scholarly journals Surgical Outcomes of Cerebellopontine Angle Tumors in 48 Cases

2020 ◽  
Vol 9 (2) ◽  
pp. 117-220 ◽  
Author(s):  
Md Atikur Rahman ◽  
Ahsan Mohammad Hafiz ◽  
KM Tarikul Islam ◽  
Pijush Kanti Mitra ◽  
Ehsan Mahmud ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Cerebrospinal Fluid Leak ◽  
Surgical Removal ◽  
Hearing Improvement ◽  
Tumor Removal ◽  
Cerebellopontine Angle Tumors ◽  
Acoustic Schwannoma ◽  
One Year ◽  
Fluid Leak

Background: Share our experiences with a series of surgical removal of cerebellopontine angle with retrosigmoid suboccipital procedure. Materials and Methods: It was a retrospective study of 48 patients (mean age, 45 years) with Cerebellopontine Angle tumors (predominantly acoustic schwannoma) who underwent surgical removal and one year post-operative follow up. Results: Hearing improvement about 50% of patient. Facial nerve function as measured by the House Brackmann system was recorded in all patients 1 year following surgery: 35% had a score of 1 or 2; 25% had a score of 3 or 4; and 8% had a score of 5 or 6. Rest of the patient full recover Two death occurred during this study. There was one cerebrospinal fluid leak, and two patients were diagnosed as having bacterial meningitis. Complete gross tumor removal was not achieved in five patients (10%). Two cases had wound infections. Conclusion: The retrosigmoid suboccipital procedure was used in our series for removal CPA tumors, and outcome was good in this series. Bang. J Neurosurgery 2020; 9(2): 117-220

Reversible Hearing Loss from Cerebellopontine Angle Tumors

Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 310-313 ◽  
Author(s):  
Eduardo A. S. Vellutini ◽  
Oswaldo L. M. Cruz ◽  
Otavio P. Velasco ◽  
Aroldo Miniti ◽  
Gilberto M. Almeida
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Surgical Approach ◽  
Cerebellopontine Angle ◽  
Jugular Foramen ◽  
Sensorineural Hearing ◽  
Surgical Removal ◽  
Arachnoid Membrane ◽  
Tumor Removal ◽  
Cerebellopontine Angle Tumors

Abstract We report two patients who presented with a dramatic recovery from severe sensorineural hearing loss after total surgical removal of cerebellopontine angle tumors (meningioma and jugular foramen neurinoma). The factors that differentiate these “non-acoustic tumors” in relation to the prognosis for hearing are discussed. A surgical approach that maintains the labyrinthine structure and preserves the arachnoid membrane of the superior cerebellopontine angle cistern during tumor removal is stressed.

Nonsurgical Management of Small and Intracanalicular Acoustic Tumors

1986 ◽  
Vol 94 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Gale Gardner ◽  
William H. Moretz ◽  
Jon H. Robertson ◽  
Craig Clark ◽  
John J. Shea
Keyword(s):  
Cerebellopontine Angle ◽  
Medical Literature ◽  
Nonsurgical Treatment ◽  
Surgical Removal ◽  
Proper Treatment ◽  
Pertinent Literature ◽  
Ct Examination ◽  
Nonsurgical Management ◽  
Cerebellopontine Angle Tumors

It is generally accepted that the proper treatment for acoustic tumors is surgical removal. In fact, there is little, If any, reference to nonsurgical treatment of these tumors in the recent medical literature. We would like to report on the nonsurgical management of six patients with cerebellopontine angle tumors based upon CT examination. The diagnostic findings, follow-up data, and the rationale upon which the decision was made to treat the patients nonsurgically will be presented, as will a review of the pertinent literature.

Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence

2008 ◽  
Vol 108 (3) ◽  
pp. 525-532 ◽  
Author(s):  
Marco Losa ◽  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Paolo Ribotto ◽  
Maria Rosa Terreni ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Postoperative Radiotherapy ◽  
Residual Tumor ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Tumor Diameter ◽  
Tumor Removal ◽  
Early Results ◽  
Results Of Surgery

Object Nonfunctioning pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that typically cause visual and/or hormonal dysfunction. Surgery is the treatment of choice, but patients remain at risk for tumor recurrence for several years afterwards. The authors evaluate the early results of surgery and the long-term risk of tumor recurrence in patients with NFPAs. Methods Between 1990 and 2005, 491 previously untreated patients with NFPA underwent surgery at the Università Vita-Salute. Determinations of recurrence or growth of the residual tumor tissue during the follow-up period were based on neuroradiological criteria. Results Residual tumor after surgery was detected in 173 patients (36.4%). Multivariate analysis showed that invasion of the cavernous sinus, maximum tumor diameter, and absence of tumor apoplexy were associated with an unfavorable surgical outcome. At least 2 sets of follow-up neuroimaging studies were obtained in 436 patients (median follow-up 53 months). Tumors recurred in 83 patients (19.0%). When tumor removal appeared complete, younger age at surgery was associated with a risk of tumor recurrence. In patients with incomplete tumor removal, adjunctive postoperative radiotherapy had a marked protective effect against growth of residual tumor. Conclusions Complete surgical removal of NFPAs can be safely achieved in > 50% of cases. Visual symptoms and, less frequently, pituitary function may improve after surgery. However, tumor can recur in patients after apparently complete surgical removal. In patients with incomplete tumor removal, radiation therapy is the most effective adjuvant therapy for preventing residual tumor growth.

