Transaxillary Upper Thoracic Sympathectomy

Vascular lesions involving the upper extremities have been treated by different route of upper thoracic sympathectomy with varying success. More recently, the anatomic and physiologic interest for autonomic nervous system has been progressively mounted but the surgical attack has plateau. It may be worthy for academic interest and clinical practice to estimate and to compare with the different surgical method. This paper concerns the treatment of a case suffering from atherosclerotic occlusion whom were treated by upper thoracic sympathetic ganglionectomy through the transaxillary transpleural route. This operation seems to be simpler than other surgical methods with lower morbidity, fewer complication and satisfying results.

A Case of Trigeminal Neurinoma

Trigeminal neurinomas are relatively rare tumors that arise from the sheath of Schwann and constitute 2.9% of intracranial neurinomas and 0.26% of all brain tumors. The most cases are confined to the middle fossa and arising from the Gasserian ganglion. In slight fewer cases the tumor occupy the cerebellopontine angle. In minority it is an hourglass form both situations. By reason of their rarity, the complex clinical problems which may present and the difficult technical aspects involved in their removal, neurinomas of the Gasserian ganglion are of extreme interest. We are reporting a case of trigeminal neurinoma which was arised from the right Gasserian ganglion and located in both situations of middle and posterior cranial fossas. A 37 year-old female was admitted to our department with characteristic symptoms and signs involving many cranial nerves, cerebellum and cerebral peduncle. We chose temporal craniotomy and approached to and exposed the mass by extradural and intradural techniques. Complete removal of the tumor occupying the middle and posterior cranial fossas are accomplished satisfactorily.