British Skull Base Society Clinical Consensus Document on Management of Head and Neck Paragangliomas

The management of head and neck paragangliomas (HNPGLs) has changed significantly in recent years. There is, however, an absence of guidance in the literature regarding the optimal means of managing this challenging disease. This consensus document, developed by the British Skull Base Society, sets out recommendations for management of HNPGLs. A preliminary document was produced on the basis of current practice in 3 large UK skull base centers, incorporating relevant peer-reviewed evidence. This document was then modified by discussion within these units, through a national survey of British Skull Base Society members, and through discussion with stakeholders. A consensus was reached on the management of all forms of HNPGL. All patients should be managed by a multidisciplinary team and require initial surgical, endocrine, and genetic assessments as well as magnetic resonance imaging of the head, neck, chest, abdomen, and pelvis. Long-term preservation of function is the primary treatment goal, with conservative management the first choice treatment for most tumors. Radiotherapy is a safe, effective treatment for growing tumors in most cases, although there is a limited role for surgery. Screening of family members in high-risk groups is mandatory. These guidelines should help standardize high-quality care for patients with HNPGLs.

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Head and Neck Paragangliomas Radiosurgery: Long-Term, Single-Institution Experience

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1592634 ◽

2016 ◽

Vol 77 (S 02) ◽

Author(s):

Marcello Marchetti ◽

Valentina Pinzi ◽

Francesco Prada ◽

Elena De Martin ◽

Valeria Cuccarini ◽

...

Keyword(s):

Head And Neck ◽

Single Institution ◽

Head And Neck Paragangliomas

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Predicted probabilities of brain injury after carbon ion radiotherapy for head and neck and skull base tumors in long-term survivors

Radiotherapy and Oncology ◽

10.1016/j.radonc.2021.10.017 ◽

2021 ◽

Author(s):

SungChul Park ◽

Yusuke Demizu ◽

Masaki Suga ◽

Shingo Taniguchi ◽

Shinichi Tanaka ◽

...

Keyword(s):

Brain Injury ◽

Head And Neck ◽

Skull Base ◽

Carbon Ion Radiotherapy ◽

Skull Base Tumors ◽

Carbon Ion ◽

Long Term Survivors

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Growth Rate Analysis of an Untreated Glomus Vagale on MRI

Case Reports in Otolaryngology ◽

10.1155/2016/8756940 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Jeffrey Tzu-Yu Wang ◽

Allen Yu-Yu Wang ◽

Sheila Cheng ◽

Lavier Gomes ◽

Melville Da Cruz

Keyword(s):

Growth Rate ◽

Head And Neck ◽

Slow Growth ◽

Rate Analysis ◽

Mri Scans ◽

History Of ◽

Slow Growing ◽

Serial Mri ◽

Head And Neck Paragangliomas

Paragangliomas are slow growing, hypervascular neuroendocrine tumors that develop in the extra-adrenal paraganglion tissues. Paraganglioma involving the vagus nerve ganglia is termed glomus vagale. The slow growth of head and neck paragangliomas especially in the absence of symptom may obviate the necessity for any active intervention, in which case, a “wait and scan” policy is implemented involving long-term clinical and radiologic follow-ups. We present a case of a 71-year-old female with an untreated left glomus vagale who underwent a conservative “wait and rescan” plan of management and the tumor was observed with 8 serial MRI scans over a period of 7.4 years. A growth rate analysis was conducted which demonstrated a slow growth. A literature review of radiologic studies examining the natural history of head and neck paragangliomas was also performed.

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S150 – Clinical Study of 13 cases of Olfactory Neuroblastoma

Otolaryngology ◽

10.1016/j.otohns.2008.05.324 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P126-P127

Author(s):

Nobuhiro Uwa ◽

Kunitoshi Yoshino ◽

Takashi Fujii ◽

Tomonori Terada ◽

Nobuo Saeki ◽

...

