論文 - 戸田　正博

Transvenous Embolization of the Basilar Plexus Before Endoscopic Transsphenoidal Transclival Surgery.

Mizutani K, Akiyama T, Toda M, Kanazawa T, Kamamoto D, Yoshida K

World Neurosurg. 97   756 - 756 2017年01月

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Endonasal endoscopic approach for a giant cavernous sinus meningioma that extended to the middle cranial fossa with preoperative embolization

Tamura R, Toda M, Kohno M, Ozawa H, Tomita T, Akiyama T, Ogawa K, Yoshida K

Interdisciplinary Neurosurgery 6   20 - 22 2016年12月

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Analysis of the medial opticocarotid recess in patients with pituitary macroadenoma using three-dimensional images.

Kikuchi R, Toda M, Wakahara S, Fujiwara H, Jinzaki M, Yoshida K

World Neurosurg. 93   139 - 143 2016年09月

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The analysis of the petrosal vein to prevent venous complications during the anterior transpetrosal approach in the resection of petroclival meningioma

Mizutani K, Toda M, Yoshida K

World Neurosurg. 93   175 - 182 2016年09月

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Vascularized middle turbinate flap for the endoscopic endonasal reconstruction of the anterior olfactory groove

Tamura R, Toda M, Kohno M, Watanabe Y, Ozawa H, Tomita T, Ogawa K, Yoshida K

Neurosurg Rev 39 （ 2 ） 297 - 302 2016年04月

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MIF maintains the tumorigenic capacity of brain tumor-initiating cells by directly inhibiting p53

Fukaya R, Ohta S, Yaguchi T, Matsuzaki Y, Sugihara E, Okano H, Saya H, Kawakami Y, Kawase T, Yoshida K, Toda M

Cancer Res 76 （ 9 ） 2813 - 2823 2016年03月

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Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.

Borghei-Razavi H, Tomio R, Fereshtehnejad SM, Shibao S, Schick U, Toda M, Yoshida K, Kawase T

J Neurol Surg B Skull Base 77 （ 1 ） 6 - 13 2016年02月

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Various patterns of the middle cerebral vein and preservation of venous drainage during the anterior transpetrosal approach

Shibao S, Toda M, Orii M, Fujiwara H, Yoshida K

J Neurosurg 124 （ 2 ） 432 - 439 2016年02月

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Editorial: Temporal lobe venous preservation Response.

Shibao S, Toda M, Yoshida K

J Neurosurg 124 （ 2 ） 429 - 430 2016年02月

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Sigmoid incision rescue nasoseptal flap technique for endoscopic endonasal skull base surgery

Ozawa H, Tomita T, Watanabe Y, Sekimizu M, Ito F, Ikari Y, Saito S, Toda M, Ogawa K

Acta Otolaryngol    Epub ahead of print 2016年02月

Anterior Petrosal approach: The Safety of Kawase triangle as an anatomical landmark for anterior petrosectomy in petroclival meningiomas

Borghei-Razavi H, Tomio R, Fereshtehnejad SM, Shibao S, Schick U, Toda M, Kawase T, Yoshida K

Clin Neurol Neurosurg 139 （ 2015 ） 282 - 287 2015年11月

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Giant cell tumors of the clivus: case report and literature review.

Shibao S, Toda M, Yoshida K

Surg Neurol Int 6 （ (Suppl 25) ） S623 - S627 2015年11月

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Analysis of sphenoid sinus lateral pneumatization for endonasal endoscopic surgery.

Kikuchi R, Toda M, Tomita T, Ogawa K, Yoshida K

Surg Neurol Int 2015 （ 6:166 ）  2015年10月

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Analysis of the intercavernous sinus in sellar lesions using multidetector computed tomography digital subtraction venography.

