scholarly journals Skull Base Inverted Papilloma: A Comprehensive Review

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-34 ◽  
Author(s):  
Shafik N. Wassef ◽  
Pete S. Batra ◽  
Samuel Barnett

Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts.

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
R. Manes ◽  
William Scott ◽  
Samuel Barnett ◽  
Pete Batra

2021 ◽  
Vol 14 (11) ◽  
pp. e246540
Author(s):  
Ricardo J Fernández-de Thomas ◽  
Natalie Amaral-Nieves ◽  
Orlando De Jesus ◽  
Emil A Pastrana

Sacral spinal cord ependymoma is an uncommon pathology. Most of the reported cases are consistent with a myxopapillary ependymoma histopathologic subtype. Non-myxopapillary ependymomas rarely occur in the sacral region. Most lesions are intradural; however, rare extradural cases can occur. We present the case of a 46-year-old female patient diagnosed with a grade II sacral extradural ependymoma, emphasising the importance of an interdepartmental case approach for diagnosis and management. Even though grade II ependymomas are considered low grade, the potential for recurrence and metastatic disease has been reported. There are no treatment guidelines for these rare tumours besides gross total resection.


2019 ◽  
Vol 54 (6) ◽  
pp. 617-627 ◽  
Author(s):  
Phillip A. Gribble

Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.


Author(s):  
Khoruzhyi S.M. ◽  
Piontkivska O.H.

Purpose. The goal of the article is to empirically study the psychological factors of bullying among adolescents in the school environment.Methods. The following diagnostic tools were used in the study: questionnaire method (author’s questionnaire); methods of diagnosis of acceptance of others; express diagnostics of the level of self-esteem; methods of diagnostics of indicators and forms of aggression by A. Bass and A. Darka (adaptation by A.K. Osnytskyi). The following methods were used to process empirical data: descriptive statistics, correlation and multiple regression analyzes.Results. The authors include the level of self-esteem, aggression, hostility, and acceptance of others among the personal psychological factors and characteristics of bullying among adolescents. The study found that most adolescents have low self-esteem, average acceptance of others with a tendency to low or low, their level of aggression and hostility is equal to the average and in some cases found a high rate of aggression and hostility to others. Correlation analysis revealed a link between others’ self-esteem, self-esteem, and level of aggression. That is, low levels of acceptance of others and low self-esteem are associated with increased levels of aggression and hostility towards others, hostility towards peers, difficulties in establishing friendly relations, envy, unwillingness to work in a group, and so on. An empirical study has found that adolescents who have been involved in bullying, either as a passive observer or as bullies themselves, have the highest levels of hostility. That is why the hostility rate was chosen as a dependent variable for multiple regression analysis in the study of bullying. The results of multiple regression analysis show that adolescents’ hostility is due to low levels of acceptance of others, which is manifested in judgmental, contemptuous or critical attitude towards others, aggression, and inadequate self-esteem.Conclusions. The obtained results show that among the factors of bullying can be distinguished inadequate self-esteem, high levels of aggression, and adolescents’ hostility to their environment.Key worlds: bullying, psychological factors, adolescence, self-esteem, hostility, aggression. Мета статті полягає вемпіричному дослідженні психологічних чинників булінгу серед школярів підліткового віку у шкільному середовищі.Методи. У дослідженні використано діагностичний інструментарій: метод анкетування (авторська анкета); методику діагностики прийняття інших (шкала В. Фейя); експрес-діагностику рівня самооцінки, методику діагностики показників і форм агресії А. Басса й А. Дарки (адаптація А.К. Осницького). Для оброблення емпіричних даних було застосовано описову статистику, кореляційний та мно-жинний регресійний аналізи.Результати. До особистісних психологічних чинників та характеристик булінгу серед школярів підліткового віку автори статті відносять рівень самооцінки, агресивності, ворожості та прийняття інших. У процесі дослідження виявлено, що переважно підлітки мають низький рівень самооцінки, середній рівень прийняття інших із тенденцією до низького або ж низький, їхній рівень агресивності та ворожості дорівнює середньому показнику; в окремих випадках виявлено високий показник агресії і ворожого ставлення до оточення. За допомогою кореляційного аналізу виявлено зв’язок між показником прийняття інших, самооцінкою та рівнем агресії. Тобто низький рівень прийняття інших і низька самооцінка пов’язані зі збільшенням рівня агресії та ворожості до оточення, ворожого ставлення до однолітків, труднощів у налагодженні дружніх стосунків, заздрощів, небажання працювати у групі тощо. За результатами емпіричного дослідження визначено, що серед підлітків, які були причетні до булінгу, у ролі пасивного спостерігача або в ролі самих булерів, найвищі показники за рівнем ворожості. Саме тому показник ворожості обрано за залежну змінну для проведеннямножинного регресійного аналізуу вивченні булінгу. Результати множинного регресійного аналізу свідчать, що ворожість дітей підліткового віку зумовлюється низьким рівнем прийняття інших, що проявляється в осудливому, зневажливому або критичному ставленні до оточення, агресивністю та неадекватним рівнем самооцінки.Висновки. Отримані результати демонструють, що серед чинників виникнення булінгу можна виокремити неадекватну самооцінку, високий рівень агресивності та ворожості підлітків до свого оточення.Ключові слова:булінг, психологічні чинники, підлітковий вік, самооцінка, ворожість, агресія


