scholarly journals Detailed analysis of recovery process of cranial nerve palsy after IMRT-based comprehensive treatment in nasopharyngeal carcinoma

2021 ◽  
Author(s):  
jian zang ◽  
yan li ◽  
shanquan luo ◽  
jianhua wang ◽  
bingxin hou ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Prognostic Value ◽  
Nerve Palsy ◽  
Recovery Process ◽  
Complete Recovery ◽  
Comprehensive Treatment ◽  
Definite Treatment

Abstract Background cranial nerve (CN) palsy in nasopharyngeal carcinoma with cancer-related involvement of cranial nerve has been considered as an unfavorable prognostic factor for NPC. We assessed the role of IMRT based treatment modality on the recovery of CN and investigated the prognostic value of CN palsy recovery. Methods A total of 115 NPC patients with CN palsy were included in the study. We referred CTCAE version 5.0 to evaluate the grade of CN palsy. Results All patients with grade 1 CN palsy recovered completely during the 2 years of follow-up after definite treatment. Most grade 2 palsy could change gradually to grade 1 palsy or complete recovery during two years of follow-up. The 3-year DFS were 84.9% in patients experienced 1 or 2 symptom of CN palsy compared with 60.3% in patients with more than 2 symptoms of CN palsy (HR: 0.25, 95%CI: 0.07–0.89, P = 0.001). Conclusions IMRT based comprehensive treatment could effectively promote the recovery of tumor-related CN palsy in locoregionally advanced NPC.

scholarly journals Detailed analysis of recovery process of cranial nerve palsy after IMRT-based comprehensive treatment in nasopharyngeal carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Zang ◽  
Yan Li ◽  
Shanquan Luo ◽  
Jianhua Wang ◽  
Bingxin Hou ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Disease Free Survival ◽  
Recovery Process ◽  
Complete Recovery ◽  
Comprehensive Treatment ◽  
Poor Prognostic Factor

Abstract Background Cranial nerve (CN) palsy due to cancer involvement has been considered as an unfavorable prognostic factor for patients with nasopharyngeal carcinoma (NPC). We assessed the role of IMRT based treatment on the recovery of CN palsy and investigated the prognostic value of complete recovery of CN palsy. Methods A total of 115 NPC patients with cancer-related CN palsy were included in the study. We referred CTCAE version 5.0 to evaluate the grade of CN palsy. Results All patients with grade 1 CN palsy recovered completely during the 2 years of follow-up after definite treatment. Most grade 2 palsy could change gradually to grade 1 palsy or complete recovery during 2 years of follow-up. Patients with more than 2 symptoms of CN palsy had poor 3-year disease-free survival (DFS) than these with 1 or 2 symptoms (60.3% vs. 84.9%, HR 0.25, 95% CI 0.07–0.89, P = 0.001). There were no significant differences for PFS, OS, DMFS and LRFS between patients with complete recovery and non-complete recovery from CN palsy after receiving IMRT based comprehensive treatment. Conclusions IMRT based comprehensive treatment could effectively promote the recovery of tumor-related CN palsy for NPC patient. More than 2 symptoms of CN palsy was a poor prognostic factor for DFS of NPC patients. The prognostic role of complete recovery of CN palsy was not identified in our study.

scholarly journals Prognostic value of pretreatment and recovery duration of cranial nerve palsy in nasopharyngeal carcinoma

2012 ◽  
Vol 7 (1) ◽  
pp. 149 ◽  
Author(s):  
Hao-Yuan Mo ◽  
Rui Sun ◽  
Jian Sun ◽  
Qing Zhang ◽  
Wen-Jin Huang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Prognostic Value ◽  
Nerve Palsy ◽  
Recovery Duration

Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series

2021 ◽  
Author(s):  
Mohammed Alahmari ◽  
Fahad Alkherayf ◽  
Andrea Lasso ◽  
Fatmahalzahra Banaz ◽  
Sepideh Mohajeri ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Pituitary Apoplexy ◽  
Case Series ◽  
Surgical Decompression ◽  
Tumor Type ◽  
Visual Deficit ◽  
Nerve Recovery ◽  
Sixth Nerve

Abstract Background Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification. Design Present study is a single-institution retrospective cohort. Methods A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient. Results Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery. Conclusion In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients.

