Microsurgical reconstruction of the skull base and midface after orbitomaxillary resections for malignant tumors

Background. Orbitomaxillary resection includes exenteration of the orbital contents with resection of the inferior orbital and medial walls. The main goals are: reconstruction of soft tissue and bone structure defects, tamponade of the orbital cavity and/or its preparation for further ocular prosthetics, and reconstruction of the skull base defect. The purpose of the study to present the immediate results of orbitomaxillary resections in patients with malignant neoplasms of the skull base and midface. Material and methods. Between 2014 and 2020, 6 patients who previously underwent surgery for primary cancer (n=3) and recurrent cancer (n=3) were treated at the Head and Neck cancer department of N.N. Blokhin National medical Research center of oncology. To reconstruct defects after resection of bone structures (maxilla, frontal and nasal bones) and skin, a musculocutaneous alt-flap was used in 3 (50 %) cases and a fascial skin radial flap in 3 (50 %) cases. Results. The aesthetic result was assessed in 6 patients. In all cases, a satisfactory result was obtained. None of the patients who underwent resection of the dura mater followed by reconstruction had no symptoms of liquorrhea in the postoperative period. Conclusion. Flap selection depends on the defect size. In cases with a small defect size (up to 70 cm3), reconstruction with the radial fascial skin flap can be performed. If the defect size is more than 71 cm3, reconstruction with musculocutaneous alt flap can be the method of choice.

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A 12-Year Retrospective Survey of Management of Patients with Malignant Neoplasms in the Orbital Cavity in a Brazilian Cancer Hospital

The Open Dentistry Journal ◽

10.2174/1874210601307010140 ◽

2013 ◽

Vol 7 (1) ◽

pp. 140-145 ◽

Cited By ~ 1

Author(s):

Daniela Sirianni ◽

Cláudio Rodrigues Leles ◽

Elismauro Francisco Mendonça

Keyword(s):

Cell Carcinoma ◽

Malignant Tumors ◽

Demographic Data ◽

Malignant Neoplasms ◽

Prosthetic Rehabilitation ◽

Chi Square ◽

Orbital Cavity ◽

Cancer Hospital ◽

Unmet Demand ◽

Chi Square Test

Purpose: The aim of this study was to investigate the distribution of different types of malignant tumors in the orbital cavity, surgical treatments, and subsequent prosthetic rehabilitation. Materials and Methods: A retrospective sample of 269 charts of patients attending a public reference cancer hospital in Goiania, Goias, Brazil, between 1998 and 2009 was selected. Study variables included demographic data, clinical and histopathological features, and patient rehabilitation. Frequency analysis, chi-square test and multiple logistic regression were used for data analysis. Results: Patients’ age ranged from 1 to 92 years and 50.2% were female. The most prevalent tumors were basal cell carcinoma (58%), retinoblastoma (17.1%), squamous cell carcinoma of the conjunctiva (7.1%), malignant melanoma (6.7%), and rhabdomyosarcoma (4.5%). Surgical treatment was performed in 250 patients (92.3%), but only 29 patients (10.8%) received ocular prosthetic rehabilitation. Lower age (p<0.001) and enucleation surgery (p<0.001) were significantly associated with prosthetic rehabilitation. Conclusions: Results revealed high occurrence of mutilating interventions and low provision of prosthetic care, limited to younger patients who had undergone enucleation surgery. The high unmet demand for rehabilitation emphasizes the need to incorporate appropriate care for ocular and orbital deformities into the Brazilian public health system.

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A Study on the Prognostic Factors in Surgical Cases of Malignant Tumors of the Skull Base

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0032-1314246 ◽

2012 ◽

Vol 73 (S 02) ◽

Author(s):

T. Asakage ◽

Y. Ebihara ◽

Y. Saito ◽

G. Omura ◽

K. Kawai ◽

...

Keyword(s):

Prognostic Factors ◽

Skull Base ◽

Malignant Tumors

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A New Method of 3-D Visualization of Malignant Tumors Located at the Skull Base

Skull Base ◽

10.1055/s-2006-958374 ◽

2007 ◽

Vol 16 (S 1) ◽

Author(s):

Ilka Hertel ◽

Gero Straus ◽

Jana Dornheim ◽

Jeanette Cordes ◽

Arno Krüger ◽

...

Keyword(s):

Skull Base ◽

Malignant Tumors ◽

New Method

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Delayed Complications of Craniofacial Resection and Proton Beam Radiation Therapy for Malignant Tumors of the Skull Base

Skull Base ◽

10.1055/s-2009-1242384 ◽

2009 ◽

Vol 19 (03) ◽

Author(s):

Stacey Gray ◽

William Curry ◽

Annie Chan ◽

Fred Barker ◽

Daniel Deschler ◽

...

