-
Zhurnal Voprosy Neirokhirurgii Imeni N.... 2024To date, treatment of chordomas involves maximal tumor resection followed by proton therapy. Various approaches are used depending on location of tumor (transcranial and...
UNLABELLED
To date, treatment of chordomas involves maximal tumor resection followed by proton therapy. Various approaches are used depending on location of tumor (transcranial and through natural anatomical openings (nose, mouth), as well as their combinations). Although transoral approach has been introduced into neurosurgical practice for a long time, it is routinely used in patients with chordoma only in certain hospitals in the world.
OBJECTIVE
To analyze postoperative outcomes in patients with chordomas of skull base and craniovertebral joint after transoral surgery.
MATERIAL AND METHODS
We analyzed literature data devoted to patients with chordomas of skull base and craniovertebral joint after transoral surgery or another approach combined with transoral access. Among 111 primary articles, we selected 38 manuscripts including description of 109 patients with skull base chordoma who underwent transoral surgery or combination of approaches including transoral one.
RESULTS
Gross total resection was achieved in 45.9% (=50) of cases including 1 patient after en bloc resection. Subtotal resection was carried out in 28.4% of cases, partial - in 24.8%, biopsy - in 0.9% of cases. The complication rate in this group was 30%. The most common events were swelling of the tongue (10%) and diastasis of posterior pharyngeal wall sutures (8.2%) that required redo surgery. CSF leakage and meningitis were rare (1.8% and 3.6%, respectively).
CONCLUSION
Transoral access allows for gross total resection of midline tumors with low incidence of severe complications. Combination of transoral and transcranial approaches is advisable to increase extent of resection.
Topics: Humans; Chordoma; Skull Base Neoplasms; Female; Neurosurgical Procedures; Male
PubMed: 38881024
DOI: 10.17116/neiro202488031111 -
Oral Oncology Aug 2024
Topics: Humans; Plastic Surgery Procedures; Maxilla; Male; Maxillary Neoplasms; Female; Surgical Flaps
PubMed: 38878354
DOI: 10.1016/j.oraloncology.2024.106893 -
Acta Neurochirurgica Jun 2024Samii Type-D jugular foramen schwannomas (JFSs) are the most challenging for neurosurgeons because of anatomical complexity. Various neurosurgical approaches have been...
BACKGROUND
Samii Type-D jugular foramen schwannomas (JFSs) are the most challenging for neurosurgeons because of anatomical complexity. Various neurosurgical approaches have been described to gain access to JF.
METHODS
We present a female with incidental diagnosis of the Type-D JFS. Complete radical resection was achieved via the carotid triangle approach without any bony structure removal. And the patient was discharged asymptomatic and without new-developed neurological deficits.
CONCLUSIONS
The carotid triangle is a secure and appropriate approach for some cases of selected Type-D JFSs. However, the specific indications of this approach should be further explored and investigated.
Topics: Humans; Female; Neurilemmoma; Jugular Foramina; Microsurgery; Neurosurgical Procedures; Skull Base Neoplasms; Treatment Outcome; Magnetic Resonance Imaging; Middle Aged; Adult
PubMed: 38874622
DOI: 10.1007/s00701-024-06159-y -
Frontiers in Medicine 2024The present case studies report malignant neoplastic and traumatic lesions observed on two ancient Egyptian skulls held at the Duckworth Collection (Cambridge...
The present case studies report malignant neoplastic and traumatic lesions observed on two ancient Egyptian skulls held at the Duckworth Collection (Cambridge University). The analysis aims to characterise the lesions and provide a diagnosis using a methodology based on micro-CT scanning and microscopic bone surface analysis. Results pointed towards neoplastic lesions in both cases and healed severe skull trauma in one of them suggesting successful traumatological therapy. Interestingly, our analysis has identified the presence of perimortem cutmarks associated with metastatic lytic lesions in one of the skulls, indicating a potential surgical treatment attempt or postmortem medical exploration. We argue that the two cases, although not contemporary, allow a palaeopathological discussion on oncological and traumatological understanding and management of such conditions in the past. The confrontation of two potential managements represented by two different types of lesions represent a clear boundary in ancient Egyptian medical care and a milestone in the history of medicine.