2019 ◽  
Vol 80 (03) ◽  
pp. e31-e35
Author(s):  
Joshua Prickett ◽  
Juan Altafulla ◽  
Anna Knisely ◽  
Zachary Litvack

Introduction Encephalitis due to Cryptococcus neoformans has been seen almost exclusively in patients with severe compromise of their immune systems, such as acquired immune deficiency syndrome (AIDS). Fungal sinusitis with frank invasion through the cranial base and subsequent seeding of the central nervous system is rare, but should be considered in the differential of patients presenting with meningitis and sinus/skull base lesions even without obvious immune compromise. Improvements in diagnostic testing has increased the ability to correctly identify and new antimicrobials have allowed a condition that once carried a high morbidity and mortality to be managed with better outcomes. We present our treatment algorithm for successful management of an immunocompetent patient with extensive fungal encephalitis due to erosion through the skull base. Case Description The patient is a 59-year-old male presenting unresponsive with sphenoid mass erosive of the skull base and symptoms of meningitis and encephalitis due to C. neoformans. Magnetic resonance imaging (MRI) at presentation demonstrated extensive diencephalic invasion, and a sphenoid mass with erosion of the skull base. Lumbar puncture (LP) confirmed elevated opening pressure of 45 cm H2O, and cultures confirmed infection with C. neoformans. He underwent operative sinonasal debridement followed by placement of an external ventricular drain for management of hydrocephalus. He was treated aggressively with a combination of both intravenous (IV) amphotericin B daily and intrathecal amphotericin B via the ventriculostomy thrice weekly. By the 2nd week of treatment, patient regained consciousness. After 4 weeks of therapy, cerebrospinal fluid (CSF) cultures turned negative, and the external ventricular drain (EVD) was converted to a ventriculoperitoneal shunt (VPS) to manage chronic postinfectious hydrocephalus. We also placed a contralateral Ommaya reservoir to permit continued weekly intrathecal amphotericin B without violation of the shunt valve. With each instillation, the shunt was set to its highest setting to minimize CSF egress for 6 hours then reset to its “drainage” setting. After an additional 6 weeks of outpatient therapy, intrathecal therapy was discontinued. We continued CSF surveillance via Ommaya sampling monthly. At 9-month follow-up, he has remained clinically stable without evidence of recurrent infection. He has residual mild cognitive deficits, but is living semiindependently with his brother. Conclusions Fungal sinusitis is uncommon, especially in those without significantly compromised immune systems. Invasive fungal meningitis resulting in meningitis and encephalitis is even rarer. The condition carries high morbidity and mortality that can only be mitigated with a multidisciplinary effort by neurosurgery, otolaryngology, and infectious disease specialists. While there are no clear treatment guidelines, we present an approach that may permit longer term independent survival.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2092203
Author(s):  
Susanne Flach ◽  
Aaron SJ Ferguson ◽  
Sharon White ◽  
Paul S White ◽  
Jaiganesh Manickavasagam

Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.


2019 ◽  
Vol 6 (3) ◽  
pp. 95-99
Author(s):  
Neethu Gopal ◽  
George K. Vilanilam ◽  
Vivek Gupta ◽  
Prasanna Vibhute ◽  
Alok A. Bhatt

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