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Juan F. Villalonga

Juan F. Villalonga

MD

About

88
Publications
25,221
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138
Citations
Citations since 2016
86 Research Items
138 Citations
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201620172018201920202021202201020304050
201620172018201920202021202201020304050
Introduction
Juan F. Villalonga currently works at the Azienda Ospidaliera Federico II di Napoli. Juan does Fellowship in Skull Base Endoscopy Surgery.
Additional affiliations
June 2019 - present
LINT - Universidad Nacional de Tucumán
Position
  • Managing Director
June 2019 - present
University of Naples Federico II
Position
  • Fellow

Publications

Publications (88)
Article
Full-text available
Background Recently, it was defined that the sellar barrier entity could be identified as a predictor of cerebrospinal fluid (CSF) intraoperative leakage. The aim of this study is to validate the application of the sellar barrier concept for predicting intraoperative CSF leak in endoscopic endonasal surgery for pituitary adenomas with a machine lea...
Article
Intracranial trigeminal schwannomas are rare tumors that may extend into multiple cranial compartments and may emerge from the root, ganglion or intracranial portion of any of its branches.¹⁻⁶ The aim of this three-dimensional operative video is to present a single-stage complete removal of a dumbbell shaped trigeminal schwannoma through a pretempo...
Article
Full-text available
Background/aim: Extraventricular supratentorial ependymomas are rare entities. Most ependymomas are located at the infratentorial and intraventricular level, and only in a small group of cases they do not present continuity with the ventricular system. This is a case report of a patient with an atypical location of a cerebral ependymoma, which req...
Article
Background: Endoscopic third ventriculostomy (ETV) is currently used as a treatment for different types of hydrocephalus. However, the anatomical endoscopic variants of the third ventricle floor (3VF), as well as their surgical implications, have been underrated. The anatomic variations of the 3VF can influence the technique and the success rate o...
Article
In certain cases, the closing force of a single vascular clip is not sufficient for complete aneurysmal occlusion and the use of multiple clips or “clip stacking” is required. Many stacking techniques have been described in the literature, such as "in tandem” and “over-stacking”. However, these may not be feasible during procedures with limited exp...
Article
Paraclinoid aneurysms represent a true microsurgical challenge for resolution [1], [2] due to the proximity with neurovascular structures of the skull base [3], [4], [5]. We present a case: a 42-year-old woman with headache, detecting left paraclinoid aneurysm in angiography. A left pterional approach plus exposure of the internal carotid at the ce...
Article
The temporomesial region is a frequent site of neurosurgical lesions such as tumors, cavernomas, or arteriovenous malformations. This region has been divided into 3 regions: anterior, middle, and posterior.1, 2, 3, 4 The objective of Video 1 is to present the case of a posterior temporomesial cavernoma resection through a supracerebellar transtento...
Article
The porpose of this video is to describe the microsurgical corridor of the trans-tonsillar approach for resection of a tumor located in the right lateral aspect of the medulla. We presented a 56-year-old patient with headache and diplopia. On the preoperative MRI we found a localized tumor with surrounding edema, in the anterior portion of the righ...
Article
Introduction: The risks and benefits of coagulating intradural venous elements during a retrosigmoid approach for trigeminal neurovascular decompression has not been accurately established. The objectives of this study are to identify the veins that drain into the superior petrosal sinus, classify them in relation to the suprameatal tubercle and d...
Article
Full-text available
Background: Carotid-ophthalmic aneurysms usually cause visual problems. Its surgical treatment is challenging because of its anatomically close relations to the optic nerve, carotid artery, ophthalmic artery, anterior clinoid process, and cavernous sinus, which hinder direct access. Despite recent technical advancements enabling risk reduction of t...
Article
The removal of petroclival meningiomas (PMs) is considered a neurosurgical challenge due to the critical mobilization of key neurovascular structures. Limited knowledge about the benefits of operating on patients with PMs using the combined presigmoid-subtemporal approach (CPSA) in a semi-sitting position has precluded its generalizability. We repo...
