (2022) Long-term results of upfront, single-session Gamma Knife radiosurgery for large cystic vestibular schwannomas. Neurosurg Rev 46(1):2PubMedCrossRef
25.
Anaizi AN, DiNapoli VV, Pensak M, Theodosopoulos PV (2016) Small Vestibular Schwannomas: Does Surgery Remain a Viable Treatment Option? J Neurol Surg B Skull Base 77(3):212–218PubMedCrossRef
26.
Frischer JM, Gruber E, Schoffmann V et al. (2018) Long-term outcome after Gamma Knife radiosurgery for acoustic neuroma of all Koos grades: a single-center study. J Neurosurg 1–10
27.
Ansari SF, Terry C, Cohen-Gadol AA (2012) Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus 33(3):E14PubMedCrossRef
28.
Berger A, Alzate JD, Bernstein K et al (2022) Modern Hearing Preservation Outcomes After Vestibular Schwannoma Stereotactic Radiosurgery. Neurosurgery 91(4):648–657PubMedPubMedCentralCrossRef
29.
Ismail O, Sobhy O, Assal S, Sanghera P, Begg P, Irving R (2022) Comparing Hearing Outcomes in Irradiated and Conservatively Managed Vestibular Schwannoma. Otol Neurotol 43(3):e374–e381PubMedCrossRef
30.
Watanabe S, Yamamoto M, Kawabe T et al (2016) Stereotactic radiosurgery for vestibular schwannomas: average 10-year follow-up results focusing on long-term hearing preservation. J Neurosurg 125(Suppl 1):64–72PubMedCrossRef
31.
Dowling EM, Patel NS, Lohse CM et al (2019) Durability of Hearing Preservation Following Microsurgical Resection of Vestibular Schwannoma. Otol Neurotol 40(10):1363–1372PubMedCrossRef
32.
Boari N, Bailo M, Gagliardi F et al (2014) Gamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients. J Neurosurg 121(Suppl):123–142PubMedCrossRef
33.
Bashjawish B, Kilic S, Baredes S, Eloy JA, Liu JK, Ying YM (2019) Changing trends in management of vestibular schwannoma: A National Cancer Database study. Laryngoscope 129(5):1197–1205PubMedCrossRef
34.
35.
Kirchmann M, Karnov K, Hansen S, Dethloff T, Stangerup SE, Caye-Thomasen P (2017) Ten-Year Follow-up on Tumor Growth and Hearing in Patients Observed With an Intracanalicular Vestibular Schwannoma. Neurosurgery 80(1):49–56PubMedCrossRef
36.
Wu MJ, Knoll RM, Chen JX et al (2022) A Subset of Intracanalicular Vestibular Schwannomas Demonstrates Minimal Growth Over a 10-Year Period. Otol Neurotol 43(3):376–384PubMedCrossRef
37.
van Linge A, Borsboom GJ, Wieringa MH, Goedegebure A (2016) Hearing Loss Progresses Faster in Patients With Growing Intracanalicular Vestibular Schwannomas. Otol Neurotol 37(9):1442–1448PubMedCrossRef
38.
Alzhrani G, Shelton C, Couldwell WT (2017) Middle fossa approach for resection of vestibular schwannoma. Acta Neurochir (Wien) 159(6):1023–1026PubMedCrossRef
39.
Wang AC, Chinn SB, Than KD et al (2013) Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach. J Neurosurg 119(1):131–138PubMedCrossRef
40.
Ginzkey C, Scheich M, Harnisch W et al (2013) Outcome on hearing and facial nerve function in microsurgical treatment of small vestibular schwannoma via the middle cranial fossa approach. Eur Arch Otorhinolaryngol 270(4):1209–1216PubMedCrossRef
41.
Kutz JW, Jr., Scoresby T, Isaacson B et al. (2012) Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma. Neurosurgery 70(2):334–340; discussion 340–331
42.
Tawfik KO, Khan UA, Friedman RA (2021) Treatment of Small Vestibular Schwannomas. Curr Otorhinolaryngol Reports 9(2):139–154CrossRef
43.
Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). (1995) American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC. Otolaryngol Head Neck Surg 113(3):179–180
44.
House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93(2):146–147PubMedCrossRef
45.
Gantz BJ, Parnes LS, Harker LA, McCabe BF (1986) Middle cranial fossa acoustic neuroma excision: results and complications. Ann Otol Rhinol Laryngol 95(5 Pt 1):454–459PubMedCrossRef
46.
Shelton C, Brackmann DE, House WF, Hitselberger WE (1989) Middle fossa acoustic tumor surgery: results in 106 cases. Laryngoscope 99(4):405–408PubMedCrossRef
47.
