Browsing by Author "Tomlinson, Samuel B."

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    Innovations in the Art of Microneurosurgery for Reaching Deep-Seated Cerebral Lesions
    (Elsevier, 2019) Tomlinson, Samuel B.; Hendricks, Benjamin K.; Torregrossa, Fabio; Grasso, Giovanni; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Deep-seated cerebral lesions have fascinated and frustrated countless surgical innovators since the dawn of the microneurosurgical era. To determine the optimal approach, the microneurosurgeon must take into account the characteristics and location of the pathological lesion as well as the operator’s range of technical expertise. Increasingly, microneurosurgeons must select between multiple operative corridors that can access to the surgical target. Innovative trajectories have emerged for many indications that provide more flexible operative angles and superior exposure but result in longer working distances and more technically demanding maneuvers. In this article, we highlight 4 innovative surgical corridors and compare their strengths and weaknesses against those of more conventional approaches. Our goal is to use these examples to illustrate the following principles of microneurosurgical innovation: (1) discover more efficient and flexible exposures with superior working angles; (2) ensure maximal early protection of critical neurovascular structures; and (3) effectively handle target pathology with minimal disruption of normal tissues.
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    Virtual Exploration of Safe Entry Zones in the Brainstem: Comprehensive Definition and Analysis of the Operative Approach
    (Elsevier, 2020) Meybodi, Ali Tayebi; Hendricks, Benjamin K.; Witten, Andrew J.; Hartman, Jerome; Tomlinson, Samuel B.; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Background Detailed and accurate understanding of intrinsic brainstem anatomy and the inter-relationship between its internal tracts and nuclei and external landmarks is of paramount importance for safe and effective brainstem surgery. Using anatomical models can be an important step in sharpening such understanding. Objective To show the applicability of our developed virtual 3D model in depicting the safe entry zones (SEZs) to the brainstem. Methods Accurate 3D virtual models of brainstem elements were created using high-resolution magnetic resonance imaging and computed tomography to depict brainstem SEZs. Results All the described SEZs to different aspects of the brainstem were successfully depicted using our 3D virtual models. Conclusions The virtual models provide an immersive experience of brainstem anatomy, allowing users to understand the intricacies of the microdissection that is necessary to appropriately traverse the brainstem nuclei and tracts toward a particular target. The models provide an unparalleled learning environment for illustrating SEZs into the brainstem that can be used for training and research.