Endoscopic transnasal image-guided approach to diagnosis in orbital apex and optic canal lesions

2019 ◽  
Vol 133 (06) ◽  
pp. 501-507 ◽  
Author(s):  
S N Unadkat ◽  
C E Rennie ◽  
W E Grant
Keyword(s):  
Skull Base ◽  
Optic Canal ◽  
Cerebrospinal Fluid Leakage ◽  
Orbital Apex ◽  
Malignant Tumours ◽  
Immunoglobulin G4 ◽  
Presenting Symptoms ◽  
Hunt Syndrome ◽  
Impact On Treatment ◽  
Benign Tumours

AbstractObjectivePrompted by a recurring skull base multidisciplinary team debate on the necessity of securing a definitive tissue diagnosis before initiating treatment for lesions of the orbital apex, a review of anterior skull base procedures over an 11-year period was undertaken.MethodsData collected prospectively on cases from 2006 to 2017 were analysed. Presenting symptoms, imaging and histology findings, outcomes, complications, and impact on treatment were evaluated. All surgery was carried out endoscopically with the aid of image guidance.ResultsTwenty-one patients undergoing endoscopic orbital apex and/or optic canal biopsy were included. The mean patient age was 49 years. Five malignant tumours were identified, five benign tumours, seven infective cases (two tuberculosis and five fungal) and two cases of immunoglobulin G4 related disease. Two patients had non-diagnostic biopsies (one lesional) and were treated successfully as Tolosa–Hunt syndrome cases.ConclusionA successful diagnosis was achieved in nearly all cases without adverse impact, other than one cerebrospinal fluid leakage case. Management was directly influenced by the outcome in all cases.

Skull base meningiomas mimicking otitis media

2012 ◽  
Vol 126 (6) ◽  
pp. 619-624 ◽  
Author(s):  
R Shihada ◽  
M Lurie ◽  
M Luntz
Keyword(s):  
Skull Base ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Rare Condition ◽  
Presenting Symptoms ◽  
Benign Tumours ◽  
Case Presentations ◽  
Skull Base Meningiomas

AbstractIntroduction:Meningiomas are slow-growing, benign tumours originating from the arachnoid villi of the meninges. They account for 13 to 26 per cent of all intracranial neoplasms. Less than 1 per cent of all meningiomas are primary extracranial tumours of the ear and temporal bone. Intracranial meningiomas extending to the middle-ear cleft are uncommon, with fewer than 100 cases reported to date. Presenting symptoms of the latter condition may include hearing loss, tinnitus, dizziness, vertigo and facial palsy. Otitis media with effusion secondary to eustachian tube dysfunction has also been reported.Aim:To describe three patients in whom chronic otitis media was the presenting sign of skull base meningioma.Method:Case presentations.Results:Presentation of clinical and imaging findings as well as management considerations.Conclusion:Meningioma involving the middle ear is an extremely rare condition, and is diagnosed by computed tomography in conjunction with magnetic resonance imaging. When biopsy is performed, the histological features, characteristic immunophenotype and ultrastructural analysis are valuable aids to definitive diagnosis. In patients with no neurological symptoms, ‘wait and scan’ is often the best management option.

scholarly journals Metastatic Skull Base Tumor From Thymic Carcinoma Mimicking Tolosa-Hunt Syndrome

2010 ◽  
Vol 50 (6) ◽  
pp. 499-502 ◽  
Author(s):  
Satoshi TSUTSUMI ◽  
Yusuke ABE ◽  
Yukimasa YASUMOTO ◽  
Saori SHIONO ◽  
Masanori ITO
Keyword(s):  
Skull Base ◽  
Thymic Carcinoma ◽  
Skull Base Tumor ◽  
Hunt Syndrome

HISTOPATHOLOGICALANALYSIS OF TUMOURS AND TUMOUR-LIKE LESIONS OF COLON AND RECTUM

2021 ◽  
pp. 9-11
Author(s):  
Durga Nand Jha ◽  
Hari Shankar Mishra ◽  
Ajit Kumar Chaudhary ◽  
Debarshi Jana
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Malignant Tumour ◽  
Juvenile Polyp ◽  
Tubular Adenoma ◽  
Malignant Tumours ◽  
Cross Sectional ◽  
Colorectal Biopsies ◽  
Colon And Rectum ◽  
Benign Tumours

Background:Tumours and tumour like lesions of the colon and rectum have overlapping clinical presentation and may be difcult to diagnose on clinical grounds alone. Histopathological examination although helpful to arrive at correct diagnosis, at times may be difcult and may require ancillary tests such as immunohistochemistry. Materials and Methods: A prospective cross sectional study enrolled 125 cases of colorectal biopsies after histopathological conrmation of tumours and tumour like lesions. The specimens were received at the Department of Pathology, DMCH, Laheriasarai, Bihar from December 2019 to November 2020. Results: Out of 125 cases, 32 cases were benign tumours, 36 cases were malignant tumours and 57 cases were tumour like lesions. Most common age range was 51-60 years with mean age of 38 years. Males comprised 76.74% and females 23.26% with ratio of 3:1. Juvenile polyp was the commonest lesion. Among benign tumours, tubular adenoma was the most common (19.2%), adenocarcinoma was most common malignant tumour (25.6%) and juvenile polyp was the most common tumour like lesion (27.2%). Left side was most common side (66.67%) and rectum was the most common site (48.8%). Conclusions: The commonest indications for colorectal biopsies were tumours and tumour like lesions. Juvenile polyp was the most common tumour like lesion, tubular adenoma was the most common benign tumour and adenocarcinoma was the most common malignant tumour. Histopathological examination is a gold standard for conrmation of all tumour and tumours like lesions of colon and rectum.

