North American Skull Base Society Research Articles

The Opening of a Neurosurgical Skull Base Laboratory in St. Petersburg, Russia

Introduction: During the last 15 years in Russia there have been cardinal changes in political and economic life. Russia turned from a closed totalitarian state to an open democratic country. These changes have also affected Russian medicine in general and neurosurgery in particular. Insufficient development of the field of microneurosurgery was caused by the weak training of neurosurgeons, insufficient material resources for development of hi-tech and precise techniques, and isolation of Russian neurosurgeons from their colleagues in North America, Europe, and Asia. Methods: For the last several years neurosurgeons from St. Petersburg have had an opportunity to attend trainings in conducting clinics in the United States and to attend neurosurgical conferences and meetings. Russian neurosurgeons took part in North American Skull Base Society meetings in 2004 and 2005 for the first time. In September 2005 in the Research Institute for Traumatology and Orthopedics we organized a training room equipped with a microscope (LOMO, St. Petersburg, Russia), endoscopic equipment (Karl Storz), high-speed drills (Mides Rex, Medtronic; Hall, Zimmer), and surgical instrumental kits (Aesculap, Codman). There it is possible to work on plastic models; in addition, we have a specially equipped room for improving neurosurgical approaches by using cadavers. Results: Opening of the training center has improved the system of preparation of young neurosurgeons to allow them to carry out masters' classes in various problems of neurosurgery. Much attention is given to formation of the skills of working with a microscope, drilling techniques, and research of microneuroanatomy. Conclusions: The international communication with American colleagues has allowed us to lift up the level of neurosurgical knowledge, to create the microneurosurgical training center, and to assist our patients using more modern technologies.

Postoperative Imaging and Follow-Up of Vestibular Schwannomas

No standards exist regarding patient follow-up after complete vestibular schwannoma resection. We surveyed neurotologists and neurosurgeons to determine practice patterns. A nonrandomized sample of American Neurotology Society and North American Skull Base Society members was surveyed. Questions concerned years in practice, experience with vestibular schwannoma surgery, and postoperative follow-up algorithms given the scenario of complete gross tumor removal. Data were collected, tallied, and statistically analyzed. Academic and private practice neurotologists and neurosurgeons. Nonrandom sample of American Neurotology Society and North American Skull Base Society members. Number of postoperative magnetic resonance imaging scans, timing of magnetic resonance imaging scans, timing of final magnetic resonance imaging scan, timing of final visit, and variability between specialties. Four hundred ninety-eight surveys were sent and 135 were returned (27.1%). The average number of postoperative magnetic resonance imaging scans was 3.6 for neurotologists (range, 1-11) and 5.6 for neurosurgeons (range, 1-13). This was statistically significant (p >0.001). There was no correlation between number of magnetic resonance imaging scans and either years in practice or tumor experience. Average length of follow-up varied greatly (1 year to lifetime) but was most commonly 5 years. Eight percent of neurotologists varied their postoperative routine on the basis of surgical approach, whereas none of the neurosurgeons did. There remains no standard postoperative imaging algorithm for patients after complete vestibular schwannoma resection.

4th Annual Meeting of the North American Skull base Society

4th Annual Meeting of the North American Skull base Society