Amr Safwat - Academia.edu (original) (raw)

Papers by Amr Safwat

Research paper thumbnail of Impact of Endoscopic Skull Base Reconstruction on Patient Quality of Life

Studying patient quality of life after endoscopic skull base surgery is important for proper iden... more Studying patient quality of life after endoscopic skull base surgery is important for proper identification of possible risks associated with the surgery and help preoperative informed consent taking process so as to help both the surgeon and the patient make the right treatment option. The patients social and personal aspects may be affected as a result of surgery. This necessitates proper preoperative counseling to address patients worries and concerns.

Research paper thumbnail of Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Surgical Neurology International, 2020

Background:Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almo... more Background:Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almost all aspects of health-care delivery. Emergency procedures are likely continuing in most countries, however, some of them raises certain concerns to the surgeons such as the endoscopic endonasal skull base surgeries. The aim of this study is to present the current situation from a developing country perspective in dealing with such cases at the time of the COVID-19 pandemic.Methods:A cross-sectional analytical survey was distributed among neurosurgeons who performed emergency surgeries during the COVID-19 pandemic in Cairo, Egypt, between May 8, 2020, and June 7, 2020. The survey entailed patients’ information (demographics, preoperative screening, and postoperative COVID-19 symptoms), surgical team information (demographics and postoperative COVID-19 symptoms), and operative information (personal protective equipment [PPE] utilization and basal craniectomy).Results:Our survey was comp...

Research paper thumbnail of Syringomyelia associated with Cervical Spondylosis: A case report

Romanian Neurosurgery, 2014

Although cervical spondylosis is an extremely common condition causing spinal cord compression, i... more Although cervical spondylosis is an extremely common condition causing spinal cord compression, it is rarely involved in syringomyelia formation.Here we describe a case of syringomyelia associated with cervical spondylosis.

Research paper thumbnail of Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

Journal of Neurosciences in Rural Practice, 2016

Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challe... more Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforemen...

Research paper thumbnail of Posterior Atlanto-Axial Stabilization using Laminar Hooks: Experience of 20 Cases

Background: Trauma is a common cause of C1-C2 instability. Treatment of atlantoaxial instability ... more Background: Trauma is a common cause of C1-C2 instability. Treatment of atlantoaxial instability is aimed at stabilization, bony fusion, improvement of neurological status and restoration of normal anatomy. Various surgical techniques were described including; Transarticular and transpedicular screws, laminar hooks, and sublaminar wiring. Objective: Determining the outcome of C1-C2 fixation with posterior laminar hook system for treatment of C1-C2 instability, concerning the clinical picture and rate of fusion. Patients & Methods: Twenty patients assigned for C1-C2 fusion for nonneoplastic causes were included. Patients were assessed clinically and radiologically before and on second day after surgery. Patients were followed up for a period of 6 months. All patients were operated upon by posterior laminar hooks with bony grafting. Results: Postoperative imaging showed proper reduction and alignment in all cases. In the last follow up, there was evidence of bone fusion in thirteen cases (65%), while the rest of cases showed proper hook positions with no movement on dynamic images. Postoperative clinical evaluation revealed significant improvement of neurological ASIA grading in 90% of cases, while two patients (10%) had persistent upper limb weakness. Conclusion: Posterior C1-C2 fixation using sublaminar clamps is a technically simple technique with high success rates of fusion and clinical improvement. The main disadvantage of this technique is the need for intact posterior bony elements.

Research paper thumbnail of Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

Journal of Neurosciences in Rural Practice, 2016

Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neur... more Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Total-near total excision in 14 (66.67%) subtotal in 6 (28.57%), and biopsy in 1 case (4.57%). In long-term follow-up, only one case experienced persistent dysphasia. In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision.

Research paper thumbnail of Impact of Endoscopic Skull Base Reconstruction on Patient Quality of Life

Studying patient quality of life after endoscopic skull base surgery is important for proper iden... more Studying patient quality of life after endoscopic skull base surgery is important for proper identification of possible risks associated with the surgery and help preoperative informed consent taking process so as to help both the surgeon and the patient make the right treatment option. The patients social and personal aspects may be affected as a result of surgery. This necessitates proper preoperative counseling to address patients worries and concerns.

Research paper thumbnail of Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Surgical Neurology International, 2020

Background:Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almo... more Background:Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almost all aspects of health-care delivery. Emergency procedures are likely continuing in most countries, however, some of them raises certain concerns to the surgeons such as the endoscopic endonasal skull base surgeries. The aim of this study is to present the current situation from a developing country perspective in dealing with such cases at the time of the COVID-19 pandemic.Methods:A cross-sectional analytical survey was distributed among neurosurgeons who performed emergency surgeries during the COVID-19 pandemic in Cairo, Egypt, between May 8, 2020, and June 7, 2020. The survey entailed patients’ information (demographics, preoperative screening, and postoperative COVID-19 symptoms), surgical team information (demographics and postoperative COVID-19 symptoms), and operative information (personal protective equipment [PPE] utilization and basal craniectomy).Results:Our survey was comp...

Research paper thumbnail of Syringomyelia associated with Cervical Spondylosis: A case report

Romanian Neurosurgery, 2014

Although cervical spondylosis is an extremely common condition causing spinal cord compression, i... more Although cervical spondylosis is an extremely common condition causing spinal cord compression, it is rarely involved in syringomyelia formation.Here we describe a case of syringomyelia associated with cervical spondylosis.

Research paper thumbnail of Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

Journal of Neurosciences in Rural Practice, 2016

Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challe... more Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforemen...

Research paper thumbnail of Posterior Atlanto-Axial Stabilization using Laminar Hooks: Experience of 20 Cases

Background: Trauma is a common cause of C1-C2 instability. Treatment of atlantoaxial instability ... more Background: Trauma is a common cause of C1-C2 instability. Treatment of atlantoaxial instability is aimed at stabilization, bony fusion, improvement of neurological status and restoration of normal anatomy. Various surgical techniques were described including; Transarticular and transpedicular screws, laminar hooks, and sublaminar wiring. Objective: Determining the outcome of C1-C2 fixation with posterior laminar hook system for treatment of C1-C2 instability, concerning the clinical picture and rate of fusion. Patients & Methods: Twenty patients assigned for C1-C2 fusion for nonneoplastic causes were included. Patients were assessed clinically and radiologically before and on second day after surgery. Patients were followed up for a period of 6 months. All patients were operated upon by posterior laminar hooks with bony grafting. Results: Postoperative imaging showed proper reduction and alignment in all cases. In the last follow up, there was evidence of bone fusion in thirteen cases (65%), while the rest of cases showed proper hook positions with no movement on dynamic images. Postoperative clinical evaluation revealed significant improvement of neurological ASIA grading in 90% of cases, while two patients (10%) had persistent upper limb weakness. Conclusion: Posterior C1-C2 fixation using sublaminar clamps is a technically simple technique with high success rates of fusion and clinical improvement. The main disadvantage of this technique is the need for intact posterior bony elements.

Research paper thumbnail of Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

Journal of Neurosciences in Rural Practice, 2016

Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neur... more Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Total-near total excision in 14 (66.67%) subtotal in 6 (28.57%), and biopsy in 1 case (4.57%). In long-term follow-up, only one case experienced persistent dysphasia. In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision.