scholarly journals Posterior fossa ependymomas in children: still a challenge for pediatric neurosurgeons and oncologists.

2021 ◽  
Author(s):  
Rel Gerald Boukaka kala ◽  
pierre-aurélien beuriat ◽  
federico di rocco ◽  
Pierre Leblond ◽  
Cecile Faure-Conter ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Facial Nerve Palsy ◽  
Surgical Removal ◽  
Cerebellar Syndrome ◽  
Metastatic Recurrence ◽  
Operative Complications ◽  
Spinal Mri ◽  
Aggressive Tumors

Introduction: Posterior fossa ependymomas in children are associated with a poor prognosis. This retrospective study tries to determine prognostic factors for the outcomes and the quality of life. Material and Methods: Thirty-three patients with posterior fossa ependymomas were treated from 2002 to 2018. All patients had a cranio-spinal MRI and 3.12% were metastatic. Removal was complete in 29 patients (90.62%). All patients received a complementary treatment: 11patients chemotherapy, radiotherapy in 35 patients, 24 cases of neoadjuvant type and for recurrence in 11. Results: Average age was 5.8 years with a range from 9 months to 18 years. The sex ratio was 2.3 (M/F: 23/10). Sixteen patients had one recurrence (3 metastatic). 90% of the EpPCF were of the PFA group. Overall Survival was 65% with a mean follow-up of 8.4 and a median of 9 years. Twenty-one patients were alive (63.63%) at last follow-up. All were tumour-free according the MRI except 2 patients, 1 with a stable residue for 5 years and 1 in palliative treatment for metastatic recurrence for 5 years. Post-operative complications were as follow, facial nerve palsy in four cases (12.12%), swallowing disorders in three cases (9.09%), transient cerebellar syndrome in 4 cases (12.12%). Fifteen patients had normal schooling. Conclusion: Posterior fossa ependymomas are aggressive tumors. Complete surgical removal remains the most important prognostic factor even if responsible of sequels. Despite molecular studies and the expression of different genes, no obvious therapeutic target has yet emerged.

Post-operative roentgenological findings and changes after mastoid obliteration

1983 ◽  
Vol 97 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Kauko Ojala ◽  
Reijo Lahti ◽  
Antti Palva ◽  
Martti Sorri
Keyword(s):  
Bone Formation ◽  
Frequent Occurrence ◽  
New Bone Formation ◽  
Mastoid Obliteration ◽  
X Ray ◽  
Radiological Features ◽  
Operative Complications ◽  
Post Operative Complications

AbstractThis study consisted of the evaluation of the plain X-ray findings of films taken at early follow-up (mean 1.5 months after surgery) and at late follow-up(4–14 years after the early films) of 211 ears which had been operated on radically and obliterated. Residual cells which were detected on the basis of the early films were associated with a more frequent occurrence of post-operative infection and were thus hallmarks of a poorer prognosis. Changes in the bone surrounding the surgical cavity and the radiological quality of the walls of the surgical cavity, the presence of new bone formation in the cavity and other radiological features did not yield useful information about post-operative complications. New bone formation was associated with a smaller amount of post-operative cavitation. Post-operative X-ray examination of the obliterated ear is a prognostically useful examination, but it does not significantly contribute further to the information available by clinical and otomicroscopic examination in regards to the complications of infection and cholesteatoma.

scholarly journals The role of screening spinal MRI in children with solitary posterior fossa low-grade glial tumors

2020 ◽  
Vol 25 (2) ◽  
pp. 106-110
Author(s):  
Jonathan Roth ◽  
Neal Fischer ◽  
David D. Limbrick ◽  
Travis CreveCoeur ◽  
Liat Ben-Sira ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Spinal Tumor ◽  
Low Grade ◽  
Tumor Spread ◽  
Glial Tumors ◽  
Screening And Surveillance ◽  
Spinal Mri ◽  
Cranial Metastasis

OBJECTIVESolitary posterior fossa low-grade glial tumors (SPFLGT) in children are rarely associated with leptomeningeal dissemination (LMD). To date, there are no clear guidelines regarding the role of screening and surveillance spinal MRI (sMRI) in children with SPFLGT, at diagnosis or during follow-up periods. The current study reviews a cohort of children with SPFLGT, focusing on sMRI findings.METHODSIn this binational retrospective study, the authors analyzed 229 patients with SPFLGT treated and followed over 13 years. One hundred twelve children had at least 1 total sMRI screening or surveillance examination. One hundred seventeen had no sMRI, but did not present with clinical spinal signs or symptoms. Collected data included demographics, disease characteristics, radiology, pathology, and clinical follow-up data.RESULTSFor the 112 children with at least 1 sMRI, the mean duration from diagnosis to first sMRI was 11.73 ± 28.66 months (range 0–165 months). All sMRI scans were conducted as screening examinations, with no spinal-related symptoms. One patient was found to have a sacral intradural lesion concurrent to the brain tumor diagnosis. Over the course of 180 radiological and 533 clinical follow-up years for the 112 patients with sMRI, and 582 clinical follow-up years for the 117 patients with no sMRI, there were no additional cases with spinal tumor spread.CONCLUSIONSThe yield of screening sMRI in the absence of cranial metastasis, or spinal symptoms, is extremely low. Because preoperative sMRI is recommended for medulloblastomas and ependymomas, it may be logical to acquire. During the follow-up period the authors recommend limiting sMRI in patients without symptoms suggesting a spinal lesion, in patients without known cranial metastases, or recurrence or residual SPFLGT.