Radiosurgical Management of Benign Cavernous Sinus Tumors: Dose Profiles and Acute Complications

Neurosurgery ◽  
2001 ◽  
Vol 48 (5) ◽  
pp. 1022-1032 ◽  
Author(s):  
Joseph C.T. Chen ◽  
Steven L. Giannotta ◽  
Cheng Yu ◽  
Zbigniew Petrovich ◽  
Michael L. Levy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Radiation Dose ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Tumor Volume ◽  
Grade Iii

Abstract OBJECTIVE Radiosurgery has emerged as an alternative treatment modality for cranial base tumors in patients deemed not suited for primary surgical extirpation, patients with recurrent or residual tumor after open surgery, or patients who refuse surgical treatment. We review our short-term experience with radiosurgical management of cavernous sinus region tumors with the Leksell gamma knife. METHODS From August 1994 to February 1999, 69 patients with cavernous sinus lesions were treated in 72 separate treatment sessions. The tumor type distribution was 29 pituitary adenomas, 35 meningiomas, 4 schwannomas, and 1 paraganglioma. The median follow-up was 122 weeks. Lesions were stratified according to a five-level surgical grade. The grade distribution of the tumors was as follows: Grade I, 13; Grade II, 21; Grade III, 19; Grade IV, 12; Grade V, 4. Median tumor volume was 4.7 cm3. The median radiation dose was 15 Gy to the 50% isodose line. Median maximal radiation dose was 30 Gy. RESULTS Analysis of tumor characteristics and radiation dose to optic nerve and pontine structures revealed a significant correlation between distance and dose. Much lower correlation coefficients were found between tumor volume and dose. One lesion in this series had evidence of transient progression and later regression on follow-up radiographic studies. No other lesions in this series were demonstrated to have exhibited progression. Complications after radiosurgical treatment were uncommon. Two patients had cranial nerve deficits after treatment. One patient with a surgical Grade III pituitary adenoma had VIth cranial nerve palsy 25 months after radiosurgical treatment that spontaneously resolved 10 months later. A patient with a bilateral pituitary adenoma experienced bilateral VIth cranial nerve palsy 3 months after treatment that had not resolved at 35 months after treatment. Six patients with preoperative cranial nerve deficits experienced resolution or improvement of their deficits after treatment. One patient with a prolactin-secreting adenoma experienced normalization of endocrine function with return of menses. CONCLUSION Radiosurgical treatment represents an important advance in the management of cavernous sinus tumors, with low risk of neurological deficit in comparison with open surgical treatment, even in patients with high surgical grades.

scholarly journals Prognostic value of Ki-67 in nasopharyngeal carcinoma: a meta-analysis

2021 ◽  
Author(s):  
Yulin Li ◽  
Liang Yue ◽  
Yanqing Li ◽  
Qinxiu Zhang ◽  
Xin Liang
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Ki 67 ◽  
Free Survival ◽  
Prognostic Effect ◽  
Study Designs ◽  
Local Recurrence Free Survival

The prognostic value of Ki-67 in nasopharyngeal carcinoma (NPC) was controversial according to previous studies. We aimed to clarify the association between K-67 expression and survival in NPC through meta-analysis. We conducted a meta-analysis to explore the potential prognostic effect of Ki-67 on overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) in NPC. A total of 13 studies comprising 1314 NPC patients were included. High Ki-67 expression was associated with poor OS (hazard ratio [HR]=2.70, 95% confidence interval [CI]=1.97–3.71, p<0.001), DFS (HR=1.93, 95% CI=1.49–2.50, p<0.001), and LRFS (HR=1.86, 95% CI=1.11–3.12, p=0.019). However, there was no significant association between Ki-67 and DMFS (HR=1.37, 95% CI=0.78–2.38, p=0.270). Furthermore, the prognostic role of Ki-67 was maintained throughout different sample sizes, analyses of HR, and study designs for OS and DFS in various subgroups. Elevated Ki-67 expression is a reliable prognostic factor for poorer survival outcomes in NPC.

