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 221 - 240 de 551
221.
Radiographic Imaging of the Distal Dural Ring for Determining the Intradural or Extradural Location of Aneurysms - Beretta, Federica; Sepahi, Ali Nader; Zuccarello, Mario; Tomsick, Thomas A.; Keller, Jeffrey T.
The effectiveness of several anatomical and radiological landmarks proposed to determine whether an aneurysm is located intradurally or extradurally is still debated. In anatomical and radiological studies, we examined the relationships of the distal dural ring (DDR) to the internal carotid artery (ICA) and surrounding bony structures to aid in the localization of aneurysms near the DDR. Anatomical relationships were examined by performing dissections on 10 specimens (5 formalin-fixed cadaveric heads). After the position of the DDR, optic nerve, and tuberculum sellae were marked with surgical steel wire, radiographs were taken in multiple projections. The only bony landmark consistently visible...
222.
Clinicoradiological and Surgical Considerations in the Treatment of Cholesterol Granuloma of the Petrous Pyramid - Bockmühl, Ulrike; Khalil, Hisham S.; Draf, Wolfgang
We describe a 71-year-old woman who complained of a 1-year history of double vision when looking to the left, numbness over the right cheek, intermittent tinnitus, and gradually increasing unsteadiness when walking. Computed tomography and magnetic resonance imaging revealed a cholesterol granuloma at the right pyramidal apex anterior to the internal auditory canal and a slight compression of the brainstem on the ipsilateral side. For surgical removal we used the transtemporal approach instead of the trans-sphenoidal approach to obtain better control over the internal carotid artery. To avoid the problems of stenting, the resulting dead space was obliterated with fat....
223.
Ameloblastic Carcinoma Arising from Anterior Skull Base - Ozlugedik, Samet; Ozcan, Muge; Basturk, Olca; Deren, Orgun; Kaptanoglu, Erkan; Adanali, Gökhan; Unal, Adnan
Ameloblastic carcinoma (AC) is an aggressive malignant epithelial odontogenic tumor. It may appear de novo or originate from a pre-existing ameloblastoma or odontogenic cyst. To our knowledge, an AC that originates from the anterior skull base has not been reported before in the English literature. We report a case of an AC that originated from the anterior skull base and invaded the dura of the anterior fossa and discuss its clinical course and treatment.
224.
Aggressive Syringomatous Carcinoma of the Orbit - Hasegawa, Shingo; Kohmura, Eiji; Ichinose, Akihiro; Tahara, Shinya; Azumi, Atsushi; Ohbayashi, Chiho; Nibu, Ken-ichi
A 68-year-old woman with an unusual tumor involving the right orbit presented with painful exophthalmos of the right eye. Excision biopsy of her right eyelid was performed. The specimen showed ductal differentiation with comma-like extensions identical to syringoma. Cellular atypia, an invasive growth pattern, and remarkable perineural invasion led to the diagnosis of syringomatous carcinoma. Magnetic resonance imaging showed that the tumor exhibited maxillary involvement, invading the supraorbital fissure and bone of the middle skull base. The patient underwent craniofacial resection and has been alive with no sign of recurrence for 2 years. This case suggests that wide excision of...
225.
Carcinoma of the Breast Metastatic to the Optic Nerve Mimicking an Optic Nerve Sheath Meningioma: Case Report and Review of the Literature - Fox, Benjamin; Pacheco, Paulette; DeMonte, Franco
Isolated metastatic tumors to the optic nerve are extremely rare. We describe a rare and unusual case of metastatic breast carcinoma to the optic nerve that mimicked an optic nerve sheath meningioma in its presentation due to its indolent symptom progression, initial radiological appearance, and minimal growth on serial imaging. The patient, a 46-year-old woman with a history of stable metastatic breast carcinoma, presented with progressive visual loss in her right eye over a 6-month interval. Magnetic resonance imaging revealed an enhancing lesion in the optic canal with an extension to the right anterior clinoid process and planum sphenoidale and...
