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Cost effectiveness and vestibular schwannoma surgery

This is the first cost effectiveness modelling study looking at the three main treatment options for small to medium sized vestibular schwannomas. This study uses the widely accepted cost per quality adjusted life year (QALY) outcome measure to evaluate three...

Surgical approach to trigeminal neuralgia

This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...

Gender inequality across medical specialties in the United States

The authors of this study collected and evaluated 4222 surveys of patient satisfaction ratings of male and female residents across subspecialties in the United States. Half of the evaluated residents were females, with first and second year residents being evaluated...

Microsurgical trainees to avoid strenuous exercises?

It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...

Predictors of diabetes insipidus post-hypophysectomy

Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...

Skull base imaging: a review

This excellent review paper describes the anatomy, imaging protocols and differentiating imaging findings on CT and MRI in myriad skull base lesions. Skull base protocol MRI and thin section CT are required to evaluate all skull base lesions. According to...

Physician burnout and resident wellness

Physician burnout and high rates of mental health issues amongst physicians are an important concern today. Several articles on this subject have been published recently. However, few articles have been written about starting life balance training early during residency. This...

Recovery room cortisol to predict long-term glucocorticoid supplementation

The authors report the results of using recovery room (RR) cortisol to predict the need for long-term glucocorticoids in patients who underwent transsphenoidal surgery (TSS). They conducted a retrospective study of preoperative morning serum cortisol (MSC), RR cortisol and day...

Surgery safety checklists

The time-outs were based on pre-flight checklists adopted by airline pilots and were instituted in all accredited hospitals and ambulatory care centres in the United States in 2003. The guidelines originate from general surgery and are not specific for the...

Choosing Wisely!

This article focuses on the prickly topic of healthcare costs and specifically on reducing spending on neuroimaging for headaches. Epidemiological studies indicate that the prevalence of lifetime headaches is 93 to 99% and accounts for 1.5% of all primary care...