Long-Term Results of Combined Surgery and Radiotherapy of Pilocytic Astrocytomas in the Middle Cranial Fossa

Author(s):  
F. Rauhut ◽  
V. Reinhardt ◽  
H. Wiedemayer ◽  
V. Budach
2002 ◽  
Vol 81 (1) ◽  
pp. 30-33 ◽  
Author(s):  
Jack L. Pulec

A rare cause of otalgia is geniculate neuralgia. In its most typical form, it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain can be of a gradual onset and of a dull, persistent nature, but occasionally it is sharp and stabbing. When the pain becomes intractable, an operation to surgically excise the nervus intermedius and geniculate ganglion via the middle cranial fossa approach is indicated. The purpose of this article is to review the long-term outcomes in 64 patients who were treated in this manner. Findings indicate that excision of the nervus intermedius and geniculate ganglion can be routinely performed without causing facial paralysis and that it is an effective definitive treatment for intractable geniculate neuralgia.


Lab Animal ◽  
2010 ◽  
Vol 39 (11) ◽  
pp. 352-359 ◽  
Author(s):  
Angelika Ehlert ◽  
Bastian Tiemann ◽  
Jörg Elsner ◽  
Klaus Püschel ◽  
Gerd Manthei

2018 ◽  
Vol 39 (1) ◽  
pp. 92-98 ◽  
Author(s):  
Sameer Ahmed ◽  
H. Alexander Arts ◽  
Hussam El-Kashlan ◽  
Gregory J. Basura ◽  
B. Gregory Thompson ◽  
...  

2017 ◽  
Vol 133 (1) ◽  
pp. 32 ◽  
Author(s):  
I. Ya. Baranov ◽  
I. V. Shiryaev ◽  
N. V. Mitrofanova ◽  
N. A. Molodkina ◽  
L. I. Balashevich

2007 ◽  
Vol 86 (6) ◽  
pp. 338-341 ◽  
Author(s):  
Marc A. Cohen ◽  
Noam A. Cohen ◽  
Gul Moonis ◽  
David W. Kennedy

Arachnoid cysts are benign intracranial lesions that are typically diagnosed incidentally. We describe the case of a 56-year-old man who presented with a multiloculated arachnoid cyst of the middle cranial fossa that extended into the sphenoid sinus. The lesion was identified on computed tomography of the head, which had been obtained for an unrelated investigation. However, establishing a definitive diagnosis proved to be difficult. Because the cyst had caused extensive skull base erosion, the patient was managed conservatively with close observation. We report the radiographic progression of this lesion during more than a decade of follow-up, and we review the literature pertaining to the presentation, pathophysiology, and treatment of arachnoid cysts.


2016 ◽  
Vol 18 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Gabriela Simonova ◽  
Petra Kozubikova ◽  
Roman Liscak ◽  
Josef Novotny

OBJECTIVE The purpose of this study was to evaluate long-term treatment results, radiation-related toxicity, and prognostic factors for the progression-free survival (PFS) of patients with pilocytic astrocytomas treated by means of stereotactic radiosurgery with a Leksell Gamma Knife. METHODS A total of 25 patients with pilocytic astrocytomas underwent Gamma Knife surgery during the period 1992–2002. The median target volume was 2700 mm3 (range 205–25,000 mm3). The 18 patients treated with 5 daily fractions received a median minimum target dose of 25 Gy. Doses for the 2 patients treated with 10 fractions over 5 days (2 fractions delivered on the same day at least 6 hours apart) were 23 and 28 Gy. For the 5 patients treated with a single fraction, the minimum target dose ranged from 13 to 20 Gy (median 16 Gy). RESULTS Complete regression occurred in 10 patients (40%) and partial regression in 10 patients (40%). The 10-year overall survival rate was 96% and the 10-year PFS rate was 80%. Target volume appeared to be a significant prognostic factor for PFS (p = 0.037). Temporary Grade 3 toxicity appeared in 2 patients (8%), and these patients were treated with corticosteroids for 2 months. Permanent Grade 4 toxicity appeared in 2 patients (8%) and was associated with neurocognitive dysfunction. In these 2 individuals, the neurocognitive dysfunction was also felt to be in part the result of the additional therapeutic interventions (4 in one case and 6 in the other) required to achieve durable control of their tumors. CONCLUSIONS Radiosurgery represents an alternative treatment modality for small residual or recurrent volumes of pilocytic astrocytomas and provides long-term local control. Target volume appears to be the most important factor affecting PFS.