Keyword(s):

Survival Rate ◽

Skull Base ◽

Skull Base Surgery ◽

Olfactory Neuroblastoma ◽

Primary Treatment ◽

Clinical Staging ◽

Primary Tumors ◽

Neck Lymph Node ◽

Neck Lymph Node Metastasis

Objectives Olfactory neuroblastoma is a rare neuroendocrine tumor that arises in the upper nasal cavity of the olfactory epithelium. We examined 13 patients with olfactory neuroblastoma and report the findings. Methods The subjects were the primary treated patients of olfactory neuroblastoma at our departments between 1986 and 2008 (age: 29–72). Using the clinical staging proposed by Dulguerov, we examined the treatment methods, the sites of recurrence, and the prognoses in those cases. Results According to Dulguerov's staging, 1 patient was categorized as T1, 3 patients as T2, 8 patients as T3, and 1 patient as T4. Among the 4 cases in T1 and T2, 3 patients underwent radiotherapy as their primary treatment, whereas the remaining 1 patient underwent endoscopic surgery. Eight patients in T3 and T4, whose tumors were resectable, underwent skull base surgery combined with radiotherapy. Among the 13 cases, 4 patients developed primary recurrence, 3 patients developed neck lymph node metastasis, and one patient developed lung metastasis. The overall 10-year survival rate of the 13 cases was 83.3%. The primary tumors could be controlled in all of the 8 patients who underwent skull base surgery and radiotherapy. All of those patients are currently alive without disease. There was 1 patient whose tumor recurred approximately 20 years after the initial treatment. Conclusions The survival rate can be improved performing skull base surgery combined with radiotherapy provided that the tumors are resectable. Long-term clinical follow-up is also significant.

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Early Glottic Tumours With Anterior Commissure Involvement. Literature Review and Consensus Document. Head and Neck and Skull Base Commission, SEORL-CCC

Acta Otorrinolaringologica (English Edition) ◽

10.1016/j.otoeng.2020.02.004 ◽

2020 ◽

Vol 71 ◽

pp. 1-20

Author(s):

Eulalia Porras Alonso ◽

Isabel Vilaseca González ◽

Miguel García Teno ◽

Rafael Barberá Durbán ◽

Guillem Viscasillas Pallàs ◽

...

Keyword(s):

Literature Review ◽

Head And Neck ◽

Skull Base ◽

Anterior Commissure ◽

Consensus Document

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Arterial embolization with Onyx of head and neck paragangliomas

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2014-011582 ◽

2015 ◽

Vol 8 (6) ◽

pp. 626-635 ◽

Cited By ~ 7

Author(s):

Caterina Michelozzi ◽

Anne Christine Januel ◽

Victor Cuvinciuc ◽

Philippe Tall ◽

Fabrice Bonneville ◽

...

Keyword(s):

Head And Neck ◽

Skull Base ◽

Transarterial Embolization ◽

Arterial Embolization ◽

Long Term Results ◽

Complete Regression ◽

Ethylene Vinyl Alcohol ◽

Volume Stability

ObjectTo report the morbidity and long term results in the treatment of paragangliomas by transarterial embolization with ethylene vinyl alcohol (Onyx), either as preoperative or palliative treatment.MethodsBetween September 2005 and 2012, 18 jugulotympanic, 7 vagal, and 4 carotid body paragangliomas (CBPs) underwent Onyx embolization, accordingly to our head and neck multidisciplinary team's decision. CBPs were embolized preoperatively. Jugulotympanic and vagal paragangliomas underwent surgery when feasible, otherwise palliative embolization was carried out alone, or in combination with radiotherapy or tympanic surgery in the case of skull base or tympanic extension. Treatment results, and clinical and MRI follow-up data were recorded.ResultsIn all cases, devascularization of at least 60% of the initial tumor blush was obtained; 6 patients underwent two embolizations. Post-embolization, 8 patients presented with cranial nerve palsy, with partial or complete regression at follow-up (mean 31 months, range 3–86 months), except for 2 vagal and 1 hypoglossal palsy. 10 patients were embolized preoperatively; 70% were cured after surgery and 30% showed residual tumor. 19 patients received palliative embolization, of whom 5 underwent radiotherapy and 3 received tympanic surgery post-embolization. Long term follow-up of palliative embolization resulted in tumor volume stability (75%) or extension in intracranial or tympanic compartments. Onyx embolization of CBPs resulted in more difficult surgical dissection in 2 of 4 cases.ConclusionsOnyx embolization is a valuable alternative to surgery in the treatment of jugulotympanic and vagal paragangliomas; tympanic surgery or radiosurgery of the skull base should be considered in selected cases. Preoperative Onyx embolization of CBPs is not recommended.

