PubMed Central (PMC3 - NLM DTD)
(2,081,148 recursos)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
Mostrando recursos 141 - 160 de 551
141.
Polymicrobial Osteomyelitis of the Odontoid Process with Epidural Abscess: Case Report and Review of Literature - Haridas, Avinash; Walsh, Daniel C.; Mowle, David H.
Osteomyelitis of the odontoid process is a rare disease and Staphylococcus aureus is the usual causative organism. We present a case caused by a synergistic infection with Staphylococcus aureus and Proteus mirabilis, which has not been reported previously. A high index of suspicion is required for diagnosis, and early institution of broad antimicrobial therapy, including agents active against gramnegative organisms, is mandatory.
142.
An Osteoma of the Middle Ear Presenting with the Tullio Phenomenon - Hornigold, Rachael; Pearch, Ben J.; Gleeson, Michael J.
The Tullio phenomenon is an extremely rare condition in which loud noise induces a brisk vestibular response. Osteomas of the middle ear cleft are also uncommon. We report a patient with an osteoma of the middle ear cleft that became symptomatic with progressive facial palsy and mixed hearing loss. The onset was heralded by the Tullio phenomenon, which she had experienced for 10 years. The differential diagnosis of the Tullio phenomenon and the management of middle ear osteomas are discussed.
144.
Anterior and Posterior Facial Nerve Rerouting: A Comparative Study - Russo, Alessandra; Piccirillo, Enrico; De Donato, Giuseppe; Agarwal, Manoj; Sanna, Mario
The infratemporal fossa type A (IFTA) and the modified transcochlear approach are used to remove glomus jugular tumors type C and petroclival tumors extending to the prepontine cistern, respectively. Anterior rerouting is a key step in IFTA, whereas the modified transcochlear approach involves posterior rerouting. The aim of this study was to analyze facial nerve function after application of the two procedures. One year after surgery, anterior rerouting was associated with excellent to good outcomes (grade I to III) in 94?% of the cases, while posterior rerouting was associated with good outcomes (grade III) in 70?% of the cases.
145.
Microsurgery for Potential Radiosurgical Skull Base Lesions: A Retrospective Analysis and Comparison of Results - Nanda, Anil; Jawahar, Ajay; Sathyanarayana, Satish
The outcomes of 26 complex skull base tumors treated with microsurgery were compared with the outcomes of similar tumors treated with radiosurgery as reported in the literature. The University neurosurgery database was searched for patients who underwent microsurgery for the treatment of skull base tumors between 1990 and 2001 at Louisiana State University Health Sciences Center in Shreveport, Louisiana. Twentysix skull base meningiomas treated by microsurgery by the senior author (AN) were identified retrospectively. On imaging, the tumors were well defined and less than 3 cm in the greatest diameter, making them ideal candidates for a radiosurgical procedure had this...
146.
Endoscopic and Microscopic Extended Subfrontal Approach to the Clivus: A Comparative Anatomical Study - Mortini, Pietro; Roberti, Fabio; Kalavakonda, Chandrasekar; Nadel, Amal; Sekhar, Laligam N.
Ten cadaveric heads fixed and injected were dissected in the operative position. An enlarged subfrontal approach was adopted. The clival bone was drilled as much as possible under direct microscopic vision. Dissection in blind angles was avoided until the clival dura was exposed. The rigid 4mm endoscope (angled 0 degrees and 30 degrees) was secured in a holder so the surgical cavity could be inspected. The residual bone was drilled under endoscopic visualization. The amount of bone removed was measured and compared with that removed under microscopic view. Blind angles in both microscopic and endoscopic views were recorded. The additional...
147.
