Biomedical subjects

D A Gol'bin

Publications and source records attributed to D A Gol'bin.

3 recordsLinked to original sources

PubMedDate not supplied

[Experience in using a molecular resonance coagulator in neurooncology].

The paper analyzes the experience gained in using a molecular resonance coagulator in 145 patients with tumors of the base of the skull and brain. The Vesalius NEUROsurgery N1 molecular resonance apparatus is an innovational bipolar device that is specially designed for neurosurgical application,(operations on the brain). Due to the fact that the temperature at the site of a cut does not exceed 45-50 degrees C, the apparatus has the minimum effect on tissues, nerves, nerve ending, and blood vessels, permitting a surgeon to make interventions into sophisticated anatomic formations. The apparatus operates in the modes "cut" and "coagulation" that enable operations to be performed on particularly minor and fine structures. While working on brain tissues, it is particularly important that there is no thermal injury, tissue charring, or sticking effect due to low working temperatures. The possibility of concurrently making hemostasis and tissue dissection reduces the time of an operation and considerably decreases the extent of blood loss. The clinical case given in this paper demonstrates the universality of the Vesalius NEUROsurgery N1 molecular resonance apparatus used in an infiltrative tumor of the bases of the skull. One forceps operated in different modes may provide sparing coagulation of minor cortical arteries, reduce the volume of a tumor through its bloodless dissection, arrest bleeding from the hyperostosis (wax sticking effect), prepare nerves in the upper lid slit and cavernous sinus. The Vesalius NEUROsurgery N1 molecular resonance surgical apparatus is recommended for neurosurgical care to perform brain operations requiring great caution in handling the tissues being operated on.

Adolescent↗

PubMedDate not supplied

[Anatomic rationale for a transmaxillary access to the cavernous sinus].

UNLABELLED: W. Couldwell et al. were the first to propose a transmaxillary access to the cavernous sinus in 1997. The authors showed that this approach was low-invasive and cosmetic and it ensured visualization of different nervous formations of the cavernous sinus and the intracavernous segment of the internal carotid artery. This study was undertaken to study microsurgical anatomy, to simulate a transmaxillary access, to demonstrate its expediency, and to assess the use of endoscopic techniques when this access was applied. The study was conducted in 3 steps: 1) a craniometric study on 33 skulls and 25 craniograms to examine the craniological and geometric parameters of the anatomy of the osseous structures included into the transmaxillary access; 2) simulation of the access on the osseous structures of the skull (2 sides); by including anterior and posterior maxillotomy and bone drilling-out around the round foramen; 3) microsurgical preparation--dissection was performed on 3 head samples (5 sides) at the Laboratory of Microneurosurgical Anatomy, Acad. N. N. Burdenko Research Institute of Neurosurgery, Russian Academy of Medical Sciences. Endoscopy was tested when the transmaxillary access was applied. The results were as follows: 1. The depth of the access failed to correlate with the shape of the skull. The operative observation angle averaged 18-23 degrees. 2. Simulation of the transmaxillary access on the dried skull made it possible to visualize the medial portion of the infratemporal fossa, by enlarging the pterygpid-maxillary fissure. The bone drilling-out boundaries for the skull base were defined. 3. Microsurgical dissection after removal of the posterior maxillary sinus wall and opening the pterygopalatine fossa. The topography of the maxillary artery and nerve was studied. After drilling out the bone of the skull base, the lower wall of the cavernous sinus was crescent. The cavernous sinus was opened as far as possible both above the maxillary nerve and between the second and third branches of the trigeminal nerve. CONCLUSIONS: 1. The access is deep and narrow, yet low-traumatic. 2. It may be the access of choice in removing a small pathological focus in the pterygopalatine fossa, round foramen or lower portions of the cavernous fossa. 3. The access may be used to approach the medial portion of the infratemporal fossa. 4. The described stepwise microsurgical anatomy and internal guiding lines in the retromaxilllary space permit one to perform surgical operations with confidence. 5. With this access, there is no guidance over the great vessel (internal carotid artery). 6. The access passes through the vestibule of the mouth; in this connection its application is undesirable at surgery for intradural abnormalities.

Cavernous Sinus↗

PubMedDate not supplied

[Intracranial plasmocytomas: biology, diagnosis, and treatment].

Intracranial plasmocytomas are a rare abnormality in a neurosurgeon's practice. The plasmocytomas may originate from the skull bones or soft tissue intracranial structures; they may be solitary or occur as a manifestation of multiple myeloma, this type being typical of most intracranial plasmocytomas. Progression of solitary plasmocytoma to multiple myeloma is observed in a number of cases. Preoperative diagnosis involves computed tomography or magnetic resonance imaging; angiography is desirable. The final diagnosis of plasmocytoma is chiefly based on a morphological study. Special immunohistochemical studies yield very promising results; these are likely to be of high prognostic value. Intracranial plasmocytomas require a differential approach and a meticulous examination since the presence or absence of multiple myeloma radically affects prognosis. There are well-defined predictors; however, it is appropriate that craniobasal plasmocytomas show a worse prognosis than plasmocytomas of the skull vault and more commonly progress to multiple myeloma. Plasmocytomas respond to radiotherapy very well. The gold standard of treatment for plasmocytoma is its total removal and adjuvant radiation therapy; however, there is evidence for good results when it is partially removed and undergoes radiotherapy or after radical surgery without subsequent radiation. The role of chemotherapy has not been defined today.

Humans↗