226.
Craniofacial resection for nonmelanoma skin cancer of the head and neck. Laryngoscope 2005;115:931-937 - Backous, D D.; Demonte, F; El-Naggar, A; Wolf, P; Weber, R S.
Objectives/Hypothesis: We reviewed our experience with craniofacial resection for advanced, nonmelanoma skin cancer of the head and neck to determine prognostic factors, local control rate, disease free survival, morbidity, and mortality.
227.
Determination of the Clinical Growth Index in Unilateral Vestibular Schwannoma - Diensthuber, Marc; Lenarz, Thomas; Stöver, Timo
Objectives: To analyze factors associated with the clinical growth index of sporadic unilateral vestibular schwannoma and to evaluate the validity of the index as an indicator of tumor growth. Design: A retrospective case review study. Patients and methods: A series of 118 patients with unilateral vestibular schwannomas. Clinical growth index was calculated by dividing tumor size by the length of clinical history. Clinical growth index, tumor size, symptoms, and symptom duration were tested for a relationship with tumor location, patient sex, and age. All tests were performed for the total group and separately for three subgroups: intrameatal tumors (IT group,...
228.
Endoscopic Nasal and Anterior Craniotomy Resection for Malignant Nasoethmoid Tumors Involving the Anterior Skull Base - Castelnuovo, Paolo G.; Belli, Evaristo; Bignami, Maurizio; Battaglia, Paolo; Sberze, Federica; Tomei, Giustino
Objectives: The traditional approach to sinonasal tumors involving the skull base has been the anterior craniofacial resection. The first report by Ketcham et al (American Journal of Surgery, 1963;106:698703) documented their experience with 17 anterior craniofacial resections for malignant tumors of the sinonasal tract. Later experience with this technique at several centers has resulted in the publication of many refinements of technique and further reduction in the morbidity and mortality associated with this procedure. In our hands, endoscopic techniques have allowed us to approach the intranasal aspect of skull base lesions without external incisions and yet still achieve an en...
229.
Transzygomatic-Subtemporal Approach for Middle Meningeal-to-P2 Segment of the Posterior Cerebral Artery Bypass: An Anatomical and Technical Study - Ustun, Mehmet Erkan; Buyukmumcu, Mustafa; Ulku, Cagatay Han; Guney, Önder; Salbacak, Ahmet
We evaluated the use of a bypass between the middle meningeal artery (MMA) and P2 segment of the posterior cerebral artery (PCA) as an alternative to an external carotid artery (ECA-to-PCA) anastomosis. Five adult cadaveric heads (10 sides) were used. After a temporal craniotomy and zygomatic arch osteotomy were performed, the dura of the floor of the middle cranial fossa was separated and elevated. The MMA was dissected away from the dura until the foramen spinosum was reached. Intradurally, the carotid and sylvian cisterns were opened. After the temporal lobe was retracted, the interpeduncular and ambient cisterns were opened and...
230.
Cholesteatoma of the Clivus - Fassett, Daniel R.; Kan, Peter; Chin, Steven S.; Couldwell, William T.
Cholesteatomas (central nervous system epidermoids) can be found intradurally or extradurally in the central nervous system. Extradural intraosseous lesions are most commonly found in the petrous bone. The authors describe a unique case of a clival cholesteatoma in a 64-year-old woman who presented with headaches. No other neurological complaints or physical examination findings were noted. Magnetic resonance imaging showed an expansile lesion centered in the middle portion of the clivus. A large portion of the clivus was eroded. The lesion was explored via a transnasal trans-sphenoidal approach and granular debris was evacuated. The cystic lining was stripped from the surrounding...
231.
