Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively

Objective: Compare the effects of preoperative embolization for carotid body tumor resection on surgical outcomes to carotid body tumor resections without preoperative embolization. Methods: Single-center retrospective review of all consecutive patients who underwent carotid body tumor resection from 2001 to 2019. Surgical outcomes with emphasis on operative time (estimated blood loss and cranial nerve injury) of patients undergoing carotid body tumor resection following preoperative embolization were compared to those undergoing resection alone using unpaired Student’s t-test and Fisher’s exact test. Results: Forty-six patients (15% male, mean age 50 ± 15 years) underwent resection of 49 carotid body tumors. Patients undergoing preoperative embolization ( n = 20 (40%)) had larger mean tumor size (4.0 ± 0.7 vs 3.2 ± 1 cm, p = 0.006), increased Shamblin II/III tumor classification (18 (90%) vs 22 (76%), p < 0.001), operative time (337 ± 195 vs 199 ± 100 min, p = 0.004), and cranial nerve injuries overall (8 (40%) vs 2 (10%), p = 0.01) compared to patients undergoing resection without preoperative embolization ( n = 29 (60%)). In subgroup analysis of Shamblin II/III classification tumors ( n = 40), preoperative embolization ( n = 18) was associated with increased tumor size (4.1 ± 0.6 vs 3.5 ± 0.9 cm, p = 0.01), operative time (351 ± 191 vs 244 ± 105 min, p = 0.02), and cranial nerve injury overall (8 (44%) vs 2 (9%), p = 0.03) compared to resections alone ( n = 19). In further subgroup analysis of large (⩾ 3 cm) tumors ( n = 37), preoperative embolization ( n = 18) was associated with increased operative time (350 ± 191 vs 198 ± 99 min, p = 0.006) and cranial nerve injury overall (8 (44%) vs 2 (11%), p = 0.03) compared to resections alone ( n = 19). There were no significant differences in estimated blood loss, transfusion requirement, or hematoma formation between any of the embolization and non-embolization subgroups. Conclusion: After controlling for tumor Shamblin classification and size, carotid body tumor resections following preoperative embolization were associated with increased operative time and inferior surgical outcomes compared to those tumors undergoing resection alone. Nonetheless, such results remain susceptible to the confounding effects of individual tumor characteristics often used in the decision to perform preoperative embolization, underscoring the need for prospective studies evaluating the utility of preoperative embolization for carotid body tumors.

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INTRANEURAL PERINEURIOMA OF THE VIIITH CRANIAL NERVE

Neurosurgery ◽

10.1227/01.neu.0000290915.63094.55 ◽

2007 ◽

Vol 61 (3) ◽

pp. E652-E652 ◽

Cited By ~ 4

Author(s):

Mattheos Christoforidis ◽

Ralf Buhl ◽

Werner Paulus ◽

Abolghassem Sepehrnia

Keyword(s):

Cranial Nerve ◽

Tumor Resection ◽

Magnetic Resonance Imaging Scan ◽

En Bloc ◽

Tumor Mass ◽

Nerve Tumor ◽

First Case ◽

Intraneural Perineurioma ◽

History Of ◽

Viiith Cranial Nerve

Abstract OBJECTIVE The authors describe the clinical and pathological features of the second reported case of an intraneural perineurioma involving a major intracranial nerve and the first case of this entity involving the VIIIth cranial nerve. CLINICAL PRESENTATION A 59-year-old woman presented with a long history of dizziness, tinnitus, hearing loss, and unstable gait. A magnetic resonance imaging scan revealed a small intrameatal lesion, which showed no clear progression from 2000 to 2006. INTERVENTION As a result of worsening symptoms and a suspected vestibular schwannoma, an attempt of tumor resection through a retrosigmoid approach was performed. This revealed diffusely infiltrated and fusiform enlarged vestibular and cochlear nerves, with no identifiable border between the main tumor mass and normal nerve. An en bloc nerve-tumor mass excision was performed. The pathological findings confirmed the diagnosis of an intraneuronal perineurioma. CONCLUSION The experience with this unique case and the experience of others with the management of extracranial intraneural perineuriomas lead the authors to conclude that the most reasonable surgical management of this tumor at this location is a nerve-tumor cross-section resection.