PubMed: 38868751
DOI: 10.3389/fmed.2024.1371645 -
Iranian Journal of Pathology 2024Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of...
Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue. Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses.
PubMed: 38864089
DOI: 10.30699/IJP.2023.1989943.3068 -
Cirugia Y Cirujanos 2024This study aimed to investigate the limitations, barriers, and complications in the early transition from the microscopic transsphenoidal approach (MTA) to the endonasal... (Comparative Study)
Comparative Study
OBJECTIVE
This study aimed to investigate the limitations, barriers, and complications in the early transition from the microscopic transsphenoidal approach (MTA) to the endonasal endoscopic approach (EEA) to the skull base in our institution.
METHODS
Technical challenges, as well as clinical features and complications, were compared between MTA, EEA, and mixed cases during the early surgical curve.
RESULTS
The period from the early learning curve was 1 year until the EEA protocol was used routinely. A total of 34 patients registered a resection using a transsphenoidal approach. Eighteen patients underwent EEA, 11 underwent MTA, and five underwent a mixed endonasal and microscopic approach. Non-significant differences were found in endocrine outcomes between the three groups. Patients with unchanged or improved visual function were higher in the EEA group (p = 0.147). Non-significant differences were found in terms of the extent of resection (EOR) between groups (p = 0.369). Only 1 (2.9%) patient in the whole series developed a post-operative CSF leaking that resolved with medical management, belonging to the EEA group (5.5%).
CONCLUSIONS
The early phase of the learning curve did not affect our series significantly in terms of the EOR, endocrine status, and visual outcomes.
Topics: Humans; Female; Male; Learning Curve; Middle Aged; Adult; Pituitary Neoplasms; Aged; Retrospective Studies; Microsurgery; Sella Turcica; Postoperative Complications; Nasal Cavity; Natural Orifice Endoscopic Surgery; Neuroendoscopy; Cerebrospinal Fluid Leak; Endoscopy
PubMed: 38862105
DOI: 10.24875/CIRU.23000079 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024The parapharyngeal space, a complex fascial compartment within the head and neck region, encompasses crucial anatomical structures including blood vessels and nerves.... (Review)
Review
The parapharyngeal space, a complex fascial compartment within the head and neck region, encompasses crucial anatomical structures including blood vessels and nerves. Tumors occurring within this space are rare, with the majority being benign in nature. Surgical intervention remains the primary treatment modality; however, managing parapharyngeal space tumors poses significant challenges due to their intricate anatomical configuration. Conventional open surgical approaches have been associated with significant tissue damage and a high prevalence of postoperative complications. Recently, advancements in anatomical studies and surgical techniques have led to significant progress in understanding parapharyngeal space anatomy and improving surgical management. This article aims to provide a comprehensive overview of these developments.
Topics: Humans; Parapharyngeal Space; Head and Neck Neoplasms
PubMed: 38858121
DOI: 10.13201/j.issn.2096-7993.2024.06.015 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024NUT Carcinoma(NC) is a rare malignant tumor of unknown origin, which is highly aggressive. It is characterized by chromosome rearrangement accompanied by gene. The... (Review)
Review
NUT Carcinoma(NC) is a rare malignant tumor of unknown origin, which is highly aggressive. It is characterized by chromosome rearrangement accompanied by gene. The pathological manifestations were sudden and focal squamous in poorly differentiated or undifferentiated carcinoma. gene rearrangement can be used to diagnose NC. The prognosis of NUT cancer is poor. Clinically, there is no established treatment plan. treatment options mainly comprise surgery, radiotherapy and chemotherapy. A 74-year-old patient with NC of the nasal cavity and sinuses was reported. Her clinical presentation was right nasal congestion with facial swelling. Sinus CT and MRI showed soft tissue density in the right nasal cavity and maxillary sinus with bone destruction. After admission, the patient underwent nasal endoscopic biopsy, and the postoperative pathological FISH staining showed BRD4/NUT fusion t(15, 19). The tumor was significantly reduced after two courses of sequential chemoradiotherapy. Two months later, the patient underwent a partial maxillary resection due to the rapid regrowth of sinusoidal mass, invading the hard palate. The patient died 2 months after surgery due to multiple organ failure resulted from tumor metastasis, with a survival time of 11 months. The clinical characteristics, diagnosis and treatment of this case were reported and related literature was reviewed.