2009 ◽  
Vol 3 (3) ◽  
pp. 188-196 ◽  
Author(s):  
Taylor J. Abel ◽  
Abhineet Chowdhary ◽  
Mahesh Thapa ◽  
Joseph C. Rutledge ◽  
Joseph Gruss ◽  
...  

The growth of ectopic glioneuronal tissue in the middle cranial fossa region is an uncommon event, with very few cases reported in the literature. In this paper the authors document 4 cases of ectopic glioneuronal tissue in the middle cranial fossa in children and briefly describe the clinical course and pathology. All of the children presented within the first 6 months of life. Two children presented with facial masses, 1 with airway obstruction, and another with proptosis of the right eye. Each child underwent a customized surgery dependent on the location and characteristics of the harbored lesion. Ectopic glioneuronal masses in the middle cranial fossa are rare and benign congenital tumors, and affected newborns can present with airway obstruction, feeding difficulties, and facial deformity depending on the lesion location. Determining an appropriate surgical approach and strategy is a significant challenge and may involve a multidisciplinary team of craniofacial plastic surgeons, otolaryngologists, and neurosurgeons. Although these lesions share clinical and anatomical similarities, because of their histopathological heterogeneity, it is unlikely that they represent a single pathological entity. The long-term outcome in these children is still unknown and is an area for future study. The pathogenesis of these lesions also remains unknown and may be revealed in future research.


2018 ◽  
Vol 39 (2) ◽  
pp. e151-e157 ◽  
Author(s):  
Joseph P. Roche ◽  
Erika A. Woodson ◽  
Marlan R. Hansen ◽  
Bruce J. Gantz

GlaucomaNews ◽  
2020 ◽  
pp. 69-71
Author(s):  
A.V. Postupaev ◽  
◽  
V.V. Egorov ◽  
N.V. Postupaeva ◽  
◽  
...  

Purpose. To study long-term results of combined surgery for glaucoma and cataract by trabeculotomy ab interno. Material and Methods. 62 patients (64 eyes) with combination of glaucoma and cataract. The age of patients is from 53 to 84 years. The initial stage of glaucoma - 10 eyes, developed - 33 eyes, far-advanced - 21 eyes, level of intraocular pressure (IOP) before surgery in all eyes was intolerant for these stages of glaucoma and ranged from 21 to 36 mmHg. Indications for surgical treatment were absence of persistent IOP level compensation in hypotensive mode, the presence of lens opacification, which affects central visual acuity (VA). Best corrected VA is from 0.01 to 0.6. The technique of combined surgery included: 1st stage - phacoemulsification with implantation of flexible IOL; 2nd stage - trabeculotomy ab interno. The observation period is 18 months. Results. During the observation period of up to 18 months, IOP decreased on average to 20.8±3.1 mmHg. The target level of IOP without an additional antihypertensive regimen remained in 22 eyes (34.37%), with antihypertensive regimen - in 42 eyes (65.63%). In most patients VA increased to 0.2–1.0 and only in 2 cases decreased due to development of posterior capsular fibrosis. Conducting trabeculotomy ab interno has significantly reduced number of drugs used. However, 3-12 months after surgery, IOP increase up to 26-30 mmHg was observed in 4 eyes with antihypertensive drug regimen; microinvasive non-penetrating deep sclerectomy was performed to compensate for it. Conclusion. Trabeculotomy ab interno in combination with phacoemulsification with IOL implantation was effective and safe operation. Sufficient hypotensive effect and high visual functions observe at 18 months observation period.


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