ABSTRACT
The location of jugular foramen is deep and hidden, and its local anatomical structure is complex, so it can be called "the most complicated foramen of skull base". Most of the tumors in this area are benign or low-grade malignant; currently, radical resection is the main treatment method. However, the surgery in the jugular foramen region is still a ticklish problem in neurosurgery, and there are still many shortcomings in the relevant surgical approaches and methods. This paper reviews the development of anatomical research and surgical approaches in the jugular foramen region, and discusses the advantages and disadvantages of common surgical approaches for tumors in this region, so as to provide references for further clinical anatomical research or improved surgical approaches.
ABSTRACT
The location of the skull base neoplasms are very deep, and the operation is unpredictable. The advent of skull base endoscopic technology has opened up a new surgical path for skull base neoplasms, but it also puts forward higher requirements for preoperative real-time images and detailed pathological anatomy. Obviously, traditional imaging techniques cannot keep up with it. 3D printing is a new stereoscopic rendering technology developed in recent years and applied to the medical field. It can seamlessly integrate, transform and reconstruct multi-modal imaging data such as CT/CT angiography/magnetic resonance imaging of patients into a three-dimensional model. The three-dimensional model is not only stereoscopic, intuitive, but also can display the complex anatomy of the skull base neoplasms and its surroundings point-to-point, and it can also be operated under the preoperative simulated endoscopic operation, so that the endoscopic surgery plan of the skull base neoplasms is more personalized and precise. It will undoubtedly further improve the total tumor resection rate and reduce the surgical side injury. This article reviews the application and progress of current 3D printing technologies in the field of endoscopic surgery of skull base neoplasms.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical features and treatment of skull base osteosarcoma.</p><p><b>METHODS</b>The clinical data of 18 patients with skull base osteosarcoma, who were admitted to the CAMS Cancer Hospital from January 2005 to November 2013, were retrospectively analyzed. The patients were followed up by telephone, outpatient review and other means. Fifteen patients were followed up, 4 cases received surgery only, and 11 cases received surgery with adjuvant chemotherapy and/or radiotherapy. Kaplan-Meier survival curve analysis was used to analyze the clinical data and Log rank method was used for verification.</p><p><b>RESULTS</b>Nine patients died among the 15 patients who were followed up for 3-103 months (mean 25.0 months): seven patients died of local recurrence, and two patients died of distant metastasis, and six patients were still alive. Four patients received surgery only, with a median survival time of 25.0 months, and 11 patients received comprehensive treatment, with a median survival time of 47.0 months (P = 0.02). Five patients received sub-total resection, with a mean survival time of 47.0 months, and 10 patients received total resection, with a mean survival time of 45.0 months (P = 0.37). The 1- and 2-year recurrence rates were 46.6% and 68.9%, respectively. The overall 1-, 2-, 3- and 5-year survival rates were 82.4%, 61.8%, 36.0% and 36.0%, respectively, with a median survival time of 30.0 months.</p><p><b>CONCLUSIONS</b>To compare the long bone and head and neck osteosarcoma with skull base osteosarcoma, the skull base osteosarcoma has a lower total resection rate, a higher recurrence rate, and a poorer prognosis. Radical surgery and comprehensive treatment are appropriate for skull base osteosarcoma.</p>
Subject(s)
Humans , Bone Neoplasms , Diagnosis , Pathology , Therapeutics , Chemotherapy, Adjuvant , Combined Modality Therapy , Kaplan-Meier Estimate , Neoplasm Recurrence, Local , Osteosarcoma , Diagnosis , Pathology , Therapeutics , Retrospective Studies , Skull Base , Pathology , Survival RateABSTRACT
Objective To examine the diagnosis and outcomes in the treatment of the patients with histologically confirmed central neurocytoma (CNC). Methods The data from 71 patients with CNC who were diagnosed between March 2003 and December 2007 were retrospectively evaluated. Various combinations of surgery, and radiotherapy had been used for treatment. Results The average bulk of tumors was 40 cm3. The median follow-up was 22 months. The 22 months overall survival and local control rate was 95.8%(68/71) and 95.6%(65/68), respectively. Conclusions The overall prognosis is favorable although the follow-up is not very long. Surgery and postoperative radiotherapy can significantly improve local control.
ABSTRACT
Objective To analyze and estimate, the treatment of patients with histologically confirmed subependymal giant-cell astroeytoma (SEGCA). Methods The data from 23 patients with SEG-CA who were diagnosed between February 1995 and February 2008 were retrospectively evaluated. Various combinations of surgery and radiotherapy had been used for treatment. Results Total resection was 16 cases, subtotal resection was 7 cases, radiotherapy was 17 cases. The average follow-up time was 53 months.One postoperative SEGCA recurrence. Epilepsy was totally disappeared in 17.6% (3/17), partly disappeared in 47.1%(8/17). All cases survived. Conclusions The key of treatment is total resection. The significance of radiotherapy is not sure. The overall prognosis of SEGCA is favorable.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the factors that affect the curative effect and the best method of treatment for the patients with maxillofacial cavernous hemangiomas.</p><p><b>METHODS</b>102 cases of maxillofacial cavernous hemangiomas were performed DSA examination and taken serial photography. According to the diameter, number and draining speed of efferent veins of the tumor, the cavernous hemangiomas were classified into two types-the high efferent speed and low efferent speed type. For all of them, were randomly performed embolization of efferent veins with absolute ethanol plus bleomycin-A5 intratumor injection (group I) and bleomycin-A5 intratumor injection alone (group II).</p><p><b>RESULTS</b>The cure rate and general effective rate has significant difference (P < 0.01) between two groups in 70 patients with high efferent speed veins, while no significant difference (P > 0.05) in 32 patients with low efferent speed veins.</p><p><b>CONCLUSIONS</b>This new classification is beneficial for seeking method of treatment. The embolization of efferent veins is an effective method for cavernous hemangioma with high efferent speed veins; but for the type with low efferent speed veins, bleomycin-A5 intratumor injection alone could acquire a good results.</p>