Walter Jerry Oakes

OBJECT: Facial nerve injury with resultant facial muscle paralysis is disfiguring and disabling. Reanimation of the facial nerve has been performed using different regional nerves. The nerve to the mylohyoid has not been previously explored as a donor nerve for facial nerve reanimation procedures.

METHODS: Five fresh adult human cadavers (10 sides) were dissected to identify an additional nerve donor candidate for facial nerve neurotization. Using a curvilinear cervicofacial skin ...

OBJECT: Quality improvement techniques are being implemented in many areas of medicine. In an effort to reduce the ventriculoperitoneal shunt infection rate, a standardized protocol was developed and implemented at 4 centers of the Hydrocephalus Clinical Research Network (HCRN).

METHODS: The protocol was developed sequentially by HCRN members using the current literature and prior institutional experience until consensus was obtained. The protocol was prospectively applied at each HCRN ...

OBJECTIVE: We report the control of hydrocephalus in children with presumed tectal plate gliomas by the use of endoscopic third ventriculostomy (ETV).

METHODS: The hospital records, office charts, and imaging studies from children who underwent ETV at the Children's Hospital of Alabama were reviewed. Thirteen children with the diagnosis of tectal plate glioma and hydrocephalus were identified. ETV was the primary therapy instituted for all but one of these children. Successful treatment ...

OBJECT: The purpose of this study was to define the incidence of permanent shunt placement and infection in patients who have undergone the 2 most commonly performed temporizing procedures for posthemorrhagic hydrocephalus (PHH) of prematurity: ventriculosubgaleal (VSG) shunt placement and ventricular reservoir placement for intermittent tapping.

METHODS: The 4 centers of the Hydrocephalus Clinical Research Network participated in a retrospective chart review of infants with PHH who ...

OBJECT: In neurotization procedures, donor nerves--either whole or in part-with relatively pure motor function can be carefully chosen to provide the optimal nearby motor input with as little donor site morbidity as possible. In this context, the ulnar nerve branches to the forearm muscles are relatively dispensable; however, quantitation of and landmarks for these branches are lacking in the literature.

METHODS: The ulnar branches to the flexor carpi ulnaris (FCU) and flexor digitorum ...

OBJECT: The aim of this study was to present the long-term findings of a surgical series of pediatric patients with Chiari I malformations.

METHODS: One hundred thirty symptomatic pediatric patients with Chiari I malformations underwent posterior fossa decompression. The age in this group of patients ranged from 2 months to 20 years (mean 11 years). The length of the hospital stay extended from 2 to 7 days (mean 2.7 days), and follow up was from 3 months to 15 years (mean 4.2 years). ...

BackgroundPrevious anatomic studies have shown the conus medullaris to terminate between T12 and L1 vertebral levels in adults with normal spinal anatomy. Prior anatomic and radiographic studies of conus position with flexion and extension of the spine have had conflicting results. We performed a cadaveric study with direct visualization of the conus during flexion and extension to further study this question and potentially determine if flexion and extension of the spine during magnetic ...

BackgroundScoliosis is a common finding in children with Chiari I malformation and syringomyelia. The development of scoliosis associated with a Chiari malformation typically has been ascribed to the presence of syringomyelia. Decompression of the hindbrain hernia will often alleviate the syringomyelia and, in many cases, stabilize or reverse the scoliosis.Case reportWe report a child with Chiari I malformation and scoliosis who presented with Valsalva-induced headache/neck pain. MRI ...

Although surgical procedures are often performed over the posterior head and neck, surgical landmarks for avoiding the cutaneous nerves in this region are surprisingly lacking in the literature. Twelve adult cadaveric specimens underwent dissection of the cutaneous nerves overlying the posterior head and neck, and mensuration was made between these structures and easily identifiable surrounding bony landmarks. All specimens were found to have a third occipital nerve (TON), lesser ...

OBJECT: Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%.

METHODS: The authors conducted a prospective, multicenter study of children (< 18 years) requiring ...

OBJECTIVE: The posterior fossa (PF) has been found to be small in various forms of Chiari malformation. Explanations involving a connection between growth hormone deficiency (GHD) and Chiari I malformation (CIM) have been proposed. However, to date, no quantitative analysis of the PF of patients with CIM and GHD has been performed. Our study was performed to determine the geometry of the PF in children with GHD and CIM.

METHODS: Morphometric analysis of the PF was performed in 10 ...

OBJECTIVE: The purposes of this study were as follows: 1) to determine the incidence and degree of ventral brain stem compression (VBSC) in pediatric and young adult patients with Chiari I malformations, and 2) to correlate VBSC with other imaging and clinical factors to help determine what amount of VBSC is successfully treated with a posterior decompressive procedure alone.

METHODS: The magnetic resonance images and clinical histories of 40 pediatric and young adult patients with ...

OBJECT: Injury of the facial nerve with resultant facial muscle paralysis may result in other significant complications such as corneal ulceration. To the authors' knowledge, neurotization to the facial nerve using the long thoracic nerve (LTN), a nerve used previously for neurotization to other branches of the brachial plexus, has not been explored previously.

METHODS: In an attempt to identify an additional nerve donor candidate for facial nerve neurotization, 8 adult human cadavers ...