Mizutani K, Toda M, Yoshida K

World Neurosurg    pii: S1878-8750(15)01095-5. 2015年09月

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Upfront chemotherapy and subsequent resection for molecularly defined gliomas

Sasaki Hikaru, Hirose Yuichi, Yazaki Takahito, Kitamura Yohei, Katayama Makoto, Kimura Tokuhiro, Fujiwara Hirokazu, Toda Masahiro, Ohira Takayuki, Yoshida Kazunari

Journal of Neuro-Oncology 124 （ 1 ） 127 - 135 2015年08月

ISSN  0167-594X

　概要を見る

<p>Functional preservation is critical in glioma surgery, and the extent of resection influences survival outcome. Neoadjuvant chemotherapy is a promising option because of its potential to facilitate tumor shrinkage and maximum tumor resection. The object of this study was to assess the utility of the neoadjuvant strategy in a prospective series of gliomas with favorable molecular status. Twenty-six consecutive cases of diffuse gliomas of WHO grade II or III with either 1p19q codeletion or MGMT methylation were treated with upfront chemotherapy following maximal safe removal. In cases of incomplete initial surgery, second-look resection was intended after tumor volume decrease by chemotherapy. Among 22 evaluable cases, chemotherapy led to a median change in the sum of the product of perpendicular diameters of −35 %, and 14 out of the 22 cases (64 %) showed objective response. Second-look resection after tumor volume decrease was performed in 12 out of 19 cases of incomplete initial surgery (GTR/STR 9, removal of residual methionine PET uptake 3). The median progression-free survival among the 22 patients with grade II tumors was 57 months, with some cases showing durable progression-free survival after second-look resection. MIB-1 indices of the second-look resected tumors were lower than those of the initial tumors, and the methylation status of the MGMT gene was unchanged. Neoadjuvant chemotherapy based on molecular guidance often produces significant volume decrease of incompletely resected gliomas. Radical second-look resection is an optional advantage of upfront chemotherapy for chemosensitive gliomas compared with initial radiotherapy.</p>

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Steroid psychosis caused by perioperative steroid replacement for pituitary adenoma

Mizutani Katsuhiro, Toda Masahiro, Kikuchi Ryogo, Uchida Hiroyuki, Yoshida Kazunari

Keio Journal of Medicine 64 （ 1 ） 11 - 15 2015年03月

ISSN  0022-9717

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<p>Steroid psychosis is a frequent complication of steroid treatment. Although perioperative steroid replacement therapy is generally administered in patients undergoing pituitary surgery, there are no previous reports concerning the development of steroid psychosis after perioperative steroid replacement therapy following pituitary surgery. We herein report a case of steroid psychosis induced by perioperative steroid replacement therapy for pituitary surgery. A 35-year-old man presented with a visual disturbance that had persisted for 1 year. A magnetic resonance imaging scan showed a large pituitary tumor, and a laboratory study revealed slight dysfunction of the hypothalamo-pituitary-adrenal axis. The patient was diagnosed with a non-functioning pituitary tumor and underwent tumor resection via the endoscopic endonasal approach. The initial dose of perioperative steroid replacement therapy was 200 mg of hydrocortisone administered immediately before the operation. The replacement dose was gradually tapered and discontinued over a 7-day period. On postoperative day 4, the patient exhibited an elated mood, grandiose delusions, anxiety, and agitation. We diagnosed these psychiatric symptoms as steroid psychosis induced by steroid replacement and we prescribed risperidone as a treatment. The symptoms gradually improved and did not recur. This case highlights the risk of steroid psychosis following treatment with perioperative steroid replacement therapy for pituitary adenoma and raises questions regarding the appropriateness of perioperative steroid replacement for pituitary adenoma.</p>

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Grüber's ligament as a useful landmark for the abducens nerve in the transnasal approach

Tomio Ryosuke, Toda Masahiro, Sutiono Agung B udi, Horiguchi Takashi, Aiso Sadakazu, Yoshida Kazunari