Surgical removal of corpus callosum infiltrated by low-grade glioma: functional outcome and oncological considerations

2004 ◽  
Vol 100 (3) ◽  
pp. 431-437 ◽  
Author(s):  
Hugues Duffau ◽  
Ihab Khalil ◽  
Peggy Gatignol ◽  
Dominique Denvil ◽  
Laurent Capelle
Keyword(s):  
Corpus Callosum ◽  
Functional Outcome ◽  
Surgical Removal ◽  
Low Grade ◽  
Extensive Resection ◽  
Content Type ◽  
The Impact ◽  
Fine Print

Object. Although still controversial, many authors currently advocate extensive resection in the treatment of low-grade gliomas (LGGs). Because these tumors usually migrate along white matter pathways, the corpus callosum is often invaded. Nevertheless, there is evidently no specific study featuring resection of the corpus callosum infiltrated by glioma, despite abundant literature concerning callosotomy in epilepsy surgery or transcallosal ventricular approaches. The aim of this paper was to analyze functional outcome following removal of corpus callosum invaded by LGG and to analyze the impact of this callosectomy on the quality of resection. Methods. Between 1996 and 2002, a total of 32 patients harboring an LGG involving part of the corpus callosum and having no or only a mild preoperative deficit underwent surgery aided by intraoperative electrical mapping to preserve eloquent structures identified on stimulation and to perform the most extensive resection possible. Preoperatively, no clinical response was elicited on stimulation of the corpus callosum; thus, the part of this structure that was invaded by LGG was removed. Despite immediate postoperative neurological worsening, all patients but one recovered within 3 months and returned to a normal socioprofessional life. The additional callosectomy allowed for nine total resections, 18 subtotal resections, and five partial resections. Furthermore, only two cases of contralateral hemispherical migration occurred during a median follow up of 3 years. Conclusions. Resection of the corpus callosum infiltrated by glioma improves the quality of tumor removal without increasing the risk of sequelae.

scholarly journals Solitary bone plasmacytoma as posterior fossa cranial neoplasia, presentation of two clinical cases

2022 ◽  
Vol 13 ◽  
pp. 7
Author(s):  
Luis David Molina Andaluz ◽  
Josué Alejandro Cervantes Gonzalez ◽  
Zita Elizabeth Salazar Ramírez ◽  
Nelly Ramírez ◽  
Luis Guillermo Castellanos ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Clinical Presentation ◽  
The Other ◽  
Occipital Region ◽  
Cerebellar Syndrome ◽  
Total Resection ◽  
Plasma Cell Neoplasm ◽  
Cell Neoplasm ◽  
Solitary Bone Plasmacytoma

Background: Solitary bone plasmacytoma is a plasmatic cell dyscrasia; its presentation in the posterior fossa is very rare. Case Description: We present two cases, a 59-year-old male and a 50-year-old female, both with heterogeneous clinical presentation. One had symptoms compatible with endocranial hypertension, and the other presented with a hemispheric cerebellar syndrome and ipsilateral trigeminal neuralgia. They were both related to an intraosseous tumor of the occipital region near the torcula with large extension to the posterior fossa. The diagnosis of a plasma cell neoplasm arising from the diploe of the squamous portion of the occipital bone was confirmed with immunohistochemistry. Conclusion: The treatment for a cranial tumor that is suspected to be a solitary bone plasmacytoma requires a multidisciplinary team to diagnose, plan a total resection, and after surgery continue with the follow-up of the patient. Solitary bone plasmacytoma should be considered as a differential diagnosis for a tumor that produces cancellous bone widening without sclerotic borders.

scholarly journals What’s new for the clinician? - Excerpts from and summaries of recently published papers

2021 ◽  
Vol 76 (3) ◽  
pp. 160-163
Author(s):  
Veerasamy Yengopal
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Medical Care ◽  
Third Molar ◽  
Mobile App ◽  
Surgical Removal ◽  
Good Doctor ◽  
Related Quality

Surgical removal of impacted 3rd molars is a common surgical procedure carried out by both general and specialist oral health professionals. This procedure is often associated with postoperative pain, swelling and bleeding which affects the patients eating and speaking and oral health related quality of life. Very little published studies have investigated the effect of postoperative follow-up on the quality of life of affected patients. Traditional postoperative follow-up via telephone has proven to be effective and it has effects such as reducing the cost of consultation compared with conventional on-site follow-up. However, in clinical practice, telephone follow-up was found to greatly increase the time consumption of doctors and nurses, as they have to repeat the same instructions or guidelines, and patients often reject the calls, as they think that these unknown incoming calls are harassing calls. The increase in online medical care facilitates patients’ access to medical services and also enables doctors to manage their cases more efficiently and follow up with their registered patients quickly and accurately to obtain important clinical data. Zheng and colleagues form China (2021) used the Good Doctor Online mobile app to follow up registered patients after tooth extraction. The primary aim of their study was to evaluate the effectiveness of postoperative online follow-up on patients’ quality of life following impacted mandibular third molar removal. A further objective was to investigate the application value of online medical care in the field of oral therapy.