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Extraction of underwater fragile artifacts: research status and prospect

Heritage Science ◽

10.1186/s40494-022-00645-1 ◽

2022 ◽

Vol 10 (1) ◽

Author(s):

Xue-Qiang Chen ◽

Ke Xia ◽

Wenjing Hu ◽

Ming Cao ◽

Kai Deng ◽

...

Keyword(s):

Controlled Environment ◽

First Choice ◽

Protective Strategy ◽

Long Time ◽

Archaeological Artifacts ◽

Underwater Sites ◽

Difficult Situations ◽

Long Term Preservation

AbstractThere are still many difficulties in the recovery and long-term preservation of underwater archaeological artifacts, in situ preservation should be the first choice before further procedures are considered. However, the materials, preservation status, and preservation environment of underwater artifacts are diverse, resulting in many fragile artifacts facing difficult situations. In order to prevent serious damage, it is a safe protective strategy to preserve them in a controlled environment for a long time after excavation. Extraction and transfer of fragile cultural relics are vital parts of this strategy. Due to the complexity of the underwater environment and the vulnerability of fragile artifacts, safety in extraction and transfer still faces enormous challenges. Researchers have developed new materials and technologies to tackle this problem. This paper focuses on introducing and developing prospects to different preservation techniques for fragile artifacts from underwater sites.

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Long-term efficacy of imepitoin in the treatment of naive dogs affected by idiopathic epilepsy

Veterinary Record ◽

10.1136/vr.104187 ◽

2017 ◽

Vol 181 (6) ◽

pp. 144-144 ◽

Cited By ~ 3

Author(s):

A. Gallucci ◽

T. Gagliardo ◽

M. Menchetti ◽

E. Bianchi ◽

D. Bucci ◽

...

Keyword(s):

Seizure Frequency ◽

Treatment Success ◽

Positive Association ◽

Primary Treatment ◽

Idiopathic Epilepsy ◽

Factors Affecting ◽

First Choice ◽

The Status

The purpose of this study was to evaluate the long-term (12 months) efficacy and tolerability of imepitoin as first-choice treatment in 56 dogs suffering from idiopathic epilepsy and identify possible factors affecting the outcome. Primary treatment success (PTS) was defined as the achievement of a seizure-free interval three times longer than the pretreatment interictal interval (at least three months). Secondary treatment success (STS) was achieved by a decrease in seizure frequency ≥50 per cent compared with the pretreatment frequency. In the long-term follow-up, PTS was recorded in 14 (25 per cent) dogs and responder-dogs (PTS+STS) were 30 (54 per cent) showing significant reduction in the monthly average number of seizures (P<0.001). Median seizure frequency per month was 1.69 pretreatment and 0.3 at 12-month follow-up. Dogs with cluster seizures were significantly reduced (P=0.02). PTS at three and six months was associated with PTS (P=0.006 and <0.001, respectively) and with the status of responder dogs (P=0.002) at 12-month follow-up. Dogs aged >36 months at the start of imepitoin treatment had a positive association to become responder dogs (P<0.001) and achieve PTS (P=0.004). 16 dogs (29 per cent) discontinued imepitoin due to its inefficacy. The receiver operator curve highlighted ≥19 mg/kg twice a day as the most effective minimal dosage. Mild and transient side effects were observed in 16 dogs (29 per cent).

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