Ten cases of cholesteatoma with labyrinthine destruction, skull base involvement and intracranial extension: management and long-term follow-up

A case of extramedullary plasmacytoma with its unusual appearance is reported. This is the second reported case in world literature affecting the paranasal sinuses with intracranial extension. The role of surgery is to obtain tissue for diagnosis and to excise residual disease. Radiotherapy is the treatment of choice and long-term follow-up is necessary for monitoring disease recurrence. The overall 10-year survival is about 50%. The case is discussed with a general review of the management of this pathology.

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Mucoceles of the Paranasal Sinuses with Intracranial Extension-Postoperative Course

American Journal of Rhinology ◽

10.1177/194589240101500405 ◽

2001 ◽

Vol 15 (4) ◽

pp. 243-247 ◽

Cited By ~ 6

Author(s):

Keiichi Ichimura ◽

Yasushi Ohta ◽

Yoh-Ichiro Maeda ◽

Hiroyoshi Sugimura

Keyword(s):

Skull Base ◽

Paranasal Sinuses ◽

Original Position ◽

Intracranial Extension ◽

Transnasal Approach ◽

Postoperative Course ◽

Transnasal Surgery ◽

Long Term Follow Up ◽

Magnetic Resonance Imaging Mri

Mucoceles of the paranasal sinuses cause progressive distension of the bony walls and induce compressive symptoms. Although rare, cases of massive intracranial extension have occurred. We believe that an endoscopic transnasal approach is the best choice for such huge mucoceles because it is the least invasive and can provide an adequate surgical field of view for wide marsupialization. However, the results of long-term follow-up after endoscopic transnasal surgery have not been reported. This study was designed to evaluate prospectively the postoperative course of patients with intracranially extended mucocele. In the last 5 years, we have operated on four patients with intracranially extended mucocele. Although postoperative scanning is not recommended routinely after surgery for inflammatory disease, we followed up two patients who consented by using magnetic resonance imaging (MRI) along with endoscopy. Dural descent to the original skull base plane necessitated long periods of follow-up, lasting 18 and 5 months, respectively. On the mucocele wall mucosa, which had been smooth during surgery, polyps and granulations developed after surgical drainage and lasted for a considerable time. Although endoscopic transnasal opening of mucocele is a method of choice, we recommend follow-up of such patients for long periods, at least until the frontal skull base dura returns to its original position.

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Differential Tumor Progression Patterns in Skull Base Versus Non–Skull Base Meningiomas: A Critical Analysis from a Long-Term Follow-Up Study and Review of Literature

World Neurosurgery ◽

10.1016/j.wneu.2017.12.035 ◽

2018 ◽

Vol 112 ◽

pp. e74-e83 ◽

Cited By ~ 14

Author(s):

Amey R. Savardekar ◽

Devi Prasad Patra ◽

Shyamal Bir ◽

Jai Deep Thakur ◽

Nasser Mohammed ◽

...

Keyword(s):

Tumor Progression ◽

Skull Base ◽

Critical Analysis ◽

Review Of Literature ◽

Follow Up Study ◽

Long Term Follow Up ◽

Skull Base Meningiomas ◽

Progression Patterns

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Aggressive scalp carcinoma with intracranial extension: A multidisciplinary experience of 25 patients with long-term follow-up

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2007.09.014 ◽

2008 ◽

Vol 15 (9) ◽

pp. 988-992 ◽

Cited By ~ 9

Author(s):

P.F. Soma ◽

S. Chibbaro ◽

O. Makiese ◽

M. Marsella ◽

P. Diemidio ◽

...

Keyword(s):

Intracranial Extension ◽

Long Term Follow Up

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Risk factors for preoperative and postoperative late seizure in supratentorial meningiomas

Romanian Neurosurgery ◽

10.33962/roneuro-2019-053 ◽

2019 ◽

pp. 316-321

Author(s):

Rahsan Kemerdere ◽

Mehmet Yigit Akgun ◽

Orkhan Alizada ◽

Sureyya Toklu ◽

Burak Tahmazoglu ◽

...

Keyword(s):

Risk Factors ◽

Skull Base ◽

Surgical Complications ◽

Significant Risk ◽

Significant Risk Factor ◽

Binary Logistic Regression Analysis ◽

Seizure Outcome ◽

Long Term Follow Up

Introduction. Seizure following meningioma surgery is common and management may be challenging. Identifying risk factors may help physicians to initiate optimal medical management. The aim of this study is to report seizure outcome and risk factors for perioperative seizure. Materials and Methods. Sixty-three adult patients who underwent supratentorial meningioma resection were included, and perioperative data and long-term follow-up were provided in this retrospective study. Binary logistic regression analysis was used to identify the risk factors for perioperative seizure and postoperative late seizure. Results. The results showed that 20 (37.1 %) patients had preoperative seizure and 10 (50 %) patients were seizure free at the long-term follow-up. Absence of headache was associated with preoperative seizure (p=0.002) while presence of early seizure was significant predictor for postoperative late seizure (p=0.03). Although not significant, occurrence of surgical complications (p=0.08) and non-skull base location (p=0.06) tended toward being a significant risk factor for postoperative late seizure. Conclusion. Presence of early seizures, surgical complications and locations out of skull base may direct postoperative anti-epileptic treatment to decrease seizure incidence which, indeed, increases quality of life for patients with meningioma.

