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  1. Article ; Online: Endoscopic Transsphenoidal Resection of Cystic Third Ventricular Craniopharyngioma with Cystocisternal Fenestration.

    Wong, Andrew K / Raviv, Joseph / Wong, Ricky H

    World neurosurgery

    2024  Volume 185, Page(s) 224

    Abstract: Cystic craniopharyngiomas of the third ventricle can be challenging to treat because complete resection of the cyst wall can be associated with hypothalamic dysfunction and minimal rostral displacement of the optic chiasm leads to a small endonasal ... ...

    Abstract Cystic craniopharyngiomas of the third ventricle can be challenging to treat because complete resection of the cyst wall can be associated with hypothalamic dysfunction and minimal rostral displacement of the optic chiasm leads to a small endonasal operative corridor. Various methods to overcome the frequent recurrences have been described, such as intracystic bleomycin or catheter placement, with mixed results.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Video-Audio Media
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2024.02.089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1159: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Keyhole retrosigmoid approach without watertight dural closure - Evaluation of a minimalistic approach.

    Wong, Andrew K / Wong, Ricky H

    Clinical neurology and neurosurgery

    2023  Volume 227, Page(s) 107625

    Abstract: Background: The retrosigmoid craniotomy is a versatile surgical approach to the cerebellopontine angle though cerebrospinal fluid leak remains a concern, with a reported prevalence of 0-22 %. A host of closure materials and strategies have been proposed ...

    Abstract Background: The retrosigmoid craniotomy is a versatile surgical approach to the cerebellopontine angle though cerebrospinal fluid leak remains a concern, with a reported prevalence of 0-22 %. A host of closure materials and strategies have been proposed to achieve a watertight dural closure to varying degrees of success. We review our series of keyhole retrosigmoid craniotomies and describe our simple, standardized method of closure without watertight dural closure.
    Methods: A retrospective review of all retrosigmoid craniotomies performed by the senior author was completed. Closure was achieved by placing an oversized piece of gelatin in the subdural space. The dura is grossly approximated. An oversized sheet of collagen matrix is placed as an overlay followed by gelatin sponge in the craniectomy defect held in place with titanium mesh. The superficial layers are approximated. The skin is closed with a running sub-cuticular suture followed by skin glue. Patient demographics, cerebrospinal fluid leak risk factors, and surgical outcomes were determined.
    Results: A total of 114 patients were included. There was one case (0.9 %) of CSF leak, which resolved with placement of a lumbar drain for 5 days. The patient had one defined risk factor (morbid obesity, BMI 41.0 kg/m
    Conclusions: Obtaining a watertight dural layer closure has been the generally accepted strategy in preventing CSF leaks in a traditional retrosigmoid approach. In keyhole retrosigmoid approaches it may not be necessary by utilizing a simple gelfoam bolstered collagen matrix onlay technique potentially improving outcome measures including operative time.
    MeSH term(s) Humans ; Cerebrospinal Fluid Leak/surgery ; Craniotomy/methods ; Dura Mater/surgery ; Gelatin ; Neurosurgical Procedures/adverse effects ; Postoperative Complications/etiology ; Retrospective Studies
    Chemical Substances Gelatin (9000-70-8)
    Language English
    Publishing date 2023-02-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 193107-6
    ISSN 1872-6968 ; 0303-8467
    ISSN (online) 1872-6968
    ISSN 0303-8467
    DOI 10.1016/j.clineuro.2023.107625
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Letter to the Editor Regarding "Make Clipping Great Again: Microsurgery for Cerebral Aneurysms by Dual-Trained Neurosurgeons".

    Wong, Ricky H

    World neurosurgery

    2020  Volume 139, Page(s) 651

    MeSH term(s) Endovascular Procedures/instrumentation ; Endovascular Procedures/standards ; Humans ; Intracranial Aneurysm/surgery ; Microsurgery/instrumentation ; Microsurgery/standards ; Neurosurgeons/education ; Neurosurgeons/standards ; Surgical Instruments/standards
    Language English
    Publishing date 2020-07-07
    Publishing country United States
    Document type Letter
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2020.03.034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Minimally Invasive Lateral Orbital Wall Approach for Sphenocavernous Meningioma Resection with Endoscope Assistance.

    Wong, Ricky H

    World neurosurgery

    2020  Volume 138, Page(s) 261

    Abstract: Sphenocavernous meningiomas are technically challenging tumors that, in addition to cavernous sinus neurovascular involvement, frequently affect the optic nerve and carotid artery. The surgical goal generally consists of complete resection of the ... ...