Sameshima T, Fukushima T, McElveen JT, Jr., Friedman AH (2010) Critical assessment of operative approaches for hearing preservation in small acoustic neuroma surgery: retrosigmoid vs middle fossa approach. Neurosurgery 67(3):640–644; discussion 644–645
48.
Budohoski KP, Rennert RC, Gordon SA, et al. (2022) Factors associated with hearing outcomes after a middle fossa approach in 131 consecutive patients with vestibular schwannomas. J Neurosurg 1–10
49.
Meyer TA, Canty PA, Wilkinson EP, Hansen MR, Rubinstein JT, Gantz BJ (2006) Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 27(3):380–392PubMedCrossRef
50.
Xian-Hao J, Zhen G, Ya-Sheng Y, Wei-Dong Z (2022) Resection of Vestibular Schwannoma Through Middle Cranial Fossa Approach with Endoscopic Assistance. World Neurosurg 158:e225–e230PubMedCrossRef
51.
Moon IS, Choi IS, Shin SH, Yang S, Jung Y, Na G (2022) Endoscopic-Assisted Keyhole Middle Cranial Fossa Approach for Small Vestibular Schwannomas. J Clin Med 11(9)
52.
Kohlberg GD, Lipschitz N, Raghavan AM et al (2021) Middle Cranial Fossa Approach to Vestibular Schwannoma Resection in the Older Patient Population. Otol Neurotol 42(1):e75–e81PubMedCrossRef
53.
Lipschitz N, Kohlberg GD, Tawfik KO et al (2019) Cerebrospinal Fluid Leak Rate after Vestibular Schwannoma Surgery via Middle Cranial Fossa Approach. J Neurol Surg B Skull Base 80(4):437–440PubMedCrossRef
54.
Scheich M, Ginzkey C, Ehrmann Muller D, ShehataDieler W, Hagen R (2017) Complications of the Middle Cranial Fossa Approach for Acoustic Neuroma Removal. J Int Adv Otol 13(2):186–190PubMedCrossRef
55.
Raheja A, Bowers CA, MacDonald JD et al (2016) Middle Fossa Approach for Vestibular Schwannoma: Good Hearing and Facial Nerve Outcomes with Low Morbidity. World Neurosurg 92:37–46PubMedCrossRef
56.
DeMonte F, Gidley PW (2012) Hearing preservation surgery for vestibular schwannoma: experience with the middle fossa approach. Neurosurg Focus 33(3):E10PubMedCrossRef
57.
Arts HA, Telian SA, El-Kashlan H, Thompson BG (2006) Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. Otol Neurotol 27(2):234–241PubMedCrossRef
58.
Colletti V, Fiorino F (2005) Is the middle fossa approach the treatment of choice for intracanalicular vestibular schwannoma? Otolaryngol Head Neck Surg 132(3):459–466PubMedCrossRef
59.
Stripf T, Bruehl K, Mann WJ, Amedee RG (2004) Clinical and radiologic sequelae of the middle fossa approach to the internal auditory canal. Otol Neurotol 25(5):787–790PubMedCrossRef
60.
Thomsen J, Stougaard M, Becker B, Tos M, Jennum P (2000) Middle fossa approach in vestibular schwannoma surgery. Postoperative hearing preservation and EEG changes. Acta Otolaryngol 120(4):517–522
61.
Holsinger FC, Coker NJ, Jenkins HA (2000) Hearing preservation in conservation surgery for vestibular schwannoma. Am J Otol 21(5):695–700PubMed
62.
Slattery WH 3rd, Brackmann DE, Hitselberger W (1997) Middle fossa approach for hearing preservation with acoustic neuromas. Am J Otol 18(5):596–601PubMed
63.
Weber PC, Gantz BJ (1996) Results and complications from acoustic neuroma excision via middle cranial fossa approach. Am J Otol 17(4):669–675PubMed
64.
Brackmann DE, House JR 3rd, Hitselberger WE (1994) Technical modifications to the middle fossa craniotomy approach in removal of acoustic neuromas. Am J Otol 15(5):614–619PubMed
65.
Monfared A, Mudry A, Jackler R (2010) The history of middle cranial fossa approach to the cerebellopontine angle. Otol Neurotol 31(4):691–696PubMedCrossRef
66.
House WF (1961) Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa. Laryngoscope 71:1363–1385PubMedCrossRef
67.
Yokoh A, Sugita K, Kobayashi S (1987) Clinical study of brain retraction in different approaches and diseases. Acta Neurochir (Wien) 87(3–4):134–139PubMedCrossRef
68.
Fukamachi A, Koizumi H, Nukui H (1985) Postoperative intracerebral hemorrhages: a survey of computed tomographic findings after 1074 intracranial operations. Surg Neurol 23(6):575–580PubMedCrossRef
69.