Topics: Humans; Aged; Female; Nasal Cavity; Nose Neoplasms; Neoplasm Proteins; Nuclear Proteins; Oncogene Proteins, Fusion; Carcinoma, Squamous Cell; Fatal Outcome; Carcinoma
PubMed: 38858120
DOI: 10.13201/j.issn.2096-7993.2024.06.014 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor(SFT) in nasal cavity, sinus and...
To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor(SFT) in nasal cavity, sinus and skull base. The clinical data of 12 patients with STF from nasal cavity, sinus and cranial base admitted to the Affiliated Hospital of Qingdao University from April 2014 to January 2022 were retrospectively analyzed, including 4 patients admitted to the department of Otolaryngology head and neck surgery and 8 patients admitted to the department of skull base surgery The clinical characteristics, diagnosis, management and prognosis were analyzed. Twelve patients were included in this research, including 7 males and 5 females. All patients received surgical treatment, and 4 patients also received postoperative adjuvant chemoradiotherapy. After follow-up for 12-60 months, 4 patients with adjuvant radiotherapy and chemotherapy had a good prognosis, and among 8 patients who did not receive radiotherapy and chemotherapy, 6 patients had good prognosis and 2 patients showed relapse. Four patients with a history of recurrence of SFT after surgery were admitted to our hospital for surgical treatment, in which 1 patient had relapse after surgery, and none had metastasis. Nasal cavity and sinus to skull base SFT is rare. The most effective treatment for this disease is surgical resection, and postoperative adjuvant chemoradiation and long-term follow-up can achieve a better prognosis. En bloc resection is the key to treatment success.
Topics: Humans; Male; Female; Nasal Cavity; Solitary Fibrous Tumors; Retrospective Studies; Skull Base Neoplasms; Prognosis; Skull Base; Middle Aged; Neoplasm Recurrence, Local; Nose Neoplasms; Adult; Paranasal Sinus Neoplasms
PubMed: 38858118
DOI: 10.13201/j.issn.2096-7993.2024.06.012 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. The...
To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. The clinical and surgical data of 17 patients with esthesioneuroblastoma who underwent endonasal endoscopic surgery in our department from September 2009 to June 2023 were retrospectively analyzed. Among all patients, the modified Kadish stage B was identified in 4 patients, C in 10 patients, and D in 3 patients. Ten of them underwent endonasal endoscopic surgery without neck dissection in one day, whose average operation time is (5.2±2.5) hours and average blood loss is (192±162)mL. Skull base reconstructions were performed in 15 patients, postoperative complications were observed in 3 patients, and negative margins were obtained in 13 patients. All 17 patients were followed up for an average of (49.7±40.2) months. Three patients died and 6 had recurrence and/or metastasis. The 1-year, 2-year and 5-year overall survival rates were 88.2%, 80.2%, and 80.2%, respectively, and the 1-year, 2-year and 5-year disease-free survival rates were 82.4%, 82.4%, and 50.8%, respectively. The 2-year overall survival rates of patients with negative and positive margins were 100% and 25%, respectively, while the 2-year disease-free survival rates were 61.5% and 25.0%, respectively. Endonasal endoscopic surgery combined with radiotherapy/chemotherapy can achieve satisfactory effect in esthesioneuroblastoma, and the prognosis of patients with positive margins is poor.
Topics: Humans; Esthesioneuroblastoma, Olfactory; Female; Male; Retrospective Studies; Middle Aged; Nose Neoplasms; Adult; Endoscopy; Nasal Cavity; Survival Rate; Treatment Outcome
PubMed: 38858115
DOI: 10.13201/j.issn.2096-7993.2024.06.009