Article
Surgical removal of anterior clinoidal meningiomas remains a challenge because of its complicated relationship with surrounding vascular and neural structures.1-3 This is a 39-yr-old female, with headaches, neurofibromatosis type 2, and history of 3 previous brain surgeries. The patient gave the consent to use the images and surgical video. In the...
Article
Full-text available
PurposePosterior fossa tumors are the most frequent pediatric solid tumor. Its main treatment is a surgical resection. Being a frequent procedure does not mean that it is exempt from complications, such as surgical site infections (SSI). The main objective of this paper is to study the risk factors associated with SSI following a resection of poste...
Article
Full-text available
RESUMEN INTRODUCCIÓN Los meningiomas de la fosa posterior (MFP) represen-tan el 20% de todos los meningiomas intracraneales. Cada subtipo tiene una base de implantación, abordaje quirúrgico y morbimortalidad postoperatoria muchas ve-ces diferente. Advertimos que en reuniones científicas y publicaciones no se sigue una forma de clasificar unifor-me,...
Article
Full-text available
Craniopharyngiomas are benign tumors of the sellar and parasellar region for which surgical resection remains the treatment of choice. There are many publications on the most frequent postoperative complications, but few reports on subclinical lesions affecting the arteries of the circle of Willis, despite their high morbidity and mortality rate. T...
Article
Among the posterolateral corridors to the ventral foramen magnum (FM), the transcondylar fossa (supracondylar transjugular tubercle) approach (TCFA) is indicated for lesions lying anteriorly to the dentate ligament and above the jugular foramen and hypoglossal canal.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 It involves the drilling of the condylar...
Article
Full-text available
Neurovascular procedures along the interhemispheric fissure harbor unique features differentiating them from those arteriovenous malformations (AVMs) located at the lateral surface of the brain.1-4 The aim of this 3-dimensional operative video is to present a microsurgical resection of an AVM in a subparacentral location, operated through an interh...
Article
Full-text available
Introduction: The petroclival region is among the most challenging anatomical areas to deal with in skull base surgery. Drilling of the anterior part of the petrous bone during the anterior transpetrosal approach involves the risk of injury of the cochlea, superior semicircular canal, internal carotid artery, and internal auditory canal. A thoroug...
Article
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Las lesiones selares son una patología con una incidencia de 3,2 a 4 / 100,000 y una prevalencia de 78 a 94 / 100,000. Un 10% son incidentalomas en la población adulta. Se cree que su prevalencia en el orden mundial actualmente va en aumento. En relación a las manifestaciones clínicas, cabe destacar que es una de las pocas enfermedades que pueden m...
Article
Full-text available
According to reports from the literature,1,2 depending on the location where cavernomas appear, range from the very common locations to unusual. Cavernous malformations arising from the optic nerve and chiasm are rare, with only few cases reported to date.3-5 We present a case of a 28-yr-old man who suddenly started with sever visual loss in the ri...
Article
Full-text available
Intracranial trigeminal schwannomas are rare tumors.1-4 The aim of this 3-dimensional operative video is to present a double stage complete removal of a dumbbell-shaped trigeminal schwannoma. This is a 25-yr-old male with headaches, diplopia, and facial pain. The MRI shows a big tumor located at the level of the cerebellopontine angle, petroclival...
Article
AIM: To analyze the effectiveness of fat and fibrin glue to prevent postoperative cerebrospinal fluid (CSF) leak in pituitary surgery. MATERIAL and METHODS: Two hundred and eleven patients affected by pituitary adenoma entered this study. Patients that underwent a microscopic transsphenoidal approach between January 2013 and April 2019 were include...
Article
Full-text available
Background: The type of sellar barrier observed between a pituitary tumor and cerebrospinal fluid (CSF) on preoperative magnetic resonance imaging (MRI) may predict intraoperative CSF leak during endonasal pituitary surgery. This is the first multicentric prospective cohort trial to study the sellar barrier concept and CSF leak rate during endosco...