scholarly journals A Rare Case of Dengue Fever with Abducens Nerve Palsy

2021 ◽  
pp. 623-625
Author(s):  
Pon Divya Bharathi ◽  
P. Manimekalai ◽  
M. C. Vinatha ◽  
Pujari Lokchaitanya ◽  
Nandhyala Durga Venkata Sainadh
Keyword(s):  
Dengue Fever ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Neuromuscular Disorders ◽  
Abducens Nerve ◽  
Recovery Process ◽  
Methyl Prednisolone ◽  
Ocular Disorders ◽  
Vector Borne

Dengue fever is one of the most common vector borne disease which is a viral infection transmitted by aedes mosquito. Most common in the tropical countries. Neurological manifestations are not commonly seen in dengue, it can present as encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a very exceptional manifestation. A 48-year-old Indian male was diagnosed with dengue, complicated with isolated unilateral sixth cranial nerve palsy. The patient was managed conservatively. Patient made a fast and full ocular recovery following treatment with methyl prednisolone. Hence, dengue can present with a cranial nerve palsy and the recovery process can be hasten with the use of corticosteroids.

Prognostic value of ebv markers in the clinical management of nasopharyngeal carcinoma (NPC): A multicenter follow-up study

1988 ◽  
Vol 42 (2) ◽  
pp. 176-181 ◽  
Author(s):  
F. De-Vathaire ◽  
H. Sancho-Garner ◽  
H. De-Thé ◽  
C. Pieddeloup ◽  
G. Schwaab ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Clinical Management ◽  
Prognostic Value ◽  
Follow Up Study

scholarly journals Prognostic Value of Volume-Based Positron Emission Tomography/Computed Tomography in Nasopharyngeal Carcinoma Patients after Comprehensive Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yueli Tian ◽  
Khamis Hassan Bakari ◽  
Shanshan Liao ◽  
Xiaotian Xia ◽  
Xun Sun ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct

Objective. We assessed the prognostic value of standardized uptake value (SUV) and volume-based methods including whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) of patients with nasopharyngeal carcinoma (NPC) after therapy. Methods. A total of 221 posttherapy NPC cases were enrolled, all of whom had undergone PET/CT scanning and follow-up in this retrospective study. The diagnostic results of PET/CT were analyzed and compared with histopathological diagnosis or clinical follow-up. Receiver operator characteristic curves, the Kaplan-Meier method, and the log-rank test were used to assess the optimal cutoff values for WBMTV and WBTLG to identify independent predictors of survival. Results. The detection rates of the threshold SUV were 2.5, 20%, and 40%, and SUV background methods were 65.6% (378/576), 80.2% (462/576), 71.5% (412/576), and 90.4% (521/576), respectively (P<0.005). Patients with a WBMTV < 8.10 and/or a WBTLG < 35.58 had significantly better 5-year overall survival than those above the cutoffs (90.7% versus 51.2%, P<0.001; 91.7% versus 50.4%, P<0.001), respectively. Multivariate Cox regression modeling showed both WBTLG (RR, 1.002; P=0.004) and age (RR, 1.046; P=0.006) could be used to predict overall survival. WBTLG (RR, 1.003; P<0.001) may have predictive relevance in estimating disease-free survival. Conclusions. SUV volume-based threshold background methodology had a significantly higher detection rate for metastatic lesions. WBTLG could be used as an independent prognostic indicator for posttherapy NPC.

