Surgical Approach to Frontal Sinus Osteoma: A Systematic Review

2019 ◽  
Vol 33 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Duncan C. Watley ◽  
Eric R. Mong ◽  
Nikunj A. Rana ◽  
Elisa A. Illing ◽  
Mohamad R. Chaaban
Keyword(s):  
Systematic Review ◽  
Surgical Approach ◽  
Frontal Sinus ◽  
Clinical Presentation ◽  
Sagittal Plane ◽  
Residual Disease ◽  
Complete Removal ◽  
Open Approach ◽  
The Past

Background Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment ( P < .0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P = .21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.

scholarly journals Perfluorocarbon Liquid: Its Application in Vitreoretinal Surgery and Related Ocular Inflammation

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Qi Yu ◽  
Kun Liu ◽  
Li Su ◽  
Xin Xia ◽  
Xun Xu
Keyword(s):  
Animal Studies ◽  
Vitreoretinal Surgery ◽  
Complete Removal ◽  
Intraocular Lenses ◽  
Perfluorocarbon Liquid ◽  
Potential Toxicity ◽  
The Past ◽  
Perfluorocarbon Liquids

The application of perfluorocarbon liquids has been well acclaimed in vitreoretinal surgery. Its unique physical properties make it an ideal intraoperative tool to improve the efficiency and safety of surgical procedures in complicated cases. The main functions of perfluorocarbon liquids in vitreoretinal surgery include relocating and fixing the detached retina, displacing the subretinal and subchoroidal to fluid anteriorly, revealing proliferative vitreous retinopathy (PVR) for further maneuvers, protecting the macula from exposure to chemicals with potential toxicity, and assisting the removal of foreign body. The related clinical applications include retinal detachment with severe proliferative vitreoretinopathy, giant tear, diabetic retinopathy (DR), retinopathy of prematurity (ROP), and posterior dislocated crystalline and intraocular lenses. The application of perfluorocarbon liquids has been expended over the past fewer years. Several PFCLs related ocular inflammations have been observed inin vitrostudies, animal studies, and clinical follow-up. The complete removal of PFCLs is recommended at the end of the surgery in most cases.

scholarly journals Meningiomas of pineal region in children

2007 ◽  
Vol 65 (4a) ◽  
pp. 1000-1006 ◽  
Author(s):  
Hamilton Matushita ◽  
Fernando Campos Pinto ◽  
José Píndaro Pereira Plese
Keyword(s):  
Clinical Presentation ◽  
Complete Removal ◽  
Pineal Region ◽  
Total Resection ◽  
Long Term Follow Up ◽  
One Year ◽  
Velum Interpositum ◽  
Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

The Modified Open Rhinoplasty

1993 ◽  
Vol 1 (3) ◽  
pp. 131-136
Author(s):  
Laurence T Glickman ◽  
Gene W Lee
Keyword(s):  
Surgical Approach ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
The Past ◽  
External Incision ◽  
Wide Exposure

LT Glickman, GW Lee. The modified open rhinoplasty. Can J Plast Surg 1993;1(3):131-136. Despite considerable attention in the past 10 to 20 years, the open rhinoplasty remains a controversial procedure. Advocates of this technique argue that the exposure and thus the surgical manoeuvres it makes are unequalled. Detractors argue that the transcolumellar scar left by the procedure is unacceptable and is most often unnecessary. This report describes a modification of the open rhinoplasty which has most of the advantages of the open approach, but is performed without the external incision. The procedure, its advantages and drawbacks, and comparisons among the modified open, open and closed rhinoplasty are described. It is concluded that the modified open rhinoplasty is an excellent surgical approach that can be used on most patients and that it provides wide exposure without an external incision.