Journal of neurosurgery 122 （ 3 ） 499 - 503 2015年03月

　概要を見る

<p>OBJECT: Extended endoscopic transnasal surgeries for skull base lesions have recently been performed. Some expert surgeons have attempted to remove tumors such as chordomas, meningiomas, and pituitary adenomas in the clival region using the transnasal approach and have reported abducens nerve injury as a common complication. There have been many microsurgical anatomical studies of the abducens nerve, but none of these studies has described an anatomical landmark of the abducens nerve in the transnasal approach. In this study the authors used cadaver dissections to describe Grüber's ligament as the most reliable landmark of the abducens nerve in the transnasal transclival view.</p><p>METHODS: The petroclival segment of the abducens nerve was dissected in the interdural space-which is also called Dorello's canal, the petroclival venous gulf, or the sphenopetroclival venous confluence-using the transnasal approach in 20 specimens obtained from 10 adult cadaveric heads.</p><p>RESULTS: The petroclival segment of the abducens nerve clearly crossed and attached to Grüber's ligament in the interdural space, as noted in the transnasal view. The average length of the dural porus to the intersection on the abducens nerve was 5.2 ± 1.0 mm. The length of the posterior clinoid process (PCP) to the intersection on Grüber's ligament was 6.4 ± 2.6 mm. The average width of Grüber's ligament at the midsection was 1.6 ± 0.5 mm.</p><p>CONCLUSIONS: Grüber's ligament is considered a useful landmark, and it is visible in most adults. Thus, surgeons can find the abducens nerve safely by visualizing inferolaterally along Grüber's ligament from the PCP.</p>

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Petrous apex cholesterol granuloma

Shibao Shunsuke, Toda Masahiro, Tomita Toshiki, Saito Katsuya, Ogawa Kaoru, Kawase Takeshi, Yoshida Kazunari

Neurologia Medico-Chirurgica 55 （ 4 ） 351 - 355 2015年

ISSN  0470-8105

　概要を見る

<p>Recently, petrous apex cholesterol granulomas (CGs) have been treated via the endoscopic endonasal transsphenoidal approach (EEA) using a silicone tube, to prevent drainage route occlusion. Occlusion of the drainage route has led to problems with recurrence. The aim of this report is to describe the use of a surgical technique to prevent drainage route occlusion. In surgical technique, the posterolateral wall of the sphenoid sinus was opened by EEA. After cyst debridement, a vascularized nasoseptal flap with a width of approximately 4 cm was inserted into the lumen with a silicone T-tube with a diameter of 7 mm. This technique was used in two patients: the first patient during the second operation after recurrence following occlusion of the drainage route, and the second patient during the first operation. Opening of the cyst wall was confirmed endoscopically in both patients 12–24 months after surgery, even after removal of the T-tube. In conclusion, the use of a pedicled nasoseptal flap with a silicone tube is useful to prevent CG recurrence, by paranasal cavitization of the cystic cavity.</p>

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Analysis of the intercavernous sinuses using multidetector computed tomography digital subtraction venography (CT-DSV)

Mizutani Katsuhiro, Toda Masahiro, Yoshida Kazunari

Clinical Neurology and Neurosurgery 131   31 - 34 2015年

ISSN  0303-8467

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<p>Purposes The intercavernous sinuses (ICSs) connect both sides of the cavernous sinus. Knowledge of the ICSs is useful when employing the endoscopic endonasal transsphenoidal approach. Although there were some studies concerning the anatomy of ICSs using cadavers, there is no well-recognized method of the radiological evaluation of the ICSs. Therefore, we evaluate the ICSs using computed tomography digital subtraction venography (CT-DSV) in the cases of unruptured aneurysm that had the normal sellae anatomy. Methods We retrospectively analyzed 97 cases of unruptured cerebral aneurysm that had normal parasellar and sellar anatomy except for the aneurysms. The analysis was performed using the multi-planar reconstruction images obtained by CT-DSV in these cases. Results The anterior ICS (AICS), inferior ICS (IICS) and posterior ICS (PICS) were detected in 51 cases (52.6%), 28 cases (28.9%) and 76 cases (78.4%) respectively. In the cases older than 51 years old, the AICS was detected significantly less often than in those younger than 50 years old. Conclusions The CT-DSV images directly reflected the blood flow. Most of the past research on the ICSs was obtained using cadavers, which could therefore not directly assess the normal human blood flow. The present study showed the usefulness of CT-DSV for evaluating the ICSs and to understand the normal anatomy of the ICSs.</p>

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GH-producing Pituitary Adenoma and Concomitant Rathke’s Cleft Cyst: A case report and short review.

Tamura R, Takahashi S, Emoto K, Nagashima H, Toda M, Yoshida K

Case Rep Neurol Med 2015   948025 2015年

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