Objectives Conventional approaches for removal of lateral skull base tumors, including transmandibular, infratemporal fossa, preauricular transzygmatic subtemporal approaches, are major invasive procedures that often ...Objectives Conventional approaches for removal of lateral skull base tumors, including transmandibular, infratemporal fossa, preauricular transzygmatic subtemporal approaches, are major invasive procedures that often sacrifice hearing and cause abnormal occlusion and cosmetic defects. Reports of the transcervical approach for resection of skull base tumors are rare, although it was described for resection of clival chordomas in as early as 1966. The purpose of this study is to review our experiences in management of lateral skull base tumors using the transcervical approach. Study Design Retrospective chart review. Methods Six lateral skull base tumor cases treated with transcervical approach procedures were reviewed, including the medical records. Results There were 4 males and 2 females. Age ranged from 12 through 52 years. Histopathological diagnoses included malignant schwannoma(n = 1), malignant carotid body tumor(n = 1), heamangioma(n=1), schwannoma (n=2) and pleomorphic adenoma (n = 1). Transcervical techniques were used in all cases with the use of microscope in the lateral skull base area. Complete tumor removal was achieved in all cases. Postoperative radiotherapy was implemented in 1 case of malignant schwannoma and 1 case of malignant carotid body tumor. Jugular foramen syndrome occurred as a surgical complication in 1 case of malignant Schwannoma of the vagus nerve. There was no tumor recurrence during the 10 - 42 month follow-up period. Conclusion Compared with conventional approaches, the transcervical approach provides a easy, safe, minimal invasive and effective procedure for removal of selected lateral skull base tumors.展开更多
Objectives:The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied.We quantified long‐term impact of postoperative steroid ir...Objectives:The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied.We quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.Methods:Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected.Preoperative,and 1‐,3‐,6‐,12‐,18‐,and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were assessed.Results:A total of 727 patients were assessed (53.4% males),with 479 patients in the no SI group and 248 patients in the SI group.Preoperative SNOT‐22 scores did not differ significantly (P = 0.19).1‐,3‐,6‐,12‐,18‐,and 24‐month post‐op SNOT‐22 scores did not significantly differ between groups.However,mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P < 0.01) and saline (P = 0.03).Conclusions:Though corticosteroid irrigations are routine in managing inflammatory sinus disease,their role in postoperative management after ESBS for tumors is unclear.Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.展开更多
Recurrent ameloblastoma is common following inadequate excision but rarely presents in the anterior skull base. We presented 3 patients with recurrent ameloblastoma in the anterior skull base including the frontotempo...Recurrent ameloblastoma is common following inadequate excision but rarely presents in the anterior skull base. We presented 3 patients with recurrent ameloblastoma in the anterior skull base including the frontotemporal fossa and the pterygomaxillary fossa that occurred following multiple enucleations, segmental mandibulectomy, or partial maxillectomy for ameloblastoma in the jaws. Attenborough approach was used in the exposure of the frontotemporal fossa. Attenborough plus Barbosa approach was used in the exposure of the pterygomaxillary fossa. The patients were treated by radical dissection. Microscopy confirmed that the histopathologic pattern of one case was fixed follicular and plexiform, two cases were follicular. All patients healed without serious complications. The local recurrences of the patients following the operations were found in 3 to 4 years. The present study showed that the tumors in the regions had a greater recurrence potential even when treated with radical dissection, and the original tumors were the high-risk follicular pattern.展开更多
目的探究并分析神经内镜治疗颅底肿瘤的应用效果。方法回顾性选取2019年1月—2021年1月贵阳市第二人民医院收治的50例颅底肿瘤患者的临床资料进行分析,根据治疗方式的差异性进行分组,将采取传统开颅手术治疗的患者(25例)纳入对照组,将...目的探究并分析神经内镜治疗颅底肿瘤的应用效果。方法回顾性选取2019年1月—2021年1月贵阳市第二人民医院收治的50例颅底肿瘤患者的临床资料进行分析,根据治疗方式的差异性进行分组,将采取传统开颅手术治疗的患者(25例)纳入对照组,将采取神经内镜治疗的患者(25例)纳入观察组,对比两组患者的治疗效果。结果观察组的临床治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分为(9.22±0.12)分高于对照组的(8.41±0.11)分,差异有统计学意义(t=24.879,P<0.05)。术前,两组炎性因子水平相比,差异无统计学意义(P>0.05)。术后,观察组炎性因子水平低于对照组,差异有统计学意义(P<0.05)。两组全切除率、复发率相比,差异无统计学意义(P均>0.05)。两组不良反应发生率相比,观察组更低,差异有统计学意义(P<0.05)。结论与传统开颅手术相比,神经内镜针对于颅底肿瘤的治疗效果更高,预后改善效果更好,同时能改善体内炎性因子水平,安全性更高。展开更多
Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods:...Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods: Ten cases were operated by the approach. Among them, 4 suffered from benign meningeomas, 6 with malignant tumors included one chondrosarcoma, two malignant meningeomas, two olfactory neuroblastomas, and one squamous sarcoma. Of the patients, 4 cases had primary tumor and 6 cases had recurrent tumors. Result: All of the ten cases underwent operation and no postopertion complication occurred. 7 cases have survived for one to four years without tumor recurrence. 3 cases with malignant tumor died of tumor relapse in one to two years. Conclusion: This method significantly has helped to reduce the persistence and recurrence of the disease.展开更多