Endoscopic Transnasal Resection of Ectopic Esthesioneuroblastoma in the Pterygopalatine Fossa: Technical Case Report

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. onsE112-onsE113 ◽  
Author(s):  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki
Keyword(s):  
Clinical Presentation ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Complete Removal ◽  
Pterygopalatine Fossa ◽  
Open Approach ◽  
Transnasal Approach ◽  
Olfactory Neuroepithelium ◽  
Endoscopic Transnasal Approach ◽  
Left Maxillary Sinus

Abstract Objective: Esthesioneuroblastoma is a rare, malignant neoplasm arising from the olfactory neuroepithelium in the upper nasal cavity. Even more rare is ectopic esthesioneuroblastoma developing from the region outside the olfactory epithelium. In addition, tumors occurring in the pterygopalatine fossa (PPF) are uncommon, and the endoscopic transnasal approach for the resection of malignant tumors in this region is also uncommon. Clinical Presentation: We describe an esthesioneuroblastoma arising from the left maxillary sinus and PPF. The tumor was resected using the endoscopic transnasal approach, followed by treatment with radiotherapy. The patient showed no evidence of recurrence 12 months postoperatively. Technique: The endoscopic transnasal approach could be successfully used for the complete removal of malignant tumors in the PPF. Conclusion: The PPF is an anatomic area that is difficult to access. The endoscopic transnasal approach improves access and visualization; it also has the potential to reduce complications compared with the open approach. The endoscopic transnasal approach might become the treatment of choice for malignant tumors in the PPF.

Myoepithelioma of the Skull

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. E901-E904 ◽  
Author(s):  
Karen J. Fritchie ◽  
Mitchel D. Bauman ◽  
Quentin J. Durward
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Bone Lesion ◽  
Myoepithelial Cells ◽  
The Past ◽  
Lytic Bone Lesion ◽  
Initial Biopsy

Abstract BACKGROUND AND IMPORTANCE: Myoepithelioma of bone is a rare osseous tumor thought to be related to myoepithelial lesions found at other anatomic sites such as the salivary gland and skin. These tumors are composed of varying proportions of epithelial and myoepithelial cells and exhibit a spectrum of biologic behavior ranging from benign to malignant. We present the first reported case of myoepithelioma of the skull. CLINICAL PRESENTATION: A 20-year-old white woman presented with a persistent right parieto-occipital skull nodule, relating its presence to a fall on the site 2 years previously. The nodule had become painful in the past 2 months. Her past medical history and workup were otherwise unremarkable. The initial biopsy was inconclusive for diagnosis. The lytic bone lesion was subsequently resected, and histopathological examination showed a proliferation of epithelioid cells in a myxochondroid background. Fluorescence in situ hybridization studies revealed a rearrangement of the EWSR1 locus. The morphologic and molecular findings were consistent with the diagnosis of myoepithelioma of bone. CONCLUSION: Six months after surgery, the patient is doing well with no evidence of recurrence. This case illustrates the clinical presentation, histopathology, and molecular findings of a myoepithelioma of the skull with successful surgical treatment. Because myoepitheliomas with benign morphological appearance may rarely act aggressively, long-term clinical follow-up is warranted.

Fifty Years of Experience with Chordomas in Southeast Scotland

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 166-170 ◽  
Author(s):  
P. O'Neill ◽  
B.A. Bell ◽  
J.D. Miller ◽  
I. Jacobson ◽  
W. Guthrie
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Slow Growth ◽  
Multicenter Trial ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
Slow Growth Rate ◽  
The Past ◽  
New Therapeutic Approaches

Abstract We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

Surgical treatment of spinal cord astrocytomas of childhood

1982 ◽  
Vol 57 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Fred Epstein ◽  
Nancy Epstein
Keyword(s):  
Spinal Cord ◽  
Clinical Presentation ◽  
Therapeutic Option ◽  
Radical Resection ◽  
Surgical Experience ◽  
Total Removal ◽  
Content Type ◽  
The Past ◽  
Spinal Cord Astrocytoma

✓ This report describes the first author's surgical experience with a series of 19 consecutive cases of spinal cord astrocytoma treated over the past 2 years, with a follow-up period of 6 to 24 months. The clinical presentation, neurodiagnostic investigation, surgical technique, and results are analyzed. The authors conclude that radical resection (gross total removal of the tumor) is the optimal therapeutic option.

