Case Series of Skull Base Meningioma Resection in the Octogenarian Population

2021 ◽  
Author(s):  
Dorian M. Kusyk ◽  
Gordon Mao ◽  
Rocco Dabecco ◽  
Alexander K. Yu
Keyword(s):  
Skull Base ◽  
Case Series ◽  
The Elderly ◽  
Outcome Data ◽  
Skull Base Tumor ◽  
Geriatric Population ◽  
Perioperative Morbidity ◽  
Wide Range ◽  
Potential Risk Factors ◽  
Skull Base Meningiomas

Abstract Introduction The geriatric population is the fastest growing segment of the American population, and octogenarians are increasingly seen by neurosurgeons for relatively common lesions such as meningiomas. Unfortunately, providers do not have clear data to guide decision-making regarding these lesions, particularly if they involve the skull base. Current research in outcomes among the elderly looks at a wide range of ages, often anyone older than 65. Previous studies in octogenarians report a wide-range of mortality rates and do not focus on skull base lesions. This paper strives to clarify the experiences and outcomes of octogenarians. Patients and Methods This retrospective series reviews skull base tumor surgeries performed at a single academic institution over the past 15 years in octogenarian patients. Primary endpoint was 30-day mortality; however, potential risk factors, perioperative morbidity, postdischarge disposition, and longer term follow-up were also captured. Multivariate logistic regression was performed to identify relevant perioperative and medical characteristics that increases the risk of adverse events. Results Fourteen patients underwent craniotomies for skull base procedures with an average age of 84.5, with a 14% 30-day mortality rate. One patient required a tracheostomy on discharge and approximately half were able to either go home or rehabilitation after their procedure. On statistical analysis, there were no noted characteristics that predisposed any of the patients to a poorer outcome. Conclusion Octogenarian patients were able to tolerate surgery for skull base meningiomas resection. This outcome data may be used to inform surgical decision and guide conversation with patients and their families.

Results in Skull Base Meningiomas Surgery in the Elderly

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Sebastiano Paterniti ◽  
Patrizia Fiore ◽  
Santi Guerrera ◽  
Antonino Levita ◽  
Giuseppe Maimone ◽  
...  
Keyword(s):  
Skull Base ◽  
The Elderly ◽  
Surgery In The Elderly ◽  
Skull Base Meningiomas

scholarly journals Cerebral bypass surgery for skull base lesions: technical notes incorporating lessons learned over two decades

2008 ◽  
Vol 24 (2) ◽  
pp. E11 ◽  
Author(s):  
Ketan R. Bulsara ◽  
Toral Patel ◽  
Takanori Fukushima
Keyword(s):  
Skull Base ◽  
Bypass Surgery ◽  
Case Series ◽  
Senior Author ◽  
Lessons Learned ◽  
Morbidity Rate ◽  
Skull Base Lesions ◽  
Cavernous Carotid Artery ◽  
Skull Base Meningiomas ◽  
Cerebral Bypass

Object Despite advancements in endovascular neurosurgery, there remains an important role for cerebral bypass surgery in the treatment of skull base lesions. The authors describe their replacement cerebral bypass surgery techniques incorporating lessons learned over 2 decades. Methods The authors performed a retrospective review of cerebral bypass surgery performed by the senior author for skull base lesions between 1986 and 2006. One hundred patients had adjunct bypass surgery for skull base lesions. Results The bypass surgeries performed are conceptually divided into Skull Base Bypass I, II, and III. The majority of lesions requiring bypass surgery were giant cavernous carotid artery aneurysms or skull base meningiomas. There were no deaths in this case series. There was a 7% morbidity rate. Conclusions The ability to perform this surgery is an important adjunct in the armamentarium of skull base/cerebrovascular neurosurgeons.

Slower growth of skull base meningiomas compared with non–skull base meningiomas based on volumetric and biological studies

2012 ◽  
Vol 116 (3) ◽  
pp. 574-580 ◽  
Author(s):  
Naoya Hashimoto ◽  
Carter S. Rabo ◽  
Yoshiko Okita ◽  
Manabu Kinoshita ◽  
Naoki Kagawa ◽  
...  
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Biological Behavior ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Biological Studies ◽  
History Of ◽  
Skull Base Meningiomas ◽  
Mib 1