Keyword(s):

Radiation Therapy ◽

Skull Base ◽

Proton Beam ◽

Malignant Tumors ◽

Craniofacial Resection ◽

Beam Radiation ◽

Proton Beam Radiation ◽

Delayed Complications ◽

Proton Beam Radiation Therapy

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The possibility of using tantalum oxide microparticles in phosphate glass for radiation therapy of malignant neoplasms

Pacific Medical Journal ◽

10.34215/1609-1175-2020-4-85-87 ◽

2020 ◽

pp. 85-87

Author(s):

O. S. Plotnikova ◽

V. I. Apanasevich ◽

M. A. Medkov ◽

A. A. Polezhaev ◽

V. I. Nevozhai ◽

...

Keyword(s):

Phosphate Glass ◽

Linear Accelerator ◽

Malignant Tumors ◽

Video Recording ◽

Tantalum Oxide ◽

Vertical Plane ◽

Secondary Radiation ◽

Semiconductor Diode ◽

Malignant Neoplasms ◽

Diode Detector

Objective: The creation of the medicine for a local radiomodification of tumors.Methods: The level of the secondary radiation on the surface of the phosphate glass powder with the inclusion of tantalum oxide processed by 6 MeV deceleration emission was studied. Medical linear accelerator TrueBeam (Varian, USA), and Semiconductor diode detector PDI 2.0 (Sun Nuclear Corp., USA) having the system of moving in vertical plane and the system of position video recording were used.Results: The presence of the phosphate glass (containing 20% Та2О5) on the surface gave a 63.7% increase to the secondary radiation. It’s around two thirds of the overall level.Conclusion: An opportunity to create a medicine on the basis of phosphate glass, containing tantalum oxide, for local radiomodification of malignant tumors.

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Aspartame and cancer – new evidence for causation

Environmental Health ◽

10.1186/s12940-021-00725-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Philip J. Landrigan ◽

Kurt Straif

Keyword(s):

Public Health ◽

Cancer Risk ◽

Malignant Tumors ◽

Daily Intake ◽

Immunohistochemical Analysis ◽

International Agency ◽

Advisory Group ◽

Malignant Neoplasms ◽

Acceptable Daily Intake ◽

New Findings

Abstract Background Aspartame is one of the world’s most widely used artificial sweeteners and is an ingredient in more than 5000 food products globally. A particularly important use is in low-calorie beverages consumed by children and pregnant women. The Ramazzini Institute (RI) reported in 2006 and 2007 that aspartame causes dose-related increases in malignant tumors in multiple organs in rats and mice. Increased cancer risk was seen even at low exposure levels approaching the Acceptable Daily Intake (ADI). Prenatal exposures caused increased malignancies in rodent offspring at lower doses than in adults. These findings generated intense controversy focused on the accuracy of RI’s diagnoses of hematopoietic and lymphoid tissue tumors (HLTs). Critics made the claim that pulmonary lesions observed in aspartame-exposed animals were inflammatory lesions caused by Mycoplasma infection rather than malignant neoplasms. Methods To address this question, RI subjected all HLTs from aspartame-exposed animals to immunohistochemical analysis using a battery of markers and to morphological reassessment using the most recent Internationally Harmonized Nomenclature and Diagnostic (INHAND) criteria. Findings This immunohistochemical and morphological re-evaluation confirmed the original diagnoses of malignancy in 92.3% of cases. Six lesions originally diagnosed as lymphoma (8% of all HLTs) were reclassified: 3 to lymphoid hyperplasia, and 3 to chronic inflammation with fibrosis. There was no evidence of Mycoplasma infection. Interpretation These new findings confirm that aspartame is a chemical carcinogen in rodents. They confirm the very worrisome finding that prenatal exposure to aspartame increases cancer risk in rodent offspring. They validate the conclusions of the original RI studies. These findings are of great importance for public health. In light of them, we encourage all national and international public health agencies to urgently reexamine their assessments of aspartame’s health risks - especially the risks of prenatal and early postnatal exposures. We call upon food agencies to reassess Acceptable Daily Intake (ADI) levels for aspartame. We note that an Advisory Group to the International Agency for Research on Cancer has recommended high-priority reevaluation of aspartame’s carcinogenicity to humans.

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The surgery of benign and malignant neoplasms adjacent to or involving the skull base

American Journal of Otolaryngology ◽

10.1016/0196-0709(89)90104-x ◽

1989 ◽

Vol 10 (5) ◽

pp. 305-313 ◽

Cited By ~ 4

Author(s):

David E. Schuller ◽

Mary C. Hart ◽

Joseph H. Goodman

Keyword(s):

Skull Base ◽

Malignant Neoplasms

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Metastases to the pituitary gland

Neurosurgical FOCUS ◽

10.3171/foc.2004.16.4.9 ◽

2004 ◽

Vol 16 (4) ◽

pp. 1-4 ◽

Cited By ~ 73

Author(s):

Daniel R. Fassett ◽

William T. Couldwell

Keyword(s):

Pituitary Gland ◽

Diabetes Insipidus ◽

Skull Base ◽

Survival Rates ◽

Tumor Resection ◽

Sella Turcica ◽

Pituitary Tumors ◽

Visual Field Defects ◽

Malignant Neoplasms ◽

Pituitary Metastases

Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

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