Unilateral multilevel interlaminar fenestration instead of laminectomy or hemilaminectomy: an alternative surgical approach to intraspinal space-occupying lesions

2007 ◽  
Vol 6 (5) ◽  
pp. 485-492 ◽  
Author(s):  
Dorothee Koch-Wiewrodt ◽  
Wolfgang Wagner ◽  
Axel Perneczky
Keyword(s):  
Surgical Approach ◽  
Vertebral Column ◽  
Complete Removal ◽  
Spinal Stability ◽  
Invasive Procedures ◽  
Dorsal Approach ◽  
Less Invasive ◽  
Keyhole Surgery ◽  
Bone Removal

✓Laminectomy is the most conventional dorsal approach to intraspinal space-occupying lesions and may result in gradually increasing instability or deformity of the vertebral column. Less invasive procedures such as hemilaminectomy and osteoplastic laminotomy have been described by other authors, but an approach that interferes with spinal stability to an even lesser extent seems desirable. In an attempt to further reduce the need for bone removal, the authors used interlaminar fenestration (mostly unilateral) at one or more spinal levels to remove intramedullary, extramedullary, or extradural lesions, and even some lesions that extended over several spine segments. The authors present their experiences with this surgical approach in 78 patients harboring different intraspinal lesions. Up to 16 segments were fenestrated in one patient. Complete removal of the lesion was possible in most patients, and no postoperative spinal instabilities were observed in up to 8 years of follow up. Multilevel interlaminar fenestration, also called “multiple spinal keyhole surgery,” is a feasible, safe, and effective approach to intraspinal lesions.

scholarly journals Uncommon surgical emergencies in neonatology

2014 ◽  
Vol 36 (5-6) ◽  
Author(s):  
R. Angotti ◽  
A.L. Bulotta ◽  
F. Ferrara ◽  
F. Molinaro ◽  
E. Cerchia ◽  
...  
Keyword(s):  
Gestational Age ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Oral Feeding ◽  
Clinical Approach ◽  
Associated Anomalies ◽  
Multiple Factors ◽  
The Past ◽  
Surgical Emergencies

Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

scholarly journals Adjuvant Hysterectomy for Cervical Cancer Patients Treated with Chemoradiation Therapy: A Systematic Review on the Pathology-Proven Residual Disease Rate

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6190
Author(s):  
Kim van Kol ◽  
Renée Ebisch ◽  
Jurgen Piek ◽  
Maaike Beugeling ◽  
Tineke Vergeldt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Survival Rate ◽  
Residual Disease ◽  
Survival Rates ◽  
Chemoradiation Therapy ◽  
Disease Rate ◽  
Cochrane Database ◽  
Adjuvant Hysterectomy

Objective: To determine the incidence of pathology-proven residual disease in adjuvant hysterectomy specimens in patients with cervical cancer, treated with chemoradiation therapy. Secondly, to assess a possible association for pathology-proven residual disease regarding the time between chemoradiation therapy and adjuvant hysterectomy. Additionally, the survival rate and complication rate were assessed. Methods: PubMed, EMBASE, and the Cochrane database were searched from inception up to 8 March 2021. Results: Of the 4601 screened articles, eleven studies were included. A total of 1205 patients were treated with chemoradiation therapy and adjuvant hysterectomy, ranging from three to twelve weeks after chemoradiation therapy. A total of 411 out of 1205 patients (34%) had pathology-proven residual disease in the adjuvant hysterectomy specimen. There was no association found in the time between chemoradiation therapy and adjuvant hysterectomy. Follow-up ranged from 2.4 to 245 months, during which 270 patients (22%) relapsed, and 298 patients (27%) were deceased. A total of 202 (35%) complications were registered in 578 patients. Conclusion: there is no association found in the time between chemoradiation therapy and residual disease on adjuvant hysterectomy specimens. The survival rates after chemoradiation therapy and adjuvant hysterectomy are suboptimal, while the risk of complications after adjuvant hysterectomy is high.

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