Object The precise natural history of incidentally discovered meningiomas (IDMs) remains unknown. It has been reported that for symptomatic meningiomas, tumor location can be used to predict growth. As to whether the same is true for IDMs has not been reported. This study aims to answer this question and provide biological evidence for this assumption by extending the study to involve symptomatic cases. Methods A total of 113 IDMs were analyzed by fine volumetry. A comparison of growth rates and patterns between skull base and non–skull base IDMs was made. Subsequently, materials obtained from 210 patients with symptomatic meningiomas who were treated in the authors' hospital during the same period were included for a biological comparison between skull base and non–skull base tumors using the MIB-1 index. Results The 110 patients with IDMs included 93 females and 17 males, with a mean follow-up period of 46.9 months. There were 38 skull base (34%) and 75 non–skull base (66%) meningiomas. Forty-two (37%) did not exhibit growth of more than 15% of the volume, whereas 71 (63%) showed growth. Only 15 (39.5%) of 38 skull base meningiomas showed growth, whereas 56 (74.7%) of 75 non–skull base meningiomas showed growth (p = 0.0004). In the 71 IDMs (15 skull base and 56 non–skull base), there was no statistical difference between the 2 groups in terms of mean age, sex, follow-up period, or initial tumor volume. However, the percentage of growth (p = 0.002) was significantly lower and the doubling time (p = 0.008) was significantly higher in the skull base than in the non–skull base tumor group. In subsequently analyzed materials from 94 skull base and 116 non–skull base symptomatic meningiomas, the mean MIB-1 index for skull base tumors was markedly low (2.09%), compared with that for non–skull base tumors (2.74%; p = 0.013). Conclusions Skull base IDMs tend not to grow, which is different from non–skull base tumors. Even when IDMs grow, the rate of growth is significantly lower than that of non–skull base tumors. The same conclusion with regard to biological behavior was confirmed in symptomatic cases based on MIB-1 index analyses. The authors' findings may impact the understanding of the natural history of IDMs, as well as strategies for management and treatment of IDMs and symptomatic meningiomas.

Recurrent and self-remitting sixth cranial nerve palsy: pathophysiological insight from skull base chondrosarcoma

2013 ◽  
Vol 12 (6) ◽  
pp. 633-636 ◽  
Author(s):  
Paolo Frassanito ◽  
Luca Massimi ◽  
Mario Rigante ◽  
Gianpiero Tamburrini ◽  
Giulio Conforti ◽  
...  
Keyword(s):  
Skull Base ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Clinical History ◽  
Skull Base Tumor ◽  
Sixth Cranial Nerve ◽  
Sixth Cranial Nerve Palsy ◽  
Wide Range

Palsy of the abducens nerve is a neurological sign that has a wide range of causes due to the nerve's extreme vulnerability. Need of immediate neuroimaging is a matter of debate in the literature, despite the risks of delaying the diagnosis of a skull base tumor. The authors present 2 cases of skull base tumors in which the patients presented with recurrent and self-remitting episodes of sixth cranial nerve palsy (SCNP). In both cases the clinical history exceeded 1 year. In a 17-year-old boy the diagnosis was made because of the onset of headache when the tumor reached a very large size. In a 12-year-old boy the tumor was incidentally diagnosed when it was still small. In both patients surgery was performed and the postoperative course was uneventful. Pathological diagnosis of the tumor was consistent with that of a chondrosarcoma in both cases. Recurrent self-remitting episodes of SCNP, resembling transitory ischemic attacks, may be the presenting sign of a skull base tumor due to the anatomical relationships of these lesions with the petroclival segment of the sixth cranial nerve. Physicians should promptly recommend neuroimaging studies if SCNP presents with this peculiar course.

scholarly journals False lateralazing sign in skull base tumor a case series of five patients

2021 ◽  
Vol 26 ◽  
pp. 101340
Author(s):  
Lea Kahanov ◽  
Uri P. Hadelsberg ◽  
Andrew Kaye ◽  
Sergey Spektor ◽  
Fidel Valero ◽  
...  
Keyword(s):  
Skull Base ◽  
Case Series ◽  
Skull Base Tumor

scholarly journals Imaging and Outcomes for a New Entity: Low-Grade Sinonasal Sarcoma with Neural and Myogenic Features

2017 ◽  
Vol 78 (01) ◽  
pp. e15-e19 ◽  
Author(s):  
Richard Cannon ◽  
Richard Wiggins ◽  
Benjamin Witt ◽  
Yusuf Dundar ◽  
Tawni Johnston ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Outcomes ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Intracranial Extension ◽  
Low Grade ◽  
Skull Base Tumor ◽  
Imaging Characteristics ◽  
Sinonasal Mass

