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  1. Article ; Online: How I do it: intradural anterior petrosectomy.

    Boschi, Andrea / Paggetti, Filippo / Vajkoczy, Peter

    Acta neurochirurgica

    2023  Volume 165, Issue 10, Page(s) 2957–2961

    Abstract: Background: The anterior transpetrosal approach (ATPA) is a cranial base approach for addressing upper petroclival or lateral pontine lesions. It is fundamentally an epidural procedure involving the drilling of the petrous apex. However, this approach ... ...

    Abstract Background: The anterior transpetrosal approach (ATPA) is a cranial base approach for addressing upper petroclival or lateral pontine lesions. It is fundamentally an epidural procedure involving the drilling of the petrous apex. However, this approach has significant procedure-related morbidity, and the surgeon must perform a complete petrosectomy, as the intradural structures are not in view during the drilling. For selected cases, a rationale exists for choosing a tailor-made intradural anterior petrosectomy (IAP).
    Method: This article describes the relevant surgical anatomy and the different surgical steps of the IAP.
    Conclusion: IAP represents a feasible alternative to the standard ATPA with the advantage of minimizing the extent of petrous bone removal to the individual need.
    MeSH term(s) Humans ; Meningioma/surgery ; Meningeal Neoplasms/surgery ; Neurosurgical Procedures/methods ; Cranial Fossa, Posterior/surgery ; Skull Base Neoplasms/surgery ; Petrous Bone/surgery
    Language English
    Publishing date 2023-06-21
    Publishing country Austria
    Document type Journal Article
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-023-05683-7
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  2. Article ; Conference proceedings: Lateral Supracerebellar Approach (LSA) to the Posterior Wall of the Cavernous Sinus: Microsurgical and Endoscopic Anatomy

    Boschi, Andrea / Lastrucci, Giancarlo / Barbagli, Giovanni / Puppa, Alessandro Della

    Journal of Neurological Surgery Part B: Skull Base

    2024  Volume 85, Issue S 01

    Event/congress 33rd Annual Meeting North American Skull Base Society, Atlanta Marriott Marquis Atlanta, Georgia, United States, 2024-02-16
    Language English
    Publishing date 2024-02-01
    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-0044-1780198
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  3. Article ; Online: 5-ALA fluorescence on tumors different from malignant gliomas. Review of the literature and our experience.

    Boschi, Andrea / Della Puppa, Alessandro

    Journal of neurosurgical sciences

    2019  Volume 63, Issue 6, Page(s) 661–669

    Abstract: Introduction: Fluorescence guided surgery with 5-aminolevulinic acid (5-ALA) is a well-established technique for improving resection of malignant cerebral glioma. In recent years, this technique is being increasingly applied off label to other brain ... ...

    Abstract Introduction: Fluorescence guided surgery with 5-aminolevulinic acid (5-ALA) is a well-established technique for improving resection of malignant cerebral glioma. In recent years, this technique is being increasingly applied off label to other brain tumor entities such as Low-grade glioma, meningioma, metastases, lymphoma and other central nervous system tumors. In this paper We collected all the data of 5-ALA guided surgery in "not malignant glioma" in literature compared to our experience.
    Evidence acquisition: We searched the PubMed/Medline database all clinical series reporting 5-ALA guided-surgery in not malignant glioma. We reviewed all data also showing our experience.
    Evidence synthesis: Fluorescence guided surgery with 5-ALA might be helpful not only in high-grade glioma but also in other brain tumor especially in Low grade glioma with a suspect of anaplastic spot, meningioma with bone invasion or parenchymal infiltration, ependymoma, lymphoma and pediatric tumors.
    Conclusions: Due to the relatively few number or clinical studies, prospective clinical trials are needed to increase the overall level of evidence concerning the usage of 5-ALA in CNS tumors different from high-grade glioma. Furthermore, a greater us of new tools such as, spectroscopy or confocal microscope or the use of combination of other fluorescence could make more effective this technique.
    MeSH term(s) Aminolevulinic Acid ; Brain Neoplasms/surgery ; Fluorescence ; Glioma/surgery ; Humans ; Neuronavigation/methods ; Surgery, Computer-Assisted/methods
    Chemical Substances Aminolevulinic Acid (88755TAZ87)
    Language English
    Publishing date 2019-07-29
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 193139-8
    ISSN 1827-1855 ; 0390-5616 ; 0026-4881
    ISSN (online) 1827-1855
    ISSN 0390-5616 ; 0026-4881
    DOI 10.23736/S0390-5616.19.04766-0
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  4. Article ; Conference proceedings: Artery of Percheron Stroke following Endoscopic Pituitary Surgery

    Boschi, Andrea / Pisano, Antonio / Galletti, Anastasia / Barbagli, Giovanni / Fainardi, Enrico / Puppa, Alessandro Della

    Journal of Neurological Surgery Part B: Skull Base

    2024  Volume 85, Issue S 01

    Event/congress 33rd Annual Meeting North American Skull Base Society, Atlanta Marriott Marquis Atlanta, Georgia, United States, 2024-02-16
    Language English
    Publishing date 2024-02-01
    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-0044-1780120
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  5. Article: Calcifying Pseudoneoplasms of the Neuraxis: Not Only Surgical Treatment.