Article
Sellar arachnoidocele is a term used to define the herniation of the subarachnoid space to the sella.¹ This is a rare radiologic finding that, in most cases, does not require treatment.2, 3, 4, 5 When symptoms appear, the term empty sella syndrome is used. Two varieties exist: primary and secondary empty sella syndrome.² The aim of this 3-dimension...
Chapter
The foramen magnum is a complex region with diverse pathologies of intra and extradural location; the first includes mainly meningiomas and neurinomas, while the second corresponds to chordomas and bone tumors. Together, these pathologies are very rare. Foramen magnum meningiomas (FMM) represent 1.8–3.2% of all meningiomas. In most of the cases, FM...
Article
Full-text available
Existe un marcado superávit de neurocirujanos en la Argentina que irá in crescendo. Esto impide desarrollar condiciones laborales dignas para los mismos. Se trata de una situación extrema que requiere medidas drásticas. Todos debemos involucrarnos.
Article
Full-text available
RESUMEN Introducción: En las últimas décadas el uso de la posición sentada ha disminuido en frecuencia a causa de 2 complicaciones mayores: el embolismo aéreo venoso y la hipotensión intraoperatoria. Sin embargo es innegable que la posición sentada ofrece una serie de ventajas al neurocirujano, el anestesiólogo y al electrofisiólogo. Materiales y...
Article
Full-text available
Introduction: The indication of a ventriculoperitoneal shunt (VPS) is discussed in patients with idiopathic normal pressure hydrocephalus (iNPH), due to the heterogeneity of the response to treatment and the risks involved in neurosurgery. Objective: To search for clinical factors and complementary studies in order to determine predictors of a favo...
Article
The meningo-orbital band (MOB) is the most superficial dural band that tethers the fronto-temporal dura to the periorbita. It is usually encountered when performing a pterional or fronto-temporo-sphenoidal approach, and it disrupts surgical access to deeper regions. Our objective was to perform a detailed anatomy study and a stepwise method to succ...
Article
Full-text available
Resumen: Introducción: La región temporal mesial (RTM) es asiento frecuente de lesio-nes de resolución neuroquirúrgica, como ser tumores, cavernomas y malfor-maciones arteriovenosas. Es el objetivo del presente trabajo es describir la anatomía microquirúrgica y los abordajes a la RTM, en relación a cavernomas de dicho sector. Material y métodos: Ci...
Article
Objective Intracranial hemangiopericytoma (HPC) is a rare central nervous system tumor characterized by its low incidence, high rate of local recurrence and risk of metastasis. The main objectives of this paper are two: to show the results in the treatment of HPC in our institution in the last 20 years and to make a review of the literature on this...
Article
Full-text available
At the beginning of the 20th century, craniotomies for intracranial aneurysms were large due to a deficit in the illumination of the surgical field, lack of optical magnification, and inadequate surgical instruments. Even after the microscope was introduced, the size of the craniotomies did not diminish significantly. It was only after 1981 when Sa...
Article
Introduction: Up to date, there are few conditions where the nasoseptal flap (NSF) is not considered as a valid option in the reconstructive phase: 1) when the neurosurgeon does not use an endoscopic technique or 2) when the neurosurgeon uses the endoscopic technique, but there is no genuine indication for the mentioned flap. Therefore, the young...
Article
Full-text available
Introducción: Diversos estudios demuestran que la tasa de complicaciones asociadas a craneoplastías ha sido subestimada. A mediados de 2016 advertimos una serie de complicaciones asociadas a este procedimiento en nuestro Hospital. Por esto, se decidió cambiar el material que se utilizaba hasta entonces (i.e. polimetilmetracrilato de metilo, PMMAM)...
Article
Full-text available
Background: Sphenoid wing meningiomas account for 20% of supratentorial meningiomas. The main supply of these tumors is provided by branches of the middle and accessory meningeal arteries. Surgical resection of meningiomas requires early tumor devascularization. Our objective is to present the role of transzygomatic approach plus mini-peeling of th...
Article
Full-text available
Introducción: La Academia Americana de Neurología propone que, para que un paciente sea candidato a descompresiva neurovascular trigeminal (DNV), se debe demostrar la presencia de contacto neurovascular a través de la resonancia magnética (RM). Sin embargo, recientes estudios han demostrado que la sensibilidad de la RM para diagnosticar un conflict...