Endonasal Endoscopic Duraplasty: Our Experience - Castelnuovo, Paolo G.; Delú, Giovanni; Locatelli, Davide; Padoan, Giovanni; Bernardi, Francesca De; Pistochini, Andrea; Bignami, Maurizio
Objective: Endoscopic repair of cerebrospinal fluid (CSF) leaks is a recognized technique. We consider our experience and evaluate the outcomes in patients who underwent endoscopic repair of CSF leaks. Methods: A retrospective case note review of 135 patients who underwent anterior cranial repairs of CSF leaks between August 1995 and December 2004 at a tertiary referral center. We describe the technical details and outcomes of care by purely endoscopic procedures. Results: Thirteen patients had combined transcranial and endonasal repairs and 122 patients had their repairs using an endoscopic approach only. There were 64 males and 71 females with ages that...
232.
Esthesioneuroblastoma: Endonasal Endoscopic Treatment - Castelnuovo, Paolo G.; Delù, Giovanni; Sberze, Federica; Pistochini, Andrea; Cambria, Cristhian; Battaglia, Paolo; Bignami, Maurizio
Objectives: To illustrate endoscopic techniques used in the treatment of esthesioneuroblastoma and to advocate this method of management followed by radiation therapy in selected cases. Methods: A retrospective case series of 10 patients with esthesioneuroblastomas treated between 1999 and 2004 at a tertiary referral center using endonasal techniques. Results: Mean age of patients at presentation was 56.2 years (median 57 years). Seven patients were female and 3 patients were male. Kadish staging at presentation was: A 3 patients, B 5 patients, C 2 patients. Dulguerov stage at presentation was: T1 4 patients, T2 4 patients,...
233.
Endoscopic Endonasal Partial Middle Turbinectomy Approach: Adaptability of the Procedure in a Cadaveric Study and in Surgery for Different Sphenoid Sinus and Skull Base Lesions - El-Banhawy, Omar A.; El-Dien, Abd El-Hafiz Shehab; Zolfakar, Ahmed Said; Halaka, Ahmed N.; Ayad, Heshmat
Objective: To demonstrate the flexibility, adaptability, and efficacy of endoscopic endonasal removal of the inferior half of the middle turbinate in a cadaveric study and in surgery for the treatment of different sphenoid sinus and skull base lesions. Methods: Anatomic Cadaveric Study: Five adult cadaveric heads were studied. Six nostrils of 3 cadavers were studied endoscopically after the lower half of the middle turbinate was removed. Two adult cadaveric heads underwent bilateral paraseptal sagittal sectioning and were studied after the lower half of the middle turbinate was removed. Sixty-five patients with different sphenoid sinus and skull base-related lesions were treated...
234.
Surgical Management of Petroclival Chordomas: Report of Eight Cases - Takami, Toshihiro; Ohata, Kenji; Goto, Takeo; Tsuyuguchi, Naohiro; Nishio, Akimasa; Hara, Mitsuhiro
In the management of skull base chordomas, surgical treatment is essential to achieve long-term control. A petroclival chordoma growing laterally in the skull base is one of the most challenging tumors for neurosurgeons. We have treated petroclival chordomas based on the principle of maximal surgical resection of the tumor with minimal morbidity. Lateral skull base approaches were used to approach petroclival chordomas in eight patients. The surgical procedure involved removal of soft tumor tissue and extensive drilling of adjacent bony structures. Gross total resection of the tumor was achieved in six patients. Subtotal resection in the remaining two patients was...
235.
The Clinical Characteristics of Tinnitus in Patients with Vestibular Schwannoma - Baguley, David M.; Humphriss, Rachel L.; Axon, Patrick R.; Moffat, David A.
Objectives: To review the symptoms, signs, and clinical findings in a large series of patients diagnosed with unilateral sporadic vestibular schwannoma (VS) to describe the clinical characteristics of tinnitus in this population. Further, to ascertain which of the proposed mechanisms of tinnitus generation in VS was supported. Design: Retrospective case note and database review. Setting: Tertiary university teaching hospital departments of audiology and neuro-otology. Participants: Nine hundred forty-one patients with unilateral sporadic VS, diagnosed during the period 1986 to 2002. Twenty-three additional patients were excluded due to missing clinical data. Main outcome measures: The presence or absence of tinnitus, and...