    Boschi, Andrea / Pisano, Antonio / Romoli, Stefano

    Asian journal of neurosurgery

    2020  Volume 15, Issue 3, Page(s) 796–797

    Language English
    Publishing date 2020-08-28
    Publishing country India
    Document type Journal Article
    ZDB-ID 2621446-5
    ISSN 2248-9614 ; 1793-5482
    ISSN (online) 2248-9614
    ISSN 1793-5482
    DOI 10.4103/ajns.AJNS_113_20
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  6. Article ; Online: The Possible Link Between Poor Pulmonary Function and Dementia.

    Gallina, Pasquale / Boschi, Andrea / Angelini, Lucia / Lastrucci, Giancarlo

    Chest

    2020  Volume 158, Issue 2, Page(s) 833–834

    MeSH term(s) Dementia/epidemiology ; Humans ; Respiration Disorders ; Risk Factors
    Language English
    Publishing date 2020-08-20
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.02.082
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  7. Article ; Online: 5-aminolevulinic acid and sodium fluorescein in IV ventricle ependymoma surgery: preliminary experience comparing the two techniques.

    Boschi, Andrea / Lastrucci, Giancarlo / Pisano, Antonio / Becattini, Eleonora / Buccoliero, Annamaria / Della Puppa, Alessandro

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2022  Volume 43, Issue 8, Page(s) 5075–5082

    Abstract: Purpose: The aim of this study is to compare the use of 5-aminolevulinic acid (5-ALA) and sodium fluorescein (SF) in IV ventricular ependymoma (IVEP) surgical resection.: Methods: In this retrospective study, six patients with IVEP were enrolled. ... ...

    Abstract Purpose: The aim of this study is to compare the use of 5-aminolevulinic acid (5-ALA) and sodium fluorescein (SF) in IV ventricular ependymoma (IVEP) surgical resection.
    Methods: In this retrospective study, six patients with IVEP were enrolled. Gender ratio 2:1 male to female, with mean age 38.9 years old. A 5-ALA oral dose of 20 mg/kg and a SF intravenous dose of 2 mg/kg were administered. Telo-velar approach, operative microscope, and intraoperative monitoring were used in all the operations. We retrospectively compared the two fluorescence techniques at four steps during the surgical procedure: step 1: exposure of the tumor; step 2: dissection of the lesion from the cerebellum; step 3: assessment of the tumor borders and differentiation from normal tissue at the base of implants; and step 4: evaluation of possible residual tissue in the surgical cavity.
    Results: At the first step, the ependymomas resulted well delineated by both fluorescent agents. In this step, 5-ALA was particularly helpful in the case of recurrent ependymoma. At step 2, 5-ALA provided a better identification of the ependymoma boundaries and distinction from cerebellum hemispheres than SF. In steps 3 and 4, SF was really helpful to detect tumor tissue.
    Conclusion: According to our experience, fluorescence-guided surgery of IVEP with 5-ALA and SF is useful to maximize surgical resection with less risk of brainstem injury. Both fluorescence techniques are helpful in different steps of IVEP resection. However, further studies are needed to confirm our preliminary data.
    MeSH term(s) Adult ; Aminolevulinic Acid ; Brain Neoplasms/pathology ; Ependymoma/diagnostic imaging ; Ependymoma/surgery ; Female ; Fluorescein ; Humans ; Male ; Neoplasm Recurrence, Local/surgery ; Neurosurgical Procedures/methods ; Retrospective Studies
    Chemical Substances Aminolevulinic Acid (88755TAZ87) ; Fluorescein (TPY09G7XIR)
    Language English
    Publishing date 2022-03-25
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-022-06012-z
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  8. Article ; Conference proceedings: Role of Transcranial Motor Evoked Potentials in Anterior and Middle Skull Base Meningiomas Surgery

    Pisano, Antonio / Barbagli, Giovanni / Boschi, Andrea / Montemurro, Vita Maria / Pedone, Agnese / Capelli, Federico / Carrai, Riccardo / Puppa, Alessandro Della

    Journal of Neurological Surgery Part B: Skull Base

    2024  Volume 85, Issue S 01

    Event/congress 33rd Annual Meeting North American Skull Base Society, Atlanta Marriott Marquis Atlanta, Georgia, United States, 2024-02-16
    Language English
    Publishing date 2024-02-01
    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-0044-1779967
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  9. Article ; Online: A Single-Center Experience with the Olympus ORBEYE 4K-3D Exoscope for Microsurgery of Complex Cranial Cases: Technical Nuances and Learning Curve.