    Abstract Sphenocavernous meningiomas are technically challenging tumors that, in addition to cavernous sinus neurovascular involvement, frequently affect the optic nerve and carotid artery. The surgical goal generally consists of complete resection of the extracavernous portion of the tumor, whereas the cavernous sinus tumor can be treated with postoperative radiation if necessary. Traditional techniques include the pterional or orbitozygomatic approach that requires substantial soft tissue, scalp, and temporalis muscle mobilization along with temporal and frontal lobe manipulation. A keyhole craniotomy performed through a lateral orbitotomy provides a minimally invasive option with excellent tumor exposure that obviates the need for soft tissue trauma or brain manipulation. Use of an endoscope can provide further visualization for more expansive tumors. This Video 1 presentation demonstrates a case of an 84-year-old woman with a growing sphenocavernous meningioma and abducens palsy who underwent a minimally invasive lateral orbital wall approach for resection of the extracavernous tumor. There were no intra- or perioperative complications, and the patient was discharged home on postoperative day 1. This technique is a useful addition to the armamentarium of surgeons who treat these complex tumors.
    MeSH term(s) Aged, 80 and over ; Female ; Humans ; Meningeal Neoplasms/diagnostic imaging ; Meningeal Neoplasms/surgery ; Meningioma/diagnostic imaging ; Meningioma/surgery ; Neuroendoscopy/methods ; Skull Base
    Language English
    Publishing date 2020-03-17
    Publishing country United States
    Document type Case Reports ; Video-Audio Media
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2020.03.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  5. Article: Split-Thickness Decompression in the Management of Intracranial Pressure.

    Wong, Andrew K / Wong, Ricky H

    Korean journal of neurotrauma

    2021  Volume 17, Issue 1, Page(s) 48–53

    Abstract: Surgical management of elevated intracranial pressures due to stroke or traumatic brain injury has classically been through decompressive craniectomy (DC). There is significant morbidity associated with DC including subdural hygromas, syndrome of the ... ...

    Abstract Surgical management of elevated intracranial pressures due to stroke or traumatic brain injury has classically been through decompressive craniectomy (DC). There is significant morbidity associated with DC including subdural hygromas, syndrome of the trephined, and the need for subsequent cranioplasty. Alternative techniques including the hinged and floating craniotomy have shown promise though can still suffer from complications associated with an unsecured bone flap. We report a case in which a patient who presented with an acute subdural hematoma and associated midline shift that was successfully treated with decompression via thinning and re-securing of the bone flap in a "split-thickness decompression."
    Language English
    Publishing date 2021-04-14
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 3028579-3
    ISSN 2288-2243 ; 2234-8999
    ISSN (online) 2288-2243
    ISSN 2234-8999
    DOI 10.13004/kjnt.2021.17.e6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Endoscopic Endonasal Transrotundum Middle Fossa Exposure: Technique of Transpterygoid Maxillary Nerve Transposition.

    Wong, Ricky H

    World neurosurgery

    2018  Volume 112, Page(s) 131–137

    Abstract: Objective: Middle fossa floor access can be challenging. Open skull base approaches have associated morbidity and yield suboptimal working angles around the temporal lobe. Endoscopic endonasal approaches to the middle fossa are poorly described, but ... ...

    Abstract Objective: Middle fossa floor access can be challenging. Open skull base approaches have associated morbidity and yield suboptimal working angles around the temporal lobe. Endoscopic endonasal approaches to the middle fossa are poorly described, but provide an improved angle. I hypothesized that the length of the maxillary nerve can be transposed out of the foramen rotundum to provide a path to expose the full width of the middle fossa floor through the anterolateral and anteromedial triangle.
    Methods: Endoscopic endonasal transpterygoid dissections to expose the middle fossa were performed bilaterally on 2 silicone-injected cadaveric heads (4 sides). Transposition of V2 was then performed on all sides, and additional middle fossa exposure was achieved. High-resolution computed tomography imaging was obtained to quantify the extent of exposure. A transzygomatic approach was also performed for comparison.
    Results: The maxillary nerve was successfully transposed in each dissection. A periosteal fold was identified to assist in the mobilization of the infraorbital nerve. The average middle fossa exposure achieved without transposition was 50% (of the medial to lateral width). Transposition increased that to 95%. Comparison with the open transzygomatic approach demonstrated superior surgical trajectory (inferior to superior) with the endonasal route.
    Conclusions: Endoscopic endonasal transpterygoid approaches with or without transposition of the maxillary nerve provide a reasonable option for sequentially exposing the entire medial to lateral extent of the anterolateral triangle. It provides an advantageous inferior to superior surgical angle and can be considered for treatment of select middle fossa floor pathology.
    MeSH term(s) Cranial Fossa, Middle/surgery ; Humans ; Maxillary Nerve/surgery ; Natural Orifice Endoscopic Surgery/methods ; Neurosurgical Procedures/methods
    Language English
    Publishing date 2018-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2018.01.120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Conference proceedings: Osimertinib Induced Rapid Regression of Large Metastatic Tumor to the Pituitary in a Patient with Lung Adenocarcinoma

    Wong, Andrew K. / Wong, Ricky H.