236.
Midfacial Degloving: The Best Alternative for Treatment of Trans-sphenoidal Meningocele of the Pterygopalatine Fossa - Kantas, Ilias; Tzindros, Georgios; Papadopoulou, Anna; Marangos, Nikolaos
Trans-sphenoid anterobasal temporal lobe meningoceles are rare and can be associated with temporal lobe epilepsy or recurrent meningitis. Surgical treatment is described via complicated infratemporal or intracranial approaches with high morbidity. A 32-year-old man presented with an 18-year history of two types of seizures and confirmed epileptic activity in electroencephalogram. A trans-sphenoid meningocele in the left pterygopalatine fossa was found on computed tomography and magnetic resonance imaging. A midfacial degloving was chosen instead of a large neurosurgical approach to remove it and to repair the dura defect with lyophilized dura, collagen, and abdominal fat. The postoperative course was uneventful without...
237.
Conservative Management of Acoustic Neuroma - Al Sanosi, Abdulrahman; Fagan, Paul A.; Biggs, Nigel D.W.
Aim of study: To identify those patients with vestibular schwannoma (acoustic neuroma) in whom treatment becomes necessary. Method: Retrospective chart review. Result: A total of 205 patients with small tumors were followed for a mean of 40.8 months. The longest follow-up was 180 months. One hundred and ninety-seven patients had a follow-up of more than 12 months. Eight patients with a follow-up of less than 12 months were excluded from the study. In 136 patients (66.3%) the tumor did not grow. Forty-seven patients (23.9%) showed some evidence of slow growth. Eight of 197 patients (4%) had rapid growth and 6...
238.
Early Recurrence of an Intracranial Epidermoid Cyst Due to Low-Grade Infection: Case Report - Rutherford, Scott A.; Leach, Paul A.; King, Andrew T.
Intracranial epidermoid cysts are slow-growing lesions, which may recur after incomplete resection, but do so over many years. The authors present the case of an epidermoid that repeatedly recurred over a short period, which was discovered to be secondary to a low-grade bacterial infection. A 30-year-old woman presented with signs and symptoms related to brainstem and cranial nerve compromise from a large cerebellopontine angle epidermoid cyst. She underwent a subtotal excision of a macroscopically and histologically typical epidermoid. The lesion recurred within 1 year of surgery, but with atypical radiological appearances. No systemic or local evidence of infection was found...
239.
Direct Facial-to-Hypoglossal Neurorrhaphy with Parotid Release - Roland Jr, J. Thomas; Lin, Karen; Klausner, Lee M.; Miller, Philip J.
Objective: Facial nerve paralysis or compromise can be caused by lesions of the temporal bone and cerebellopontine angle and their treatment. When the facial nerve is transected or severely compromised and primary end-to-end repair is not possible, hypoglossal-facial nerve anastomosis remains the most popular method for accomplishing three main goals: restoring facial tone, restoring facial symmetry, and facilitating return of voluntary facial movement. Our objectives are to evaluate the surgical feasibility and long-term outcomes of our technique of direct facial-to-hypoglossal neurorrhaphy with a parotid-release maneuver. Design: Prospective cohort. Setting: Academic tertiary care referral center. Patients: Ten patients with facial paralysis...
240.
Unusual Tumors of the Posterior Fossa Skull Base - Kumar, Raj; Wani, Abrar Ahad
Five unusual cases of posterior skull base tumors were treated through different skull base approaches. Two or more staged operations were required to achieve total or near-total excision and decompression of two extensive tumors. Total excision of an extensive en plaque meningioma of the foramen magnum that encircled the brain stem and cervical spinal cord could not be achieved through the extreme lateral and suboccipital craniectomy approach. However, the vital structures were decompressed and the patient's postoperative morbidity was acceptable. An extended middle fossa approach was required to excise a hemangiopericytoma of the middle and posterior fossae in a 12-year-old....
221.