Objectives Low-grade sinonasal sarcoma with neural and myogenic features (LGSSNMF) is a new, rare tumor. Our goal is to describe the imaging characteristics and surgical outcomes of this unique skull base malignancy. Design Retrospective case series. Setting Academic medical center. Participants There were three patients who met inclusion criteria with a confirmed LGSSNMF. Main Outcome Measures Imaging and histopathological characteristics, treatments, survival and recurrence outcomes, complications, morbidity, and mortality. Results Patients presented with diplopia, facial discomfort, a supraorbital mass, and nasal obstruction. Magnetic resonance imaging and computed tomography imaging in all cases showed an enhancing sinonasal mass with associated hyperostotic bone formation that involved the frontal sinus, invaded the lamina papyracea and anterior skull base, and had intracranial extension. One patient underwent a purely endoscopic surgical resection and the second underwent a craniofacial resection, while the last is pending treatment. All patients recovered well, without morbidity or long-term complications, and are currently without evidence of disease (mean follow-up of 2.1 years). One patient recurred after 17 months and underwent a repeat endoscopic skull base and dural resection. Conclusions The surgical outcomes and imaging of this unique, locally aggressive skull base tumor are characterized.

scholarly journals A SYSTEMATIC REVIEW OF DIGITAL INTERVENTIONS ADDRESSING MENTAL DISORDERS AMONG THE ELDERLY POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S513-S514
Author(s):  
Md Mahbub Hossain ◽  
Samia Tasnim ◽  
Abida Sultana ◽  
Nishat Tasnim Hasan ◽  
Hoimonty Mazumder ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Elderly Population ◽  
Randomized Study ◽  
The Elderly ◽  
Geriatric Population ◽  
Widespread Application ◽  
Digital Platforms ◽  
Digital Interventions ◽  
Wide Range

Abstract Background: Many studies have reported the widespread application of digital technologies in improving mental health. However, little is known about how these technological advancements can help the geriatric population who suffer from a wide range of mental disorders. There is no extensive review of evidence which can guide effective policy-making and implementation of such interventions. Objectives: To identify digital interventions addressing mental disorders among elderly people and evaluate the outcomes of these interventions. Methodology: According to the PRISMA guidelines, we searched six major health databases and screened the literature using these criteria: 1) journal articles reporting an intervention delivered using any of the digital platforms, 2) the interventions aimed to improve at least one mental disorder among geriatric population, 3) articles published in English language, 4) studies conducted in in any settings and time frame reporting any of the mental health-related outcomes. Results: Among 4870 articles found in the preliminary literature search, only 19 studies met our criteria. Most of the studies (n=14) described digital interventions addressing depressive illness among the elderly population. However, many interventions targeted multiple mental conditions including dementia, stress, anxiety, mood disorders, phobia, and functional disabilities. These interventions used internet-based therapies, mindfulness, digital assistants, and applications improving mental health behavior and practices. Most of the interventions (n=12) were evaluated using randomized study designs. Reported outcomes included improved symptoms, better quality of living, emotional and functional advancements, and decreased cost of treatment. This evidence necessitates further research and application of such technologies to improve geriatric mental health.

The Use of Polydioxanone Plates for Endoscopic Skull Base Repair

2017 ◽  
Vol 31 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Fahad Al-Asousi ◽  
Christopher Okpaleke ◽  
Anali Dadgostar ◽  
Amin Javer
Keyword(s):  
Skull Base ◽  
Tumor Resection ◽  
Case Series ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Skull Base Tumor ◽  
Patient Reported ◽  
Sinonasal Tumor ◽  
Skull Base Defects

Background Many reconstructive techniques and materials have been reported for repair of skull base defects after sinonasal tumor excision, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone. Synthetic materials have been developed for endoscopic skull base repair to avoid donor-site morbidity. Polydioxanone plate is a bioabsorbable implant designed for nasal septal reconstruction and has the ability to retain strength for at least 10 weeks and absorbs in 6 months. Objectives This study aimed to describe the use of polydioxanone plates in endoscopic skull base defect and CSF leak repair, and to describe our experience with the surgical technique and postoperative management. Methods This was a retrospective case series of patients who, between May 2013 and December 2015, underwent endoscopic sinus surgery and skull base repair for CSF leak or after excision of a skull base tumor by using polydioxanone plates. Patients who presented with sinonasal inflammatory disease or skull base tumors underwent endoscopic skull base repair by using polydioxanone plates in an underlay fashion and mucosal membrane grafts with or without adjuvant materials in an overlay fashion. The patients were reviewed at 6 days, 6 weeks, and 3 months after surgery. Postoperative adverse events, including CSF leak, infection, bleeding, headache, and graft failure, were recorded. Results The cases of seven patients (five women, two men; mean age, 53.9 years) were reviewed. Five patients underwent sinonasal tumor resection and two underwent repair for CSF leak. The mean (standard deviation) defect size was 16.4 ± 11.4 mm. There was no evidence of postoperative CSF leak, and lumbar drains were not used. One patient reported transient headache and facial pressure at the 6-week follow-up visit. The surgeons’ experience with polydioxanone plate placement, postoperative healing, and follow-up was satisfactory. Conclusion Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.