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The applicability of established clinical and histopathological risk factors for tumor recurrence during long-term postoperative care in meningioma patients

Neurosurgical Review ◽

10.1007/s10143-021-01697-w ◽

2021 ◽

Author(s):

Swenja Lüthge ◽

Dorothee Cäcilia Spille ◽

Andrea Ulrike Steinbicker ◽

Stephanie Schipmann ◽

Eileen Maria Susanne Streckert ◽

...

Keyword(s):

Risk Factors ◽

Skull Base ◽

Tumor Recurrence ◽

Skull Base Tumor ◽

High Grade ◽

Entire Cohort ◽

Long Term Follow Up ◽

Base Location

Abstract Risk factors to predict late-onset tumor recurrence in meningioma patients are urgently needed to schedule control intervals during long-term follow-up. We therefore analyzed the value of established risk factors for postoperative meningioma recurrence for the prediction of long-term prognosis. Correlations of clinical and histopathological variables with tumor relapse after 3, 5, and 10 years following microsurgery were analyzed in uni- and multivariate analyses, and compared to findings in the entire cohort. In the entire cohort (N = 1218), skull base location (HR: 1.51, 95%CI 1.05–2.16; p = .026), Simpson ≥ IV resections (HR: 2.41, 95%CI 1.52–3.84; p < .001), high-grade histology (HR: 3.70, 95%CI 2.50–5.47; p < .001), and male gender (HR: 1.46, 95%CI 1.01–2.11; p = .042) were independent risk factors for recurrence. Skull base location (HR: 1.92, 95%CI 1.17–3.17; p = .010 and HR: 2.02, 95%CI 1.04–3.95; p = .038) and high-grade histology (HR: 1.87, 95%CI 1.04–3.38; p = .038 and HR: 2.29, 95%CI 1.07–4.01; p = .034) but not subtotal resection (HR: 1.53, 95%CI .68–3.45; p = .303 and HR: 1.75, 95%CI .52–5.96; p = .369) remained correlated with recurrence after a recurrence-free follow-up of ≥ 3 and ≥ 5 years, respectively. Postoperative tumor volume was related with recurrence in general (p < .001) but not beyond a follow-up of ≥ 3 years (p > .05). In 147 patients with a follow-up of ≥ 10 years, ten recurrences occurred and were not correlated with any of the analyzed variables. Skull base tumor location and high-grade histology but not the extent of resection should be considered when scheduling the long-term follow-up after meningioma surgery. Recurrences ≥ 10 years after surgery are rare, and predictors are lacking.

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Anterior Skull Base Defects Reconstructed Using Three-Layer Method: 78 Consecutive Cases with Long-Term Follow-Up

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1583310 ◽

2016 ◽

Vol 77 (06) ◽

pp. 499-502 ◽

Cited By ~ 2

Author(s):

Murat Geyik ◽

Ibrahim Erkutlu ◽

Mehmet Alptekin ◽

Inan Gezgin ◽

Ayse Mizrak ◽

...

Keyword(s):

Skull Base ◽

Anterior Skull Base ◽

Layer Method ◽

Long Term Follow Up ◽

Skull Base Defects

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Evaluation and Management of Frontal Sinus Fractures

Neurotrauma ◽

10.1093/med/9780190936259.003.0017 ◽

2019 ◽

pp. 143-154

Author(s):

Geoffrey Peitz ◽

Mark A. Miller ◽

Gregory W. J. Hawryluk ◽

Ramesh Grandhi

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Frontal Sinus ◽

Operative Management ◽

Intracranial Extension ◽

Long Term Follow Up ◽

Initial Injury ◽

Management Algorithms

Frontal sinus fractures are usually associated with traumatic brain injury and nasoorbitoethmoidal fractures. Much of the available evidence is retrospective, and management algorithms vary. In general, nondisplaced fractures without nasofrontal outflow tract (NFOT) obstruction may be managed with clinical and radiographic follow-up whereas fracture displacement, NFOT obstruction, and persistent CSF leaks are indications for operative management. The bicoronal incision and bifrontal craniotomy allow for proper access to the frontal sinus. If there is NFOT obstruction, the sinus should be cranialized or possibly obliterated if only the anterior table is fractured. The NFOT and sinus are packed with bone chips, fat, or muscle and then sealed with a pericardial graft, fascial graft, or synthetic dural substitute. Inadequate cranialization or obliteration can result in mucocele or mucopyocele, intracranial extension of which can lead to brain abscess or meningitis. Complications can occur years after the initial injury so long-term follow-up is necessary.

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