    Muscas, Giovanni / Battista, Francesca / Boschi, Andrea / Morone, Francesca / Della Puppa, Alessandro

    Journal of neurological surgery. Part A, Central European neurosurgery

    2021  Volume 82, Issue 5, Page(s) 484–489

    Abstract: Background:  The introduction of exoscopes in neurosurgery has been welcomed due to their maneuverability, ergonomics, and low-profile frame. 3D devices have further enabled a better stereoscopic visualization. Reports on their application, albeit more ... ...

    Abstract Background:  The introduction of exoscopes in neurosurgery has been welcomed due to their maneuverability, ergonomics, and low-profile frame. 3D devices have further enabled a better stereoscopic visualization. Reports on their application, albeit more and more frequent, are still at their beginning stages. We present our experience with the Olympus ORBEYE 4K-3D exoscope for major cranial procedures. The strengths and weaknesses of the exoscope are presented, and the nuances associated with the learning curve are illustrated.
    Methods:  Over 2 weeks, patients undergoing surgery for major cranial pathologies were offered to participate in this evaluation of the Olympus ORBEYE 4K-3D exoscope. Information on the use of the exoscope was collected to assess the features and struggles in the learning curve. A comparison with the operating microscope was made.
    Results:  Fourteen patients with different intracranial pathologies were operated on with the exoscope. No surgery-related complications occurred. The microsurgical part was performed with the exoscope in six cases. The exoscope was used for 72.9% (±37.5%) of the whole microsurgical time vs. 27.1% (±37.5%) microscope time (
    Conclusion:  The Olympus ORBEYE 4K-3D exoscope represents a useful evolution of the operating microscope. It requires time to overcome potential difficulties, mostly related to previous motor schemes acquired with operating microscopes. Its features could represent the basis for a paradigm shift in microsurgery.
    MeSH term(s) Humans ; Imaging, Three-Dimensional ; Learning Curve ; Microscopy ; Microsurgery ; Neurosurgical Procedures
    Language English
    Publishing date 2021-03-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2651663-9
    ISSN 2193-6323 ; 2193-6315
    ISSN (online) 2193-6323
    ISSN 2193-6315
    DOI 10.1055/s-0040-1719106
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  10. Article ; Online: Rhino-oropharingeal osteoradionecrotic soft-tissue and bony defect reconstruction with submental artery island flap: a case report.

    Lucattelli, Elena / Menichini, Giulio / Luparello, Paolo / Boschi, Andrea / Maggiore, Giandomenico / Innocenti, Marco / Innocenti, Alessandro

    British journal of neurosurgery

    2021  Volume 37, Issue 6, Page(s) 1850–1852

    Abstract: Background: The submental artery island flap is widely used in head and neck reconstruction, since it is easy and quick to harvest, and it can be successfully used for the coverage of perioral, intraoral and facial defects. We used this technique for ... ...

    Abstract Background: The submental artery island flap is widely used in head and neck reconstruction, since it is easy and quick to harvest, and it can be successfully used for the coverage of perioral, intraoral and facial defects. We used this technique for the reconstruction of a complex soft-tissue and bony defect of rhino-oropharinx.
    Case report: Osteoradionecrosis of rhino-oropharingeal posterior wall with C2 necrotic body exposure occurred in a 77-year-old woman. After the failure of reconstruction with a Hadad-Bassagasteguy flap, a submental island flap with cervical spine stabilization was planned to be performed in a one-stage operation. The anterior arc of C1 and odontoid process of C2 were removed and, according to the defect size, a submental island flap was designed in an elliptical fashion. The flap was rotated 180° and tunnelized under the left parapharingeal-prevertebral space, then it was positioned in the rhino-oropharinx and fixed with reabsorbable sutures. The donor site was closed primarily. No peri- or post-operative complications occurred, neither in the recipient nor in the donor-site. At the latest follow-up, 15 months postoperatively, the patient was able to speak without any impairment and started swallowing rehabilitation with good results and an aesthetically satisfactory outcome.
    Conclusion: The submental island flap may be a reliable and versatile flap for reconstruction of head and neck defects, even though in the rhino-oropharingeal posterior wall.
    MeSH term(s) Female ; Humans ; Aged ; Plastic Surgery Procedures ; Osteoradionecrosis/surgery ; Surgical Flaps ; Neck/surgery ; Arteries/surgery ; Treatment Outcome
    Language English
    Publishing date 2021-06-29
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 639029-8
    ISSN 1360-046X ; 0268-8697
    ISSN (online) 1360-046X
    ISSN 0268-8697
    DOI 10.1080/02688697.2021.1941758
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