Transorbital approach to infratemporal fossa: novel technique

2011 ◽  
Vol 125 (6) ◽  
pp. 638-642 ◽  
Author(s):  
A Mishra
Keyword(s):  
Infratemporal Fossa ◽  
Case Series ◽  
Cerebrospinal Fluid Leakage ◽  
Malignant Tumours ◽  
Operative Morbidity ◽  
Diagnostic Uncertainty ◽  
Medical College ◽  
Case Series Report ◽  
Cranial Nerve Injury ◽  
Considerable Morbidity

AbstractObjective:To present a conservative surgical approach, via the transorbital route, for selected cases of infratemporal fossa involvement or inferolateral orbital tumours extending to the infratemporal fossa.Design:Case series report.Setting:Department of ENT, CSM Medical University (King George Medical College), Lucknow, India.Participants:One patient.Main outcome measures:Operative feasibility, intra-operative access, post-operative morbidity and cosmesis.Results:This novel and relatively conservative technique provides excellent exposure in selected cases of infratemporal fossa involvement and has minimal post-operative morbidity. Cosmesis is excellent, as osteotomy is not required and scarring is minimal. There is no risk of trismus, Vth or VIIth cranial nerve injury, or cerebrospinal fluid leakage, and haemostasis is easily achieved.Conclusion:Classical, open approaches to the infratemporal fossa involve considerable morbidity, while conservative approaches have their limitations. Diagnostic uncertainty over a small infratemporal fossa mass (perhaps an extension from an inferolateral orbital tumour) is an uncommon clinical challenge. The transorbital approach described is suited to benign and early malignant tumours, and has excellent results when combined with orbital exenteration (if needed). This paper discusses this approach's technical details and feasibility in different clinical situations, and compares it with other infratemporal fossa approaches.

scholarly journals Skull base osteosarcoma presenting with cerebrospinal fluid leakage after CyberKnife® treatment: a case report

2013 ◽  
Vol 7 (1) ◽  
Author(s):  
Shoko Merrit Yamada ◽  
Yudo Ishii ◽  
So Yamada ◽  
Yoshiaki Goto ◽  
Mineko Murakami ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Skull Base ◽  
Cerebrospinal Fluid Leakage ◽  
Fluid Leakage

The Medially-Invasive Cholesteatoma: An Aggressive Subtype of a Common Pathology

2020 ◽  
Vol 130 (1) ◽  
pp. 38-46
Author(s):  
Geoffrey Casazza ◽  
Matthew L. Carlson ◽  
Clough Shelton ◽  
Richard K. Gurgel
Keyword(s):  
Skull Base ◽  
Tertiary Care ◽  
Case Series ◽  
Hearing Preservation ◽  
Csf Leak ◽  
Petrous Apex ◽  
Otic Capsule ◽  
Retrospective Case ◽  
Presenting Symptoms ◽  
Subtotal Petrosectomy

Objective: Describe the outcomes of treatment for patients with cholesteatomas that are medially invasive to the otic capsule, petrous apex, and/or skull base. Study Design: Retrospective case series Setting: Two tertiary care academic centers. Patients: Patients surgically managed for medially-invasive cholesteatoma at two tertiary care institutions from 2001 to 2017. Interventions: Surgical management of medially-invasive cholesteatomas. Main Outcome Measures: The presenting symptoms, imaging, pre- and post-operative clinical course, and complications were reviewed. Results: Seven patients were identified. All patients had pre-operative radiographic evidence of invasive cholesteatoma with erosion into the otic capsule beyond just a lateral semicircular canal fistula. Five patients had a complex otologic history with multiple surgeries for recurrent cholesteatoma including three with prior canal wall down mastoidectomy surgeries. Average age at the time of surgery was 41.3 years (range 20-83). Two patients underwent a hearing preservation approach to the skull base while all others underwent a surgical approach based on the extent of the lesion. Facial nerve function was maintained at the pre-operative level in all but one patient. No patient developed cholesteatoma recurrence. Conclusions: The medially-invasive cholesteatoma demonstrates an aggressive, endophytic growth pattern, invading into the otic capsule or through the perilabyrinthine air cells to the petrous apex. Surgical resection remains the best treatment option for medially-invasive cholesteatoma. When CSF leak is a concern, a subtotal petrosectomy with closure of the ear is often necessary.

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