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Nerve Stimulating System for Peripheral Nerve Tumor Resection Under the Thoracoscope

Journal of Reconstructive Microsurgery ◽

10.1055/s-2000-7551 ◽

2000 ◽

Vol Volume 16 (Number 3) ◽

pp. 0193-0196

Author(s):

Koichi Nemoto ◽

Hiroshi Arino ◽

Hisayuki Isaki ◽

Takashi Asazuma ◽

Kyosuke Fujikawa ◽

...

Keyword(s):

Peripheral Nerve ◽

Tumor Resection ◽

Nerve Tumor ◽

Peripheral Nerve Tumor

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Usefulness of tumor traction with a snare and endoclips in gastric submucosal tumor resection: a propensity-score-matching analysis

Gastroenterology Report ◽

10.1093/gastro/goaa050 ◽

2020 ◽

Author(s):

Qiang Zhang ◽

Jian-Qun Cai ◽

Zhen Wang

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Operative Time ◽

Perioperative Complications ◽

Tumor Resection ◽

En Bloc Resection ◽

Bloc Resection ◽

Resection Rate ◽

En Bloc ◽

Gastric Submucosal Tumors

Abstract Background Endoscopic resection, including endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFR), was used to resect small gastric submucosal tumors (SMTs). Our team explored a method of tumor traction using a snare combined with endoclips to assist in the resection of SMTs. This study aims to explore the safety and effectiveness of the method. Methods This research performed a propensity-score-matching (PSM) analysis to compare ESD/EFR assisted by a snare combined with endoclips (ESD/EFR with snare traction) with conventional ESD/EFR for the resection of gastric SMTs. Comparisons were made between the two groups, including operative time, en bloc resection rate, perioperative complications, and operation-related costs. Results A total of 253 patients with gastric SMTs resected between January 2012 and March 2019 were included in this study. PSM yielded 51 matched pairs. No significant differences were identified between the two groups in perioperative complications or the costs of disposable endoscopic surgical accessories. However, the ESD/EFR-with-snare-traction group had a shorter median operative time (39 vs 60 min, P = 0.005) and lower rate of en bloc resection (88.2% vs 100%, P = 0.027). Conclusions ESD/EFR with snare traction demonstrated a higher efficiency and en bloc resection rate for gastric SMTs, with no increases in perioperative complications and the costs of endoscopic surgical accessories. Therefore, the method seems an appropriate choice for the resection of gastric SMTs.

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Transtemporal Skull Base Surgery

Otolaryngology ◽

10.1016/s0194-5998(05)80299-2 ◽

1995 ◽

Vol 112 (5) ◽

pp. P119-P119

Author(s):

C. Gary Jackson ◽

James L. Netterville

Keyword(s):

Functional Outcome ◽

Skull Base ◽

Cranial Nerve ◽

Skull Base Surgery ◽

Tumor Resection ◽

Operative Management ◽

Educational Objectives ◽

Defect Reconstruction ◽

Lateral Skull Base

Educational objectives: To become familiar with diagnostic and operative management principles for lateral skull-base disease and its ICE, emphasizing not only multi-disciplinary tumor resection but functional outcome and to be familiar with concepts of defect reconstruction and cranial nerve rehabilitation that maximize postresection functional outcome.

