Результаты поиска

[Primary unrecognized gunshot wound in the frontal skull base].

BACKGROUND: Craniocerebral gunshot wounds demand a high degree of skill in clinical treatment. In addition to painstaking history, modern imaging techniques for preoperative diagnosis and interdisciplinary surgical treatment are important. CASE REPORT: Diagnosis and therapeutic principles are discussed on the basis of a case study of a 21-year-old soldier with an unusual craniocerebral gunshot wound.

The biology and pathology of selected skull base tumors.

This paper describes the pathobiology of some of the more common skull base tumors. In addition to clinicopathologic features, emphasis is placed upon methods of diagnosis utilizing immunoperoxidase stains and molecular markers that may or may not impact upon prognosis.

Cystic schwannoma of the sphenoid sinus and skull base.

Skull base and intracranial cystic schwannomas are rare tumors. To our knowledge, a cystic schwannoma involving the sphenoid sinus has not been previously reported. The location and fluid-filled nature of the lesion resulted in an erroneous preliminary diagnosis of a destructive sphenoid sinus mucocele. Endoscopic biopsy and decompression established the correct diagnosis and reversed a progressive visual loss until definitive surgical removal of the lesion was accomplished. Diagnostic evaluation, histologic findings and management strategies are discussed.

Chondrosarcoma of the skull base: report of six cases.

Five patients with chondrosarcoma, grade I or II, and one with mesenchymal chondrosarcoma of the skull base were treated at our clinic between 1967 and 1991. The patients were three men and three women who ranged in age from 21 to 39 years. The presenting symptoms were diplopia, decreased visual acuity, or symptoms of involvement of VIIIth and lower cranial nerves. The duration of the symptoms ranged from 18 months to 14 years. A plain skull x-ray and tomography of the skull, computed tomographic (CT) scans, and magnetic resonance images (MRI) revealed a calcified mass. Angiograms showed an oc…

Craniofacial resection for tumors involving the anterior skull base.

A consecutive series of 71 patients who underwent craniofacial resection between 1974 and 1990 for tumors that involved the anterior cranial base was reviewed. A variety of histologic diagnoses was present in this series. The most prevalent sites of origin included the nasal cavity, ethmoid sinus, and frontal sinus. Gross tumor removal was achieved in all patients, with 29 requiring orbital exenteration. Adjuvant radiation therapy was used in 25 patients. Two patients died of postoperative complications and 26 had complications that increased morbidity and length of the hospitalization. Five-y

Antimicrobial prophylaxis for fractured base of skull in children.

The details are reviewed of 50 children who were treated over a 10-year period with clinical signs of fractured base of skull. Two patients died early without signs of sepsis--due to the severity of their head injuries. Of the remainder, 23 received antibiotic prophylaxis and 25 did not. One patient from each of these groups developed pneumococcal meningitis, and they were successfully treated. Our results correlate well with those previously published, confirming the low incidence of infective complications with or without prophylaxis. The need to assemble a large enough series to make statis

Modified approach for ethmoid and anterior skull base surgery.

The use of combined craniofacial resection is well established for tumors of the ethmoid bone and the anterior aspect of the base of the skull. Mobilization of the medial fronto-orbital ridge improves the transbasal approach and can be performed with a monobloc bone flap. We describe an en bloc bifrontal craniotomy including the supraorbital ridges and the nasal bones. This provides a wider angle of approach to the anterior aspect of the base of the skull than any other method and avoids retraction of the frontal lobes. This type of bone flap procedure can be performed after a wide periosteal

[Primary malignant melanoma of the base of the skull].

A case of malignant melanoma discovered at the base of the skull is reported in a 52-year-old male. The patient with no previous significant history, complained of headaches. He developed progressive paralysis of the IX, X and XI left cranial nerves and a Claude-Bernard-Horner syndrome. The tumor, discovered at the nervous compartment of the jugular foramen was treated by surgery and radiotherapy. The patient died 27 months after surgery. The absence of other systemic localisations allows to consider this melanoma as primitive. The presence of spindle cell areas in the tumor may suggest the di

Craniofacial resection. An alternative incision and skull base repair.

Neoplasia of the superior group of paranasal sinuses (frontal, ethmoidal and sphenoidal) has an extremely poor prognosis. Resection, preceded or followed by radiotherapy offers a 5 year survival of less than 30% (1). Satisfactory surgical excision has been undermined by difficulties of access to the cribriform plate area, a common site for residual disease. Furthermore the practice of piecemeal removal invariably resulted in inadequate clearance. The craniofacial approach allows not only excellent access to the anterior skull base but also in bloc excision. The results of treating 7 patients w…

[Hormone-active paragangliomas of the base of the skull].

Biochemical examination of 15 patients with paragangliomas (PG) of the base of the skull was conducted. The content of epinephrine, and norepinephrine, dopamine, and dopa in urine and the content of serotonin and histamine in blood and tumor tissue were studied. Comparison of the biochemical findings with the vegetative symptomatology allowed 3 groups of PG to be distinguished: catecholamine-secreting, serotonin-secreting, and hormone-inactive. The group of serotonin-secreting tumors of the base of the skull has not been described in the literature. The conducted research shows that tests for

Transtemporal approach to the skull base: an anatomical study.

