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
Background:Preservation of anatomic integrity and function of the cranial nerves during the removal of skull base tumors is one of the most challenging procedures in endoscopic endonasal surgery.It is possible to use ...Background:Preservation of anatomic integrity and function of the cranial nerves during the removal of skull base tumors is one of the most challenging procedures in endoscopic endonasal surgery.It is possible to use intraoperative mapping and identification of the cranial nerves in order to facilitate their preservation.The purpose of this study was to evaluate the effectiveness of intraoperative trigger electromyography in prevention of iatrogenic damage to the cranial nerves.Methods:Twenty three patients with various skull base tumors(chordomas,neuromas,pituitary adenomas,meningiomas,cholesteatomas)underwent mapping and identification of cranial nerves during tumor removal using the endoscopic endonasal approach in Department of Neurooncology of Federal State Autonomous Institution"N.N.Burdenko National Medical Research Center of Neurosurgery"of the Ministry of Health of the Russian Federation from 2013 to 2018.During the surgical interventions,mapping and identification of the cranial nerves were carried out using electromyography in triggered mode.The effectiveness of the method was evaluated based on a comparison with a control group(41 patients).Results:In the main group of patients,44 nerves were examined during surgery using triggered electromyography.During the study,the III,V,VI,VII,and XII cranial nerves were identified intraoperatively.Postoperative cranial nerve deficiency was observed in 5 patients in the study group and in 13 patients in the control group.The average length of hospitalization was 9 days.Conclusion:We did not receive statistically significant data supporting the fact that intraoperative identification of cranial nerves using trigger electromyography reduces the incidence of postoperative complications in the form of cranial nerve deficits(p=0.56),but the odds ratio(0.6)suggests a less frequent occurrence of complications in the study group.Based on our experience,the trigger electromyography methodology appears quite promising and requires further research.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
Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies i...Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy.Results The 3- and 5-year survival rates were 48.8% (20/41) and 35.1% (13/37), respectively, while the 10-year survival rate was 20% (4/20).Conclusions Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.展开更多
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Background:Preservation of anatomic integrity and function of the cranial nerves during the removal of skull base tumors is one of the most challenging procedures in endoscopic endonasal surgery.It is possible to use intraoperative mapping and identification of the cranial nerves in order to facilitate their preservation.The purpose of this study was to evaluate the effectiveness of intraoperative trigger electromyography in prevention of iatrogenic damage to the cranial nerves.Methods:Twenty three patients with various skull base tumors(chordomas,neuromas,pituitary adenomas,meningiomas,cholesteatomas)underwent mapping and identification of cranial nerves during tumor removal using the endoscopic endonasal approach in Department of Neurooncology of Federal State Autonomous Institution"N.N.Burdenko National Medical Research Center of Neurosurgery"of the Ministry of Health of the Russian Federation from 2013 to 2018.During the surgical interventions,mapping and identification of the cranial nerves were carried out using electromyography in triggered mode.The effectiveness of the method was evaluated based on a comparison with a control group(41 patients).Results:In the main group of patients,44 nerves were examined during surgery using triggered electromyography.During the study,the III,V,VI,VII,and XII cranial nerves were identified intraoperatively.Postoperative cranial nerve deficiency was observed in 5 patients in the study group and in 13 patients in the control group.The average length of hospitalization was 9 days.Conclusion:We did not receive statistically significant data supporting the fact that intraoperative identification of cranial nerves using trigger electromyography reduces the incidence of postoperative complications in the form of cranial nerve deficits(p=0.56),but the odds ratio(0.6)suggests a less frequent occurrence of complications in the study group.Based on our experience,the trigger electromyography methodology appears quite promising and requires further research.
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
文摘Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy.Results The 3- and 5-year survival rates were 48.8% (20/41) and 35.1% (13/37), respectively, while the 10-year survival rate was 20% (4/20).Conclusions Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.