Article
Introduction The temporal muscle (TM) needs to be dissected and reflected downward in some anterolateral cranial approaches and failing to preserve its integrity could have severe functional and cosmetic consequences.Most articles focus on techniques to prevent vascular injury during retrograde dissection or techniques to preserve the facial nerve;...
Article
Resumen Objetivo Los hemangiopericitomas intracraneanos (HPC) son tumores de muy baja frecuencia, alta recidiva local y riesgo de metástasis extracraneal. El objetivo del siguiente trabajo es presentar los resultados en el tratamiento de los HPC en nuestra institución en los últimos 20 años y realizar una revisión de la literatura del tema. Mater...
Article
Full-text available
Introducción: Los tumores de hipófisis representan aproximadamente un 10% de los tumores intracraneales. Los adenomas hipofisarios son ampliamente la lesión selar más frecuente. Es fundamental que se conformen equipos capaces de tratar holísticamente esta patología en las distintas regiones de nuestro vasto territorio. El propósito del presente tra...
Article
The orbitomeningeal or meningo-orbital band (MOB) has been described as the most superficial dural band responsible for tethering the frontotemporal basal dura to the periorbita.1,2 The MBO usually interferes with the surgical approach to the most profound areas of the anterior and middle skull base. It is known that there are no cranial nerves on...
Article
Full-text available
Introducción: Los meningiomas de los ventrículos laterales actualmente continúan siendo un verdadero desafío para el neurocirujano en virtud a la contigüidad de estas lesiones con estructuras vitales. Por esto, es clave te-ner conocimientos sólidos que nos permitan seleccionar la vía de abordaje adecuada. El propósito del presente estudio es: 1) re...
Article
Cerebral spinal fluid (CSF) leak is a significant complication in pituitary surgery, increasing both patient morbidity and mortality. In a recent publication, Campero et al. observed worse postoperative prognosis and increased risk of intraoperative CSF leak in patients with reduced sellar barrier thickness. The objective of this study was to analy...
Article
Background: The sellar barrier concept reflects the association between the components of the roof of the pituitary fossa and the risk of intraoperative cerebrospinal fluid (CSF) leak in the surgery of pituitary adenomas. We based our concept in previous reports on the microsurgical anatomy of the pituitary fossa's superior wall. However, proof of...
Article
Gravity retraction is an underutilized adjunct in neurosurgery. Gravity is gentler than retractor blades; it does not cause brain edema or injury, and it tends to open natural subarachnoidal plans to deep lesions.1-3 A good example of this is the supracerebellar infratrochlear approach4-7 in semisitting position for resection to a midbrain cavernou...
Article
Background: Pituicytoma is a rare neoplasm arising in the sellar region (World Health Organization grade I). Clinically, pituicytomas mimic nonfunctioning pituitary macroadenomas and are occasionally incidentally discovered at autopsy. Pituitary adenomas can occur with other sellar pathologies, and the term "collision sellar lesions" has been coin...
Article
Full-text available
Introducción: Los meningiomas del tuberculum sellae representan aproximadamente entre el 5 - 10 % de los meningiomas intracraneanos. El tratamiento de esta entidad es un verdadero desafío para el neurocirujano. Actualmente existe cierta controversia acerca de la vía de abordaje a utilizar. Nuestro equipo utiliza la clásica vía pterional trans-silvi...
Article
Full-text available
Introducción: Los meningiomas son los segundos tumores mas frecuentes del ángulo pontocerebeloso (APC). Múltiples clasificaciones han sido propuestas considerando la base de implantación. El objetivo de este estudio es presentar nuestra experiencia en el tratamiento quirúrgico. Métodos: Estudio retrospectivo de una serie de pacientes operados de me...
Article
Full-text available
Introducción: Debido a la naturaleza impredecible y demandante de la neurocirugía, es necesaria una comunicación segura y rápida entre colegas. WhatsApp se presenta, en este contexto, como una solución rentable, fácil, accesible y rápida. Por la característica fugaz de la tecnología los avances preceden a las normativas. Actualmente WhatsApp es una...