scholarly journals Endoscopic Endonasal Transpterygoid Approach to Sphenoid Sinus Lateral Recess Defects

2019 ◽  
Vol 81 (05) ◽  
pp. 553-561
Author(s):  
Gülpembe Bozkurt ◽  
Mario Turri-Zanoni ◽  
Elisa Coden ◽  
Federico Russo ◽  
Hassan Ahmed Elhassan ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Dry Eye ◽  
Sphenoid Sinus ◽  
Cerebrospinal Fluid Leak ◽  
Significant Morbidity ◽  
Endoscopic Endonasal ◽  
Lateral Recess ◽  
Fluid Leak ◽  
Extensive Surgery

Background Lesions affecting sphenoid sinus lateral recess (SSLR) are difficult to visualize and manipulate through the transnasal routes, especially when the sinus is highly pneumatized. External approaches to this area involve extensive surgery and are associated with significant morbidity. The aims of this study are to present our experience with the endoscopic transpterygoid approach as a method for approaching lesions of the SSLR and to evaluate the outcomes of this procedure.Methods Clinical charts of patients who had lesions in the SSLR and who were treated at our institution from September 1998 to June 2018 were retrospectively reviewed. All these patients were managed by the endoscopic endonasal transpterygoid approach.Results Thirty-nine patients were identified. No cerebrospinal fluid leak recurrences were observed during follow-up (range: 1–19.7 years; median: 2.3 years). Hypoesthesia (temporary, 1; persistent, 4) in the region innervated by the maxillary branch of the trigeminal nerve was detected in five (12.8%) patients, while symptoms due to the Vidian nerve damage (dry eye, 3; dry nasal mucosa, 1) were present in four (10%) patients.Conclusions Although the endoscopic endonasal transpterygoid approach is an excellent corridor for dealing with lesions of the SSLR, limited rate of neurologic and lacrimal complications was observed. Potential morbidity of the intervention should be discussed during preoperative counselling.

Endoscopic Transsphenoidal Approach for Resection of Malignant Pituitary Blastoma in an 18-Month-Old Infant: A Technical Note

2014 ◽  
Vol 10 (4) ◽  
pp. 649-653 ◽  
Author(s):  
Malik Zaben ◽  
Mohsin Zafar ◽  
Shafqat Bukhari ◽  
Paul Leach ◽  
Charoline Hayhurst
Keyword(s):  
Malignant Tumor ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Cerebrospinal Fluid Leak ◽  
Technical Note ◽  
Transsphenoidal Approach ◽  
Nasoseptal Flap ◽  
Endoscopic Endonasal ◽  
One Year ◽  
Fluid Leak

Abstract BACKGROUND: Sella and suprasellar tumors are increasingly managed via an endoscopic transsphenoidal approach, but infant endoscopic surgery has not been reported. Pituitary blastoma is a rare sellar malignant tumor that primarily occurs in infants and is managed by surgical resection (cytoreduction) followed by adjuvant therapy. OBJECTIVE: To describe the technique and feasibility of resection of a pituitary blastoma via endoscopic endonasal transsphenoidal approach in an 18-month-old infant. METHODS: Endoscopic endonasal transsphenoidal approach for resection of a pituitary malignant tumor in an infant. RESULTS: Near-total tumor resection was achieved. The skull base was reconstructed by using a nasoseptal flap with no cerebrospinal fluid leak or any other intraoperative complications. The postoperative course was uneventful. One-year follow-up showed complete resolution of the tumor. CONCLUSION: The endoscopic endonasal transsphenoidal approach with nasoseptal flap reconstruction could be used as a safe, yet minimally invasive and innovative technique for the resection of pituitary blastoma in infants.

Follow-up Management of Patients After Transsphenoidal Approach for Resection of Pituitary Adenomas

2019 ◽  
Vol 34 (2) ◽  
pp. 150-155
Author(s):  
Allison K. Ikeda ◽  
Lauren J. Luk ◽  
Zara M. Patel ◽  
Nelson M. Oyesiku ◽  
C. Arturo Solares ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Care Center ◽  
Tertiary Care ◽  
Cerebrospinal Fluid Leak ◽  
Patient Records ◽  
Tertiary Care Center ◽  
Postoperative Course ◽  
Transsphenoidal Adenomectomy ◽  
Fluid Leak