The surgical anatomy of a transtemporal approach to the structures of the clivus was defined with the aid of dissections in 10 cadaver heads. The steps in the dissection consisted of first exposing the cervical internal carotid artery (ICA), the internal jugular vein, and the caudal cranial nerves, each at the skull base; then performing small retromastoid and temporal craniotomies; and, finally, drilling away the petrous and tympanic bone to expose the intratemporal parts of the facial nerve, the petrous ICA, the sigmoid sinus, and the jugular bulb. To expose the structures of the lower clivu…

Super-selective angiography and embolization of skull base tumours.

Treatment planning for patients with tumours of the skull requires a true multidisciplinary approach. Super-selective angiography, using a protocol approach, is necessary in building a proper strategy plan for treatment of these lesions. Embolization done by a well trained team has proven to be a valuable adjunct to the various treatment methods and it may eliminate the need for radiation of benign lesions of the base of the skull.

Pectoralis major myocutaneous reconstruction of the anterior skull base.

It was once believed that prognosis for many patients with neoplasms of the anterior skull base was hopeless. Now, however, craniofacial resection of these lesions has been curative for many patients. Massive resections of the anterior skull base pose many potentially life-threatening complications. Cerebrospinal fluid leakage with meningitis is especially troublesome when previous radiation therapy compromises wound healing. In such circumstances local tissue flaps and skin grafting may not provide reliable separation of the brain from the nose. The pectoralis major flap was utilized in eight…

Contralateral orbitopterional approach for anterior skull base meningioma resection.

The authors present the resection of an anterior skull base parasellar meningioma causing vasogenic edema due to compression of the frontopolar vein. A contralateral orbitopterional craniotomy was chosen to provide a minimally invasive approach while avoiding morbidity from a bifrontal approach. Extradural removal of the orbital roof minimized frontal lobe retraction. The infrafrontal corridor enabled identification and preservation of the olfactory and optic nerves, the carotid artery, and the frontopolar vein. Circumferential microsurgical dissection with low-power bipolar coagulation enable…

Multi-Layer Endoscopic Repair of Anterior Skull Base Defects.

Endoscopic endonasal approaches have revolutionized anterior skull base surgery, with multilayer vascularized reconstruction emerging as the gold standard for preventing postoperative cerebrospinal fluid leaks. Compared with free graft or single-layer techniques, multilayer repairs provide watertight closure, address high-flow leaks, and reduce long-term morbidity. The nasoseptal flap remains the primary vascularized option, though alternative flaps and grafts are vital in revision or salvage cases. Success depends on meticulous defect preparation, graft orientation, and material selection tai…

A case of chondromesenchymal hamartoma of the skull base.

Here, we present an unusual case of chondromesenchymal hamartoma limited to the skull base without sinonasal involvement. A 19-year-old man presented with a two-month history of diplopia and right abducens palsy. Imaging revealed a clival mass extending into the right cavernous sinus with central and peripheral calcifications, marked T2 hyperintensity, no restricted diffusion, and a heterogeneous and predominantly peripheral enhancement. Endoscopic endonasal resection was performed, and histopathological examination confirmed a chondromesenchymal hamartoma. The imaging features of chondromesen…

Obesity and Skull Base Manifestations: Clinical Implications and Management.

Obesity has become an important modifier of skull base disease. Although obesity is discussed in the context of obstructive sleep apnea, anesthesia risk, and wound healing, its most important skull base manifestation is often mediated through chronically elevated intracranial pressure. Spontaneous cerebrospinal fluid (CSF) leaks and skull base encephaloceles are now widely recognized as acquired defects that commonly arise in overweight or obese patients with idiopathic intracranial hypertension (IIH). This relationship has direct implications for diagnosis, surgical planning, reconstruction, …

Плазмоцитома черепа-база: систематический обзор терапевтических тенденций.

Фон: Плазмоцитомы основания черепа представляют собой редкие плазменные опухоли клеток, возникающие из кливуса, сфеноидной кости и желудочной апексы, поражающие краниальные нейропатии и сопряженные с высоким риском продвижения к миеломе. Оптимальное управление по-прежнему недостаточно четко определено из-за их редкости. Цель: Цель данного исследования состоит в том, чтобы дать всеобъемлющую характеристику клиническому представлению, стратегиям управления и результатам плазменной плазмы черепа и выявить изменения в литературе. Методы: Был проведен систематический поиск баз данных PubMed, EMBASE

Совпадение в аннотации оригинала
Background: Skull base plasmacytomas are rare plasma cell neoplasms arising from the clivus, sphenoid bone, and petrous apex, presenting with cranial neuropathies and bearing a high risk of progression to multiple myeloma. Optimal management remains poorly defined due to their rarity. Objective: The objectives of this study are to comprehensively characteriz…

Venous factor in surgical management of skull base meningiomas.

UNLABELLED: Skull base venous system is a variable anatomical formation in both health and pathology. Damage to venous structures during surgical treatment of craniobasal meningiomas can lead to formidable postoperative complications, such as hemorrhagic infarctions, cerebral edema and persistent neurological deficit. Despite the improvement of microsurgical techniques, methods of morphological and functional angiography, as well as modeling the mechanisms of compensation for venous hemodynamic disorders, the problem of preventing postoperative venous complications remains relevant. OBJECTIVE…