Primary Dural Repair Using Titanium Microclips Following Lateral Skull Base Surgery

2021 ◽  
Author(s):  
Camille K. Milton ◽  
Alexander G. Bien ◽  
Greg A. Krempl ◽  
Jose A. Sanclement ◽  
Rachad Mhawej ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Case Series ◽  
Jugular Foramen ◽  
Csf Leak ◽  
Skull Base Tumor ◽  
Chordoid Meningioma ◽  
Dural Repair ◽  
Lateral Skull Base ◽  
Standard Techniques

Abstract Objective Standard techniques for primary dural repair following lateral skull base surgery are both technically challenging and time consuming without the potential for primary dural repair. Inadequate closure may result in postoperative cerebrospinal fluid (CSF) leak infectious sequalae. Traditional methods of dural repair rely on secondary obliteration of the CSF fistula. We hypothesized that the use of nonpenetrating titanium microclips may serve as a useful adjunct in primary dural repair or the establishment of an immobile repair layer following lateral skull base surgery. Methods Here, we report a novel technique for primary dural repair using nonpenetrating titanium microclips as an adjunct to standard techniques in a series of six patients with lateral skull base pathologies. Results A total of six consecutive lateral skull base tumor patients with titanium microclip dural reconstruction were included in our case series. Lateral skull base pathologies represented in this group included two jugular foramen schwannomas, one vestibular schwannoma, one petroclival meningioma, one glomus jugulare paraganglioma, and one jugular foramen chordoid meningioma. Conclusion To our knowledge, this is the first report on the use of microclips in repairing dural defects following lateral skull base surgery. Surgical outcomes for this small case series suggest that dural repair of the later skull base with nonpenetrating titanium microclips is a useful adjunct in dural repair following lateral skull base surgery.

scholarly journals Spontaneous colonic perforation in adults: Evaluation of a pooled case series

2020 ◽  
Vol 103 (3) ◽  
pp. 003685042094546
Author(s):  
Ren Chongxi ◽  
Ji Jinggang ◽  
Shi Yan ◽  
Wang Hongqiao ◽  
Liu Yan ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Chronic Constipation ◽  
Univariate Analysis ◽  
Case Series ◽  
The Elderly ◽  
Clinicopathological Characteristics ◽  
Colonic Perforation ◽  
Risk Category ◽  
Stercoral Perforation ◽  
Potential Risk Factors

Spontaneous colonic perforation in adults (SCPA) is rare but important. Its clinicopathological features and outcomes remain unclear. Therefore, the aim of the current study was to explore and investigate the clinicopathological characteristics, clinical outcomes and potential risk factors for patients with SCPA. Data of seven patients with SCPA treated in our hospitals from January 2008 to December 2017, and 221 cases from research databases before 2018 were retrospectively analyzed. The description of SCPA included stercoral perforation of the colon (SPC), idiopathic perforation of the colon (IPC) and spontaneous colonic perforation (SCP) in the study. All SCPA patients presented with unexplained abdominal pain and peritonitis. The median age was 62.5 years. The definite diagnosis preoperatively was 20.6%. The commonest lesion location was sigmoid colon and Hartmann’s operation accounted for 59.3%. Histopathology of stercoral perforation (HSP) and histopathology of idiopathic perforation (HIP) were two histopathological findings. Postoperative complication was 67.7% and mortality was 31.1%. Univariate and multivariate analyses showed that chronic constipation was an independent risk factor for histopathological features ( p ≤ 0.001, p = 0.005). Age of patients was associated with both postoperative complication ( p = 0.012, p = 0.044) and mortality ( p = 0.013, p = 0.034). Univariate analysis showed that HSP was associated with postoperative complication ( p = 0.015). Our findings from the analysis pertaining to SCPA confirm those from previous studies, supporting the SCPA, as a uniform description, is an infrequent and life-threatening disease requiring early surgical intervention. We found that the elderly with chronic constipation was a high-risk category and those with HIP had a more favorable outcome than that of patients with HSP.

Sign in / Sign up

Export Citation Format

Share Document