Li D, Zeng M, Yao Y, Zhang N, Yang T, Xia C (2022) Retractorless Surgery for Petroclival Meningiomas via the Subtemporal Approach: A Try to Reduce Brain Retraction Injury. Comput Math Methods Med 2022:6436542PubMedPubMedCentral
70.
Kashimura H, Ogasawara K, Kubo Y et al (2008) Brain retraction technique using gelatin sponge in the subtemporal approach. Neurol Med Chir (Tokyo) 48(3):143–146PubMedCrossRef
71.
Nelson RF, Roche JP, Gantz BJ, Hansen MR (2016) Middle Cranial Fossa (MCF) Approach Without the Use of Lumbar Drain for the Management of Spontaneous Cerebral Spinal Fluid (CSF) Leaks. Otol Neurotol 37(10):1625–1629PubMedCrossRef
72.
Teschner M, Lang CP, Salcher R, Haumann S, Lenarz T (2015) Impact of Elevation of Temporal Lobe During Middle Fossa Acoustic Neuroma Surgery on Contralateral Speech Discrimination. Otol Neurotol 36(10):1720–1724PubMedCrossRef
73.
Ren Y, Tawfik KO, Cueva RA (2021) Audiometric Outcomes Following Transmastoid and Middle Cranial Fossa Approaches for Repair of Cerebrospinal Fluid Otorrhea. Otol Neurotol 42(3):424–430PubMedCrossRef
74.
Lobo BC, Baumanis MM, Nelson RF (2017) Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: A systematic review. Laryngoscope Investig Otolaryngol 2(5):215–224PubMedPubMedCentralCrossRef
75.
Woodson EA, Dempewolf RD, Gubbels SP et al (2010) Long-term hearing preservation after microsurgical excision of vestibular schwannoma. Otol Neurotol 31(7):1144–1152PubMedPubMedCentralCrossRef
76.
Quist TS, Givens DJ, Gurgel RK, Chamoun R, Shelton C (2015) Hearing preservation after middle fossa vestibular schwannoma removal: are the results durable? Otolaryngol Head Neck Surg 152(4):706–711PubMedCrossRef
77.
Ahmed S, Arts HA, El-Kashlan H, Basura GJ, Thompson BG, Telian SA (2018) Immediate and Long-term Hearing Outcomes With the Middle Cranial Fossa Approach for Vestibular Schwannoma Resection. Otol Neurotol 39(1):92–98PubMedCrossRef
78.
Killeen DE, Barnett SL, Mickey BE, Hunter JB, Isaacson B, Kutz JW Jr (2021) The Association of Vestibular Schwannoma Volume With Facial Nerve Outcomes After Surgical Resection. Laryngoscope 131(4):E1328–E1334PubMedCrossRef
79.
Ren Y, MacDonald BV, Tawfik KO, Schwartz MS, Friedman RA (2021) Clinical Predictors of Facial Nerve Outcomes After Surgical Resection of Vestibular Schwannoma. Otolaryngol Head Neck Surg 164(5):1085–1093PubMedCrossRef
80.
Macielak RJ, Driscoll CLW, Link MJ, Haynes DS, Lohse CM, Carlson ML (2020) Vestibular Schwannoma Practice Patterns: An International Cross-specialty Survey. Otol Neurotol 41(10):e1304–e1313PubMedCrossRef
81.
82.
83.
Metadaten
Titel
Temporal lobe injury with middle fossa approach to intracanalicular vestibular schwannomas: a systematic review
verfasst von
Gabriel Flores-Milan
Gersham J. Rainone
Keaton Piper
Ivo Peto
Christopher Danner
Kyle P. Allen
Shih Sing Liu
Harry van Loveren
Siviero Agazzi
Publikationsdatum
01.12.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Neurosurgical Review / Ausgabe 1/2024
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-024-02425-w

Weitere Artikel der Ausgabe 1/2024

Neurosurgical Review 1/2024 Zur Ausgabe

Correspondence

Craniocervical instability in patients with Ehlers‑Danlos syndromes: outcomes analysis following occipito‑cervical fusion of published cases

Research

Development of a comprehensive and clinically applicable novel projection classification system for anterior communicating artery aneurysms

Correspondence

Letter to editor: Crucial trials in neurosurgery: A must-know for every neurosurgeon

Research

Outcomes of 2-SSRS plus bevacizumab therapy strategy for brainstem metastases (BSM) over 2 cm3: a multi-center study

Correspondence

Letter to the editor: natural history and neuro-oncological approach in spinal gangliogliomas: a systematic review

Review

Directional deep brain stimulation in the management of Parkinson’s disease: efficacy and constraints—an analytical appraisal

Neu im Fachgebiet Chirurgie

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.
Bildnachweise