The skull base communicating tumor is characterized by simultaneous invasion of the intracranial and extracranial structures. The tumor may originate from the intracranial structures and invade extracranially, or vice...The skull base communicating tumor is characterized by simultaneous invasion of the intracranial and extracranial structures. The tumor may originate from the intracranial structures and invade extracranially, or vice versa. The total resection of the tumor is difficult, and a lot of complications may occur after the operation.1 From September 1998 to September 2002, 21 patients with skull base communicating tumors were treated in our hospital by endoscope-assisted combined with diode laser through approaches. microneurosurgery different operative展开更多
文摘Objectives Conventional approaches for removal of lateral skull base tumors, including transmandibular, infratemporal fossa, preauricular transzygmatic subtemporal approaches, are major invasive procedures that often sacrifice hearing and cause abnormal occlusion and cosmetic defects. Reports of the transcervical approach for resection of skull base tumors are rare, although it was described for resection of clival chordomas in as early as 1966. The purpose of this study is to review our experiences in management of lateral skull base tumors using the transcervical approach. Study Design Retrospective chart review. Methods Six lateral skull base tumor cases treated with transcervical approach procedures were reviewed, including the medical records. Results There were 4 males and 2 females. Age ranged from 12 through 52 years. Histopathological diagnoses included malignant schwannoma(n = 1), malignant carotid body tumor(n = 1), heamangioma(n=1), schwannoma (n=2) and pleomorphic adenoma (n = 1). Transcervical techniques were used in all cases with the use of microscope in the lateral skull base area. Complete tumor removal was achieved in all cases. Postoperative radiotherapy was implemented in 1 case of malignant schwannoma and 1 case of malignant carotid body tumor. Jugular foramen syndrome occurred as a surgical complication in 1 case of malignant Schwannoma of the vagus nerve. There was no tumor recurrence during the 10 - 42 month follow-up period. Conclusion Compared with conventional approaches, the transcervical approach provides a easy, safe, minimal invasive and effective procedure for removal of selected lateral skull base tumors.
文摘Objectives:The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied.We quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.Methods:Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected.Preoperative,and 1‐,3‐,6‐,12‐,18‐,and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were assessed.Results:A total of 727 patients were assessed (53.4% males),with 479 patients in the no SI group and 248 patients in the SI group.Preoperative SNOT‐22 scores did not differ significantly (P = 0.19).1‐,3‐,6‐,12‐,18‐,and 24‐month post‐op SNOT‐22 scores did not significantly differ between groups.However,mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P < 0.01) and saline (P = 0.03).Conclusions:Though corticosteroid irrigations are routine in managing inflammatory sinus disease,their role in postoperative management after ESBS for tumors is unclear.Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.
文摘Recurrent ameloblastoma is common following inadequate excision but rarely presents in the anterior skull base. We presented 3 patients with recurrent ameloblastoma in the anterior skull base including the frontotemporal fossa and the pterygomaxillary fossa that occurred following multiple enucleations, segmental mandibulectomy, or partial maxillectomy for ameloblastoma in the jaws. Attenborough approach was used in the exposure of the frontotemporal fossa. Attenborough plus Barbosa approach was used in the exposure of the pterygomaxillary fossa. The patients were treated by radical dissection. Microscopy confirmed that the histopathologic pattern of one case was fixed follicular and plexiform, two cases were follicular. All patients healed without serious complications. The local recurrences of the patients following the operations were found in 3 to 4 years. The present study showed that the tumors in the regions had a greater recurrence potential even when treated with radical dissection, and the original tumors were the high-risk follicular pattern.
文摘目的探究并分析神经内镜治疗颅底肿瘤的应用效果。方法回顾性选取2019年1月—2021年1月贵阳市第二人民医院收治的50例颅底肿瘤患者的临床资料进行分析,根据治疗方式的差异性进行分组,将采取传统开颅手术治疗的患者(25例)纳入对照组,将采取神经内镜治疗的患者(25例)纳入观察组,对比两组患者的治疗效果。结果观察组的临床治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分为(9.22±0.12)分高于对照组的(8.41±0.11)分,差异有统计学意义(t=24.879,P<0.05)。术前,两组炎性因子水平相比,差异无统计学意义(P>0.05)。术后,观察组炎性因子水平低于对照组,差异有统计学意义(P<0.05)。两组全切除率、复发率相比,差异无统计学意义(P均>0.05)。两组不良反应发生率相比,观察组更低,差异有统计学意义(P<0.05)。结论与传统开颅手术相比,神经内镜针对于颅底肿瘤的治疗效果更高,预后改善效果更好,同时能改善体内炎性因子水平,安全性更高。
文摘Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods: Ten cases were operated by the approach. Among them, 4 suffered from benign meningeomas, 6 with malignant tumors included one chondrosarcoma, two malignant meningeomas, two olfactory neuroblastomas, and one squamous sarcoma. Of the patients, 4 cases had primary tumor and 6 cases had recurrent tumors. Result: All of the ten cases underwent operation and no postopertion complication occurred. 7 cases have survived for one to four years without tumor recurrence. 3 cases with malignant tumor died of tumor relapse in one to two years. Conclusion: This method significantly has helped to reduce the persistence and recurrence of the disease.
基金Zhejiang Province Intensive Generalized Project for Medicine Scientific and Technological Production (No. 2005TG012)
文摘The skull base communicating tumor is characterized by simultaneous invasion of the intracranial and extracranial structures. The tumor may originate from the intracranial structures and invade extracranially, or vice versa. The total resection of the tumor is difficult, and a lot of complications may occur after the operation.1 From September 1998 to September 2002, 21 patients with skull base communicating tumors were treated in our hospital by endoscope-assisted combined with diode laser through approaches. microneurosurgery different operative