Surgery of Glomus Jugulare Tumors - Pareschi, Roberto; Righini, Stefano; Destito, Domenico; Raucci, Aldo Falco; Colombo, Stefano
The treatment of choice for glomus jugulare tumors is still controversial. High rates of morbidity, incomplete resection, and the aggressive behavior of these tumors are the main arguments for advocates of primary radiotherapy. However, constant refinements in skull base techniques have made complete resection of these lesions a realistic goal. The high probability of achieving local control of these tumors by surgery has convinced us to support this option strongly. Between 1993 and 2000 we diagnosed 52 glomus tumors of the temporal bone. Of these patients, only 42 had a class C lesion (glomus jugulare) and were included in this...
148.
Primary Malignant Cerebellopontine Angle Melanoma Presenting as a Presumed Meningioma: Case Report and Review of the Literature - Kan, Peter; Shelton, Clough; Townsend, Jeannette; Jensen, Randy
Primary intracranial melanomas are rare, especially in the primary cerebellopontine angle. We describe a patient with a presumed jugular foramen meningioma that was found to be of melanotic origin at surgery. We followed this 26yearold woman with mild ataxia with serial imaging for 18 months after the initial discovery of a cerebellopontine angle extraaxial mass. She developed worsening symptoms of ataxia, dysphagia, and rightsided hearing loss. Magnetic resonance imaging showed an interval increase in size of the mass. The lesion was thought to be a meningioma with a dural tail that extended into the jugular foramen and hypoglossal canal. She...
149.
Skull Base Plasmacytoma in a Patient with Light Chain Myeloma - Ustuner, Zeki; Basaran, Mert; Kiris, Talat; Bilgic, Bilge; Sencer, Serra; Sakar, Burak; Dizdar, Yavuz; Bavbek, Sevil; Onat, Haluk
Skull base involvement of plasmacytoma is reported in a patient with light chain myeloma. A 39yearold man was admitted after experiencing paresthesia on the left side of the face and left arm, intermittent diplopia, and hoarseness for 2 years. Cranial magnetic resonance imaging revealed a large midline mass extending from the middle and posterior skull base into the upper two cervical vertebrae. An extramedullary plasmacytoma associated with light chain multiple myeloma was diagnosed after biopsy of the mass and laboratory investigations. The imaging findings and clinical features associated with this rare site of extramedullary plasmacytoma involvement are reported.
150.
Surgical Treatment of Chiari I Malformation: Simplified Technique and Clinical Results - Pritz, Michael B.
A simplified technique for decompressing the posterior fossa and foramen magnum in symptomatic patients with a Chiari I malformation is described. The approach uses a curvilinear dural incision and an autologous pericranial graft. This procedure was used in 14 symptomatic patients, 8 of whom had a cervical or cervicothoracic syrinx. Neurologic signs and symptoms improved or were unchanged in all patients. The size of the syrinx decreased in all patients. No patient developed a new neurologic deficit, cerebrospinal fluid leak, pseudomeningocele, or infection. Postoperatively, one patient developed new, dysesthetic, unilateral arm pain that did not require medication. This technique has...
154.
Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery - Biglioli, Federico; Mortini, Pietro; Goisis, Mario; Bardazzi, Alessandro; Boari, Nicola
This retrospective study evaluated the safety and efficacy of submental intubation not only for trauma treatment but also for oncological cranial base surgery. The medical records of 24 patients who underwent submental intubation from 1996 to 2002 were reviewed. There were 6 procedures for craniofacial trauma, 12 transmaxillary approaches to the clivus for clivus chordomas, and 6 transmaxillary approaches to the cranial base for chondrosarcomas. Time required for intubation, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred....
155.
Management Strategy for Meningioma in Pregnancy: A Clinical Study - Kanaan, Imad; Jallu, Ashraf; Kanaan, Huda
We retrospectively studied 18 pregnant women from 600 cases of meningioma treated at this Institution between 1986 and 2001. The variables evaluated included clinical presentation; radiological findings; timing and extent of surgical resection; and an overview of gestational, clinical, and surgical outcomes. Visual impairment was the chief complaint followed by headache and seizures. The tumors involved the tuberculum sella (8), sphenoid wing (4), convexity (2), parasellar (2), cerebellopontine angle (CPA) (1), and anterior falx (1). Gross total resection was achieved in 14, and subtotal resection was achieved in two patients. There were no related fetal or maternal deaths. Of seven...