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The Solitary Schwannoma of the Eighth Cranial Nerve: An Immunohistochemical Study of the Cochlear Nerve-Tumor Interface

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.1990.01870090039003 ◽

1990 ◽

Vol 116 (9) ◽

pp. 1023-1025 ◽

Cited By ~ 22

Author(s):

J. F. E. Marquet ◽

G. E. J. Forton ◽

F. E. Offeciers ◽

L. L. M. Moeneclaey

Keyword(s):

Cranial Nerve ◽

Immunohistochemical Study ◽

Cochlear Nerve ◽

Eighth Cranial Nerve ◽

Nerve Tumor

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Restoration of Trigeminal Cutaneous Sensation with Cross-Face Sural Nerve Grafts: Case Report and Literature Review

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2020.5.15 ◽

2020 ◽

Vol 10 (5) ◽

Author(s):

Trung Trực Vũ ◽

Keyword(s):

Trigeminal Nerve ◽

Facial Palsy ◽

Sural Nerve ◽

Donor Site ◽

Tumor Resection ◽

Contralateral Side ◽

Nerve Graft ◽

Cutaneous Sensation ◽

Nerve Tumor ◽

First Case

Abstract Complete anesthesia leaves patients susceptible to occult injury, and facial sensation is an important component of interaction and activities of daily living. Although treating facial palsy is considered debilitating for patients, trigeminal nerve palsy and sensory deficits of the face are overlooked components of disability. The authors reported the first case in Vietnam: 38 year-old man who lost the sensation on his right face follow by V cranial nerve tumor resection one year before. The sensation of the trigeminal cutaneous nerve was restored with cross-face sural nerve graft from contralateral side in 2018. The patient demonstrated improved sensation in the reconstructed dermatomes without donor-site aNBormalities at the time of 18 months post operation. Keywords: Facial palsy, facial sensation, trigeminal nerve tumor, cross-face nerve graft.

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Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome

BioMed Research International ◽

10.1155/2015/948373 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Ran Harel ◽

Omer Doron ◽

Nachshon Knoller

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Operative Time ◽

Medical Condition ◽

Tumor Resection ◽

Spinal Metastases ◽

Medical Emergency ◽

Tubular Retractor ◽

Estimated Blood Loss ◽

Index Level

Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients’ medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS) approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS) and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients’ quality of life and enable the treatment of patients with comorbidities.

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Cranial chordomas: results of radical excision

Neurosurgical FOCUS ◽

10.3171/foc.2001.10.3.4 ◽

2001 ◽

Vol 10 (3) ◽

pp. 1-7 ◽

Cited By ~ 32

Author(s):

Chandranath Sen ◽

Aymara Triana

Keyword(s):

Skull Base ◽

Cranial Nerve ◽

Recurrent Disease ◽

Postoperative Radiotherapy ◽

Tumor Resection ◽

Surgical Techniques ◽

Residual Tumor ◽

Radical Excision ◽

Proton Beam Irradiation ◽

Csf Leakage

Object The authors analyze their experience with the treatment of 29 patients who underwent radical excision of skull base chordomas. Methods Modern skull base surgical techniques were used in all patients who were treated between August 1991 and July 2000. The degree of tumor resection was gauged according to intraoperative inspection and postoperative high-resolution imaging findings. There were 21 patients with primary disease and eight with recurrent disease. Total resection was accomplished in 18 patients. Five patients had undergone radiotherapy prior to the present surgery, and an additional eight patients underwent postoperative radiotherapy. There were no surgery-related deaths. In five patients who died of the disease, surgery and radiotherapy had failed to effect a cure. Two of the remaining patients are alive with recurrent disease, and there is questionable evidence of recurrence in another patient. All 24 patients are functioning independently. Cranial nerve impairment was the most common postoperative deficit, followed by cerebrospinal fluid (CSF) leakage and infection. Conclusions The use of skull base techiniques in radical surgery provides an opportunity to excise the tumor and the involved bone. In most cases the procedure-related cranial nerve deficits improve over time. The complications of CSF leakage and infection can be minimized and are preventable. Proton beam irradiation is an excellent adjuvant treatment but is reserved for patients with definite tumor recurrence or residual tumor that can be identified on the imaging studies.

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