Background Endoscopic transsphenoidal adenomectomy (eTSA) is widely utilized for resection of pituitary adenoma. eTSA patients undergo healing for weeks to months and are potentially at risk for complications. Multidisciplinary follow-up monitoring is necessary. We hypothesized that patients with deviations from the routine postoperative course, broadly termed complications of interest (COI) in this study, following eTSA would increase the duration of follow-up in the rhinology clinic. Methods Retrospective review was performed on patients undergoing eTSA for pituitary adenoma from August 2007 to May 2016 at a single tertiary care center. COIs were reviewed for their influence on follow-up time. Results A total of 985 patient records were reviewed (mean age 51.0 ± 15.7 years, 55.2% female), of which, 21.1% of patients had a deviation from the expected postoperative course (7.0% rhinologic, 10.8% surgical, 0.6% perioperative medical, and 2.7% endocrinologic COIs). The most common COI was cerebrospinal fluid leak 5.6% (n = 55) followed by sinusitis 5.0% (n = 49). Moreover, 935 patients (94.9%) attended rhinology follow-up (172 patients with COI). For patients seen postoperatively by the rhinology service, COIs significantly increased the number of rhinologic follow-up visits (median 2 [interquartile range, IQR: 2–3] vs 3 visits [IQR: 2–4], P < .001), duration of rhinologic follow-up (median 54.0 days [IQR: 43.0–104.0] vs 88.0 days [IQR: 54.5–242.0], P < .001), and duration of overall multidisciplinary follow-up (median 354.0 days [IQR: 104.0–789.0] vs 537.0 days [IQR: 171.5–1313.5], P < .001), compared to those without COIs. Conclusions Patients who develop postoperative complications after eTSA have significantly extended follow-up with the multidisciplinary team.

scholarly journals Fluorescein Sodium Use during Spinal Ependymoma Resection

2017 ◽  
Vol 3 (3) ◽  
pp. 123-134
Author(s):  
Zhenxing Sun ◽  
Dan Yuan ◽  
Yaxing Sun ◽  
Zhanquan Zhang ◽  
James Wang ◽  
...  
Keyword(s):  
Removal Rate ◽  
Sensory Function ◽  
Fluorescent Light ◽  
Surgical Removal ◽  
Fluorescein Sodium ◽  
Tumor Removal ◽  
Intramedullary Tumors ◽  
Complete Tumor Removal ◽  
Complete Tumor

Spinal ependymomas (SEs) are common adult intramedullary tumors; however, determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium (FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS (3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging (MRI) at 10 days and 3 months after surgical recovery; McCormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92% (103/112). Ninety-four patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in 18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function (85.8% (91/106)) and movement (84.3% (86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7% (16/24). The McCormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade (I–IV), compared with preoperative classifications (each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.

scholarly journals Early Posterior Vault Distraction Osteogenesis for the Treatment of Syndromic Craniosynostosis

2016 ◽  
Vol 9 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Dana Johns ◽  
Erin Anstadt ◽  
Daniel Donato ◽  
John Kestle ◽  
Jay Riva-Cambrin ◽  
...  
Keyword(s):  
Salt Lake ◽  
Salt Lake City ◽  
Cerebrospinal Fluid Leak ◽  
Cranial Vault ◽  
Intracranial Volume ◽  
Syndromic Craniosynostosis ◽  
Time Period ◽  
Lake City ◽  
Fluid Leak

Posterior cranial vault distraction (PCVD) has become an important modality in the management of complex craniosynostosis to increase intracranial volume and improve the cranial vault appearance. This technique can safely be performed as early as 3 months of age for the initial management of patients with complex craniosynostosis. A retrospective review was performed of all the patients with syndromic, multiple-suture synostosis treated with PCVD at Primary Children's Hospital in Salt Lake City, Utah, between 2012 and 2014. During this time period, a total of nine children with an average corrected age of 21.4 weeks were treated. Demographics, intraoperative data, and postoperative distraction data were collected. Occipital frontal head circumferences (OFCs) were recorded pre- and postdistraction, and at 3- and 6-month follow-up examinations. All patients had a substantial increase in head circumference with subjective improvement of the posterior calvarium shape. The average increase in OFC from preoperative to postdistraction was 4.9 cm. Only two significant postoperative complications were encountered, one hardware infection and one cerebrospinal fluid leak. PCVD is an effective procedure in the management of complex craniosynostosis and can be safely initiated very early in life.

Traumatic Fracture of the Medial Coronoid Process in Two Dogs

1994 ◽  
Vol 07 (04) ◽  
pp. 173-176 ◽  
Author(s):  
J. C. Yovich ◽  
R. A. Read
Keyword(s):  
Coronoid Process ◽  
Surgical Removal ◽  
Elbow Trauma ◽  
Traumatic Fracture ◽  
Elbow Movement ◽  
Long Term Follow Up ◽  
Elbow Function ◽  
One Year

SummaryAcute traumatic fracture of the me-dial coronoid process occurred in two adult dogs. The fracture was the sole injury in one dog, but was associated with further elbow trauma in the other. Surgical removal of the fractured portion of medial coronoid process resulted in a rapid return to normal elbow function which was sustained on long-term follow-up. Radiographs showed some osteophyte formation within the elbow joints at one year postoperatively. Two years later, repeat radiography of the elbow of one of the dogs did not show any further osteophyte production. In contrast, the surgical removal of fragmented coronoid processes frequently results in continuing lameness, reduced range of elbow movement and progressive osteoarthritis.Removal of a traumatically fractured portion of the medial coronoid process in two adult dogs resulted in a rapid return to soundness. Elbow function in both dogs remained normal on long-term follow-up.

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