156.
The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects - Newman, Jason; Costantino, Peter; Moche, Jason
We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site. All 3 patients had undergone previous unsuccessful repair of the fistula. Closure of such fistulas requires wellvascularized nonradiated tissue, which can be provided by a unilateral pericranial flap. This flap is flexible, thin, and well suited to the...
157.
Reconstruction of Sphenoid Wing Dysplasia with Pulsating Exophthalmos in a Case of Neurofibromatosis Type 1 Supported by Intraoperative Navigation Using a New Skull Reference System - Friedrich, Reinhard E.; Heiland, Max; Kehler, Uwe; Schmelzle, Rainer
A patient with neurofibromatosis type 1 had pulsating exophthalmos of the right eye with diplopia resulting from severe dysplasia of the sphenoid bone and consecutive herniation of the right temporal lobe. The right orbital tectum was reconstructed with titanium mesh and iliac spongiosa via a lateral orbitotomy using intraoperative navigation. For intraoperative referencing a cortical fixedreference system and a skin scanning laser device were used. Postoperatively, the diplopia was reduced, but the patient asked for further treatment and the procedure was repeated 6 months later. Intraoperatively, the previously implanted titanium mesh was deformed and most of the transplanted bone was...
158.
Primary Intraosseous Skull Base Cavernous Hemangioma: Case Report - Liu, James K.; Burger, Peter C.; Harnsberger, H. Ric; Couldwell, William T.
Primary intraosseous cavernous hemangiomas (PICHs) of the skull base are extremely rare tumors. These lesions are most common in the frontal and parietal bones of the calvarium. The authors describe a 40yearold female who presented with progressive headaches. Serial imaging revealed a contrastenhancing intraosseous lesion of the lateral body of the sphenoid bone and the greater wing associated with encroachment of the inferior cavernous sinus and mild posterior displacement of the cavernous carotid artery. Followup imaging 9 years later revealed slow growth of the lesion. The patient underwent complete excision of the PICH through an extradural frontopolar approach. Pathological examination...
159.
Does Catecholamine Secretion from Head and Neck Paragangliomas Respond to Radiotherapy? Case Report and Literature Review - Hall, Francis T.; PerezOrdonez, Bayardo; MacKenzie, Robert G.; Gilbert, Ralph W.
We report a 38yearold woman with a malignant catecholaminesecreting vagal paraganglioma. In the preceding year she had intermittent severe frontoparietal headaches. While she was receiving radiotherapy (35 Gy in 15 fractions) she developed palpitations, which steadily worsened over the following three years. A repeat CT scan showed no change in the size of the tumor. Urinary catecholamines were elevated and a MIBG scan showed increased uptake in the region of the vagal paraganglioma. She underwent near total resection of her tumor via a Fisch type C approach. Pathological examination showed a paraganglioma with metastasis involving a cervical lymph node. The...
160.
Endoscopic Craniofacial Approach for Intracranial Polyposis: The BlueSky Technique - HarEl, Gady; Todor, Roxanne
Massive sinonasal polyposis associated with skull base dehiscence and intracranial extension is a difficult disease to treat. Conventional transnasal or transfacial techniques can result in dural injury, cerebrospinal fluid (CSF) leak and infection. We describe our experience with a combined neurosurgicalendoscopic technique that protects the meninges. Five patients with massive sinonasal polyposis extending intracranially through skull base dehiscence were reviewed retrospectively. The minimum followup was 2 years. A frontal craniotomy was performed through a bicoronal approach. The dura was carefully separated from all infectious material at the floor of the anterior cranial fossa. The frontal lobe with the intact meninges...
141.