    Journal of Neurological Surgery Part B: Skull Base

    2021  Volume 82, Issue S 02

    Event/congress Special Virtual Symposium of the North American Skull Base Society, Online, 2021-02-13
    Language English
    Publishing date 2021-02-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2654269-9
    ISSN 2193-634X ; 2193-6331
    ISSN (online) 2193-634X
    ISSN 2193-6331
    DOI 10.1055/s-0041-1725511
    Database Thieme publisher's database

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    Zs.A 3425: Show issues Location:
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  8. Article ; Conference proceedings: Simple Non-Watertight Closure for Keyhole Retrosigmoid Craniotomies: Is Less More?

    Wong, Andrew K. / Wong, Ricky H.

    Journal of Neurological Surgery Part B: Skull Base

    2021  Volume 82, Issue S 02

    Event/congress Special Virtual Symposium of the North American Skull Base Society, Online, 2021-02-13
    Language English
    Publishing date 2021-02-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2654269-9
    ISSN 2193-634X ; 2193-6331
    ISSN (online) 2193-634X
    ISSN 2193-6331
    DOI 10.1055/s-0041-1725291
    Database Thieme publisher's database

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    Zs.A 3425: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  9. Article: Successful treatment of superior sagittal sinus thrombosis after translabyrinthine resection of metastatic neuroendocrine tumor: A case report and review of literature.

    Wong, Andrew K / Wong, Ricky H

    Surgical neurology international

    2020  Volume 11, Page(s) 410

    Abstract: Background: Postoperative cerebral venous sinus thrombosis (pCVST) after resection of cerebellopontine angle and posterior fossa tumor resections occur almost exclusively in the lateral venous sinuses and are generally asymptomatic. Thrombus extension ... ...

    Abstract Background: Postoperative cerebral venous sinus thrombosis (pCVST) after resection of cerebellopontine angle and posterior fossa tumor resections occur almost exclusively in the lateral venous sinuses and are generally asymptomatic. Thrombus extension and involvement of the superior sagittal sinus (SSS) - a serious and potentially devastating complication - are rarely described and, as such, successful treatment for which is still poorly understood. We report a case of pCVST involving the SSS after translabyrinthine approach for resection of a metastatic neuroendocrine tumor (NET), and the first that was successfully treated with anticoagulation therapy.
    Case description: A 40-year-old man presented with headaches, diminished right-sided hearing, and ataxia was found to have a large right-sided cerebellopontine angle (CPA) lesion with extra-axial and possible intraparenchymal invasion. A retrosigmoid craniotomy for debulking and diagnosis was undertaken. Postoperative imaging revealed patent venous sinuses. Pathology confirmed NET. Further imaging revealed a likely pancreatic primary lesion. The patient then underwent subsequent translabyrinthine approach for definitive surgical resection. Postoperative imaging again revealed patent venous sinuses. The patient subsequently developed headaches on postoperative day 10 and was found to have pCVST involving the ipsilateral internal jugular to the SSS. The patient was started on therapeutic heparin with significant improvement in pCVST and symptoms.
    Conclusion: Extensive pCVST involving the SSS after CPA and posterior fossa tumor resections is extremely rare. Initial management with anticoagulation can yield promising results and should be initiated early in the clinical course unless otherwise contraindicated.
    Language English
    Publishing date 2020-11-25
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_656_2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Keyhole clipping of a low-lying basilar apex aneurysm without posterior clinoidectomy utilizing endoscopic indocyanine green video angiography.

    Wong, Andrew K / Wong, Ricky H

    Surgical neurology international

    2020  Volume 11, Page(s) 31

    Abstract: Background: Basilar apex (BX) aneurysms are surgically challenging due to their anatomic location, need to traverse neurovascular structures, and proximity to multiple perforator arteries. Surgical approaches often require extensive bone resection and ... ...

    Abstract Background: Basilar apex (BX) aneurysms are surgically challenging due to their anatomic location, need to traverse neurovascular structures, and proximity to multiple perforator arteries. Surgical approaches often require extensive bone resection and neurovascular manipulation. Visualization of low-lying BX aneurysms is typically obscured by the posterior clinoid and upper clivus and poses a unique challenge. Subtemporal or anterolateral approaches with a posterior clinoidectomy are often required to achieve adequate exposure, though these maneuvers can add invasiveness, risk, and morbidity to the procedure. Endoscopes and, more recently, fluoroscopic angiography capable endoscopes offer the possibility of providing improved visualization with less exposure allowing for minimally invasive clipping.
    Case description: We present the case of a 42-year-old female with incidentally found 5 mm middle cerebral artery and 5 mm BX aneurysms. She underwent a minimally invasive supraorbital keyhole craniotomy for the clipping of both aneurysms. While the posterior clinoid obstructed the necessary visualization for the BX aneurysm, use of endoscopy and endoscopic fluoroscopic angiography allowed for safe and successful clipping without the need for a posterior clinoidectomy.
    Conclusion: This represents the first reported case of a BX aneurysm clipping through a minimally invasive keyhole craniotomy using endoscopic indocyanine green video angiography. Use of endoscopic indocyanine green angiography, combined with keyhole endoscopic approaches, allows for safe minimally invasive clipping of challenging posterior circulation aneurysms.
    Language English
    Publishing date 2020-02-28
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_582_2019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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