scholarly journals Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma

Cancer ◽  
2002 ◽  
Vol 95 (2) ◽  
pp. 404-409 ◽  
Author(s):  
Yaoh-Shiang Lin ◽  
Yee-Min Jen ◽  
Jiann-Chyun Lin
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy

scholarly journals Karakteristik Klinis dan Patologis Karsinoma Nasofaring di Bagian THT-KL RSUP Dr.M.Djamil Padang

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Shofi Faiza ◽  
Sukri Rahman ◽  
Aswiyanti Asri
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Clinical Symptoms ◽  
Cervical Lymphadenopathy ◽  
Stage Iv ◽  
Female Ratio ◽  
Undifferentiated Type ◽  
Clinical Characteristic

AbstrakKarsinoma nasofaring banyak terjadi di Cina dan Asia Tenggara, termasuk di Indonesia, sering didiagnosis pada keadaan lanjut dan memiliki prognosis yang buruk. Tujuan penelitian ini adalah untuk mengevaluasi epidemiologi, karakteristik klinis, dan tipe histopatologi pada pasien karsinoma nasofaring di Bagian THT-KL. Metodologi penelitian ini adalah deskriptif dengan menggunakan data rekam medik di RSUP Dr. M. Djamil Padang selama Juni 2010 sampai Juli 2013 dan data hasil pemeriksaan histopatologi sebagai konfirmasi.  Didapatkan sebanyak 44 kasus yang lengkap pada periode tersebut, yang mana 52,27% penderita adalah laki-laki dan 47,22% perempuan, perbandingan laki-laki dan perempuan adalah 1,2 : 1. Sebaran umur penderita dari 17 sampai 75 tahun dengan insiden puncak pada umur 41- 65 tahun. Gejala klinis terdiri atas massa di leher 93,17%, diikuti dengan obstruksi nasal 79,55%, dan gangguan pendengaran 79,55% sedangkan tanda klinis terdiri atas pembesaran kelenjar getah bening leher 90,91%, diikuti dengan tuli 79,55%, cranial nerve palsy  dan perluasan kelenjar getah bening ke fossa supraklavikula masing-masing 15,8%. Sebagian besar pasien berada pada stadium IV 83,16%, dengan derajat tumor terbanyak T4N2M0 15,91%. Tipe histopatologi yang terbanyak adalah nonkeratinizing carcinoma, undifferentiated type 75%, diikuti keratinizing SCC 13,64%, dan nonkeratinizing carcinoma - differentiated type 11,36%.Kata kunci: karsinoma nasofaring, karakteristik klinis, histopatologi, padang AbstractNasopharyngeal carcinoma  is more frequent in China and Southeast Asia, including Indonesia, commonly with advance stages at diagnosis and has a poor prognosis.  The objective of this study was to evaluate epidemiology, clinical characteristic and histopathology types of patients with nasopharyngeal carcinoma in the department of Otorhinolaryngology - Head and Neck Surgery.This is a descriptive study that used data from medical record of Dr. M. Djamil General Hospital in Padang during June 2010 to July 2013 and histopathology examination as confirmation. The result demonstrated 44 cases found on that period, of which 52,27% was male and 47,72% was female, hence the male and female ratio was 1,2 : 1.  The age-range from 17 to 75 years old with incidence peak between 41 - 65 years old. Clinical symptoms were neck mass 93,17%, followed by nasal obstruction 79,55 %, and audiological complaints 79,55% while clinical sign were cervical lymphadenopathy 90,91%, followed by hearing loss 79,55%, cranial nerve palsy and lymphadenopathy metastases to fossa supraclavicular each subject 15,8%. Most of patients were classified as stage IV 83,16%, with T4N2M0 15,91%.  The histopathology type were nonkeratinizing carcinoma, undifferentiated type had percentage 75%, followed by keratinizing SCC 13,64%, and nonkeratinizing carcinoma - differentiated type 11,36%. Keywords: nasopharyngeal carcinoma, clinical characteristic, histopathology types, padang

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