Article
At the beginning of 2019, our team in Tucumán published the first study that introduces the concept of the sellar barrier. It is classified into two types according to the anatomical constitution of the roof of the pituitary fossa: strong (pituitary gland/dura mater and arachnoid) and weak (only arachnoid). Also, there is a correlation between thes...
Article
Full-text available
Introduction: Ventriculoperitoneal shunting is considered a relatively straightforward procedure, though it might ensure multiple complications. Our surgical team developed and implemented a new protocol since June 2016. The objective of this paper is to describe and illustrate the surgical technique step by step and to demonstrate that the use of...
Article
Background: The use of the recent concept of sellar barrier revealed that a specific group of patients were difficult to categorize. For this reason, we propose to add a new subtype: the mixed sellar barrier. The aim of this work was to define the new mixed barrier subtype and analyze this in a series of operated patients. Methods: A retrospecti...
Article
Full-text available
A partir de la introducción de las técnicas modernas en diagnóstico por Resonancia Magnética por Imágenes (RMI), revolucionó la comprensión de las malformaciones cavernosas, permitiendo su diagnóstico preciso. En paralelo, el avance de las técnicas microquirúrgicas y el conocimiento de las zonas seguras de acceso al tronco cerebral han definido los...
Article
Full-text available
Los meningiomas constituyen aproximadamente el 10-15% (1) de las neoplasias cerebrales, y el 7% de ellos presentan una inserción supraselar. Los meningiomas del tubérculo selar presentan adherencia en este, en el surco quiasmático o en el limbo esfenoidal 2,3. Descripción del caso: Mujer de 45 años que consulta por cefalea y déficit severo de la vi...
Chapter
La anatomía de la región temporal mesial (RTM) es muy compleja. Se encuentra oculta en lo más profundo del lóbulo temporal y del sistema ventricular, cercana a las cisternas basales. Está rodeada por elementos vasculares y nerviosos que debemos intentar preservar durante la cirugía. Existen diversos estudios que tratan sobre la anatomía, la fisiolo...
Chapter
Los senos cavernosos (SC) son estructuras pares localizadas a ambos lados de la silla turca, la hipofisis y el seno esfenoidal. El SC se extiende desde la hendidura esfenoidal (fisura orbitaria superior) hasta el dorsum sellae, y su límite inferior se constituye por el borde superior del nervio maxilar. La estructura externa de cada SC está formada...
Article
Full-text available
Background and objective The orbit is a structure of interest for many medical specialties. Surgical approaches to the orbit present significant difficulties for the general neurosurgeon. Whoever decides to practice orbital surgery must have vast anatomical knowledge of this structure. However, although many of the existing publications about orbit...
Article
Background: Pituitary adenomas (PA) are usually benign neoplasm. Chiari I malformation (CIM) is an uncommon finding. There are isolated reports on the association between a producing PA and CIM, but the concomitant presence of a non producer PA and a CIM is not described in the literature. Case description: We present a case of a 35-year-old patien...
Article
Antecedentes y objetivo: La órbita es una estructura de interés para diversas especialidades médicas. Los abordajes quirúrgicos de la órbita presentan una dificultad significativa para el neurocirujano general. Quien decide incursionar en cirugía orbitaria debe tener un vasto conocimiento anatómico de esta estructura. Sin embargo, gran parte de las...
Article
Full-text available
A case is reported of a 19-year old patient with a supratentorial giant cavernous malformation (GCM). This was an incidental finding in the context of acute head trauma. Brain computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a giant supratentorial right mass. Surgical excision was performed, and histopathology findings we...
Article
Background: Cerebrospinal fluid (CSF) fistulas are among the most clinically important and frequent complications of transsphenoidal surgery for pituitary adenomas. Between the adenoma and the CSF, a “barrier” exists that consists of ≤3 elements. These, from cephalad to caudad, are the arachnoid, dura mater (sellar diaphragm), and pituitary glandul...