scholarly journals Probable Action Dimensions of Madhutailika Yapana Vasti in Hirschsprung's Disease

2021 ◽  
pp. 91-94
Author(s):  
Sruthi Radhakrishnan ◽  
Ambili Krishna ◽  
T K Sujan
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Ganglion Cells ◽  
Current Knowledge ◽  
Modern Science ◽  
Surgical Removal ◽  
Research Gaps ◽  
Operative Complications ◽  
Over Time

Hirschsprung’s disease (HD) is a congenital disorder defined by the absence of ganglion cells in terminal rectum which is responsible for non specific symptomatology including chronic constipation which is usually not relieved with oral laxatives. In modern science, the treatment option is surgical removal of affected area followed by anastomosis but more post operative complications and lower quality of life are the major concerns while adopting surgical procedures. Hence the scope of Ayurvedic modalities in HD is to be explored. When we consider the pathology as Udavartha due to deranged Pakwasayagatha Vatha, the prime importance of Vasti can be analyzed. It is the Prakupitha Apana Vayu which leads to Udavartha. Children suffer from chronic accumulation of Mala due to Pratiloma Gati of Vayu which over time becomes hard and dried and may further result in infection. Hence the line of disease management requires Sodhana for the elimination of chronic stasis of Mala with simultaneous Brimhana and Rasayana action for gut brain nourishment and regeneration. Madhutailika Yapana Vasti which is mentioned in Ashtangahrudaya Kalpasidhi Sthana serves these purposes simultaneously. The present work aims at exploring the current knowledge on probable mode of action of Madutailika Yapana Vasti in Hirschsprung’s disease and to highlight the research gaps that we must overcome to further elucidate the vast action dimensions of Yapana Vasti in the same disease.

Analysis of treatment results in craniopharyngioma.

1985 ◽  
Vol 3 (2) ◽  
pp. 252-258 ◽  
Author(s):  
B E Amendola ◽  
S S Gebarski ◽  
A G Bermudez
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Survival Rate ◽  
Subtotal Resection ◽  
Surgical Removal ◽  
Adult Group ◽  
Treatment Results ◽  
Operative Complications

A retrospective study of 30 patients treated primarily with surgery for craniopharyngioma between 1965 and 1980 was conducted. There were 13 children and 17 adults in this series. Apparent total surgical removal was obtained in six children and eight adults; the remaining patients had subtotal resection. Radiation therapy was used for salvage in five patients and after complete cyst removal in one. The ten-year survival rate was 80% in children and 30% in adults. The five-year survival was ten of 11 patients with childhood craniopharyngioma and seven (41%) of 17 patients in the adult group. Seven of 13 patients in the childhood group experienced surgically documented recurrence after first surgery. Seven of 17 patients recurred after first surgery in the adult group. Four died of operative complications. Morbidity demonstrated by quality of survival was high in these patients.

scholarly journals Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

2019 ◽  
Author(s):  
Duo Liu ◽  
Yanchun Liang ◽  
Ming Chen ◽  
Wenwei Pan ◽  
Lin Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bowel Resection ◽  
Bowel Endometriosis ◽  
Sf 36 ◽  
Operative Complications ◽  
Segmental Bowel Resection ◽  
Pain Symptoms

Abstract Purpose: To evaluate the long-term efficacy of segmental bowel resection for bowel endometriosis and the impact of post-operative complications on clinical outcomes.Methods: 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection from Jun. 2010 to Jan. 2014 were recruited. A visual analogue scale (VAS) and SF-36 questionnaire were administered before and at least 5 years after surgery. Post-operative complications and pregnancy were also recorded. Median follow-up after operation was 76 months (62-105 months).Results: 62 patients underwent laparoscopic segmental bowel resection, one of which converted to laparotomy. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, bowel movement pain, chronic pelvic pain and tenesmus. Dysmenorrhea was the most frequent. The relief of all pain symptoms after surgery was statistically significant (P<0.001). The scores for 8 domains of SF-36 questionnaire were significant improved after operation (P<0.001), and the post-operative scores were improved to the level of Chinese female population. Post-operative complication included 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, diffuse peritonitis, peripheral nerve injury, bacteraemia, incomplete intestinal obstruction and mucus bloody stool. All of these patients recovered well. There was no significant difference in post-operative SF-36 questionnaire scores between the patients with and without complications.Conclusion: Segmental bowel resection can significantly relieve pain and improve long-term quality of life for patients with bowel endometriosis. Despite the relatively high complication rate, the complications had little impact on the improvement of quality of life.

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