OBJECTIVE

To report the demographics, clinical characteristics, and surgical outcomes after microvascular decompression (MVD) for hemifacial spasm (HFS) in the Philippine General Hospital (PGH).

METHODS

Between January 2018 to December 2022, the division of Neurosurgery at PGH performed thirty-four MVD operations for Primary HFS. Records were retrospectively reviewed, and pertinent demographic, intra-operative findings, outcomes, and complications were analyzed.

RESULTS

The overall success rate is 88.2%, with a median follow-up at 15 months. Repeated measures ANOVA showed that post-op HFS and follow-up HFS grades were significantly lower than pre-op HFS grades (F=17.46, df=33, p < 0.0001). HFS average age of symptom onset was early at 38.5 years, 11.8% of which wereCONCLUSION

MVD at PGH is a viable choice treatment option for Filipino patients with success rates comparable to internationally published studies. Besides improving surgical technique, improvement of referral systems may help make surgery more accessible.

Human ; Microvascular Decompression Surgery ; Hemifacial Spasm

Objective: Neurosurgical boot camps allow trainees to hone practical skills in a risk-free environment, but the models and simulators used are relatively costly. In developing countries like the Philippines, low-cost alternatives have to be devised. The authors aimed to demonstrate the feasibility of using local, readily available, and inexpensive tropical fruits as surrogate models for basic neurosurgical skills training during a neurosurgical boot camp. Methods: Locally available tropical fruits were used to teach basic neurosurgical skills to trainees. Coconut, pomelo, and watermelon were used as models for head clamp application, scalp and dural suturing, and ventriculostomy, respectively. Feedback was obtained from the participants after the boot camp. Results: All eight residents thought that the boot camp was useful in learning new skills, and that the fruit models served their purpose. The trainees favored the fruit models that catered to the skill sets required according to level of training. The use of tropical fruits in the boot camp also provided an informal atmosphere that was conducive to learning. Conclusion The novel use of tropical fruits as surrogate models in basic neurosurgical skills training was a feasible and affordable alternative in resource-limited settings, although the activity was perceived to be more useful to junior than to senior residents. The informal atmosphere generated by the use of the fruits contributed to an improved learning experience for the trainee.
Teaching ; Simulation Training ;

RATIONALE/OBJECTIVE

Aneurysmal subarachnoid hemorrhage (aSAH) may be associated with meteorologic factors in temperate countries. The authors aimed to investigate the relationship between meteorologic factors and aSAH admissions in the Philippines, a tropical country with two seasons: rainy and dry.

METHODS

A census review of aSAH admissions from 2015 to 2019 at a tertiary hospital was performed. Meteorologic data were collected for the same time period, and statistical analysis was performed.

RESULTS

A total of 660 patients were admitted for aSAH, 275 and 385 during the rainy and dry seasons, respectively. August and October had the greatest number of mean admissions (13.2) while February had the least (6.2). There was a moderate positive correlation between aSAH admissions and mean temperature. Negligible to weak negative correlations were seen between aSAH admissions and humidity, barometric pressure and precipitation. However, there was no correlation on regression analysis.

CONCLUSION

There were no significant differences in aSAH admissions between rainy and dry seasons. The authors found an increase in aSAH admissions during months with higher temperatures and HI, and weak to negligible negative correlations between aSAH admissions and humidity, barometric pressure, and precipitation. These findings may inform health care facilities in terms of readiness for aSAH admissions.

Subarachnoid Hemorrhage ; Aneurysm ; Meteorology ; Weather