ABSTRACT
The paper presents the results of treatment in 15 cases with non-acoustic parastemal schwannomas, which amounts to 4.3% in this histological subgroup. Among them, there were 7 (2.0%) patients with trigeminal tumors, 5 (1.4%) with facial nerve schwannomas, 3 (0.9%) with schwannomas, which were localized in the jugular foramen. In 4 (57.1%) cases, trigeminal schwannomas were localized in the posterior fossa and in (3.42.9) cases, they spread into the infra- and supratentorial areas. Tumors of the jugular foramen spread extracranially in 2 (66.7%). Their diagnosis was based on clinical intrascopic (computed tomographic and magnetic resonance imaging) data. All the cases had sings of acousticofacial disorders. For tumor removal, the suboccipital retrosygmoid approach was used in 12 cases and combined approaches were applied in 3 cases, including 2 (13.3%) patients in whom schwannomas were removed via two- or three-stage interventions. The anatomic integrity of the cranial nerves adjacent to a tumor was preserved in all the cases. After surgery, their mild or moderate dysfunction that did not lower life quality was observed in most cases. Liquorea and meningitis were seen in 1 (6.7%) case after removal of an extracranial component of trigeminal schwannoma. Radical tumor resection was made in 93.3% of cases. Tumor recurrence was observed in 1 (6.7%) case. There were no fatal cases in a group of the patients operated on. Larger tumors that induce severe deformation of the brain stem should be removed in two steps; this makes it possible to rule out their rapid redislocation that deteriorates the course of an early postoperative period.
Subject(s)
Cranial Nerve Neoplasms/surgery , Neurilemmoma/surgery , Neurosurgical Procedures/methods , Adult , Aged , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neurilemmoma/diagnosis , Neurilemmoma/pathology , Tomography, X-Ray Computed , Treatment Outcome , Trigeminal Nerve/pathology , Trigeminal Nerve/surgeryABSTRACT
On the basis of data in the literature (4 cases) and one case observed by the authors themselves, a clinical characteristics is given of the rarely encountered aneurysm of the middle cerebellar-internal acoustic arteries. In the absence of subarachnoid hemorrhage the aneurysm produces a typical picture of neurinoma of the acoustic nerve. The patient described was operated on with the use of a surgical microscope. Clipping of the aneurysm resulted practically in full recovery of the patient.
Subject(s)
Cerebellum/blood supply , Ear, Inner/blood supply , Intracranial Aneurysm/diagnosis , Neuroma, Acoustic/diagnosis , Adult , Arteries , Audiometry , Brain Neoplasms/diagnosis , Cerebellopontine Angle , Diagnosis, Differential , Diagnostic Errors , Female , Humans , Intracranial Aneurysm/surgery , SyndromeABSTRACT
Spontaneous and experimental vestibular activity in 84 patients after total resection of neurinomas of the acoustic nerve is analysed. In the immediate postoperative period the frequency of marked manifestations of spontaneous vestibular activity reduced sharply, but spontaneous nystagmus persisted in 97.5% of patients. In some patients spontaneous nystagmus to the side from which the tumor had been removed become more conspicuous. In the remote postoperative period spontaneous nystagmus was unilateral in 45.5% of patients, bilateral in 40.3%, and not recorded at all in 14.2% of patients. In the early postoperative period vestibular hyperreflexia was recorded in 93.7% of cases, in the remote period it was found in 76.6% of cases. Data obtained by comparing the results of caloric tests with cold and hot water in these patients are also analysed.
Subject(s)
Neuroma, Acoustic/surgery , Nystagmus, Pathologic/physiopathology , Postoperative Complications/physiopathology , Vestibule, Labyrinth/physiopathology , Adolescent , Adult , Female , Humans , Male , Middle AgedABSTRACT
The analysis is based on the results of a total removal of acoustic neurinomas in 120 patients operated on in 1967-1975. The facial nerve was preserved after surgery in 65 patients (54.2%). In the course of the recent 3 years the employment of microsurgical techniques permitted to preserve the VII nerve in 26 among 35 operated patients (74.3%). Among 103 examined postoperatively 96 retained their full or partial capacity for work (93.2%). Ten patients (8.3%) died after surgery. Within the recent 3 years 35 patients were operated on without a single mortality case.
Subject(s)
Neurilemmoma/surgery , Peripheral Nervous System Neoplasms/surgery , Vestibulocochlear Nerve , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Neurilemmoma/rehabilitation , Peripheral Nervous System Neoplasms/rehabilitation , Postoperative Complications/mortality , Rehabilitation, VocationalABSTRACT
The study was conducted in 3 patients following the application of intracranial facial nerve anastomoses, in 25 patients with the facial nerve anastomosed with the accessory nerve, and in 17 patients with facial-hypoglossal nerve anastomoses. Apart from the clinical observations of the facial muscle contractions, the comparative evaluation of the plastic operations was conducted with the aid of electromyography, electrogustometry and salivary glands secretion studies. The authors concluded that the intracranial anastomosis results in better restoration of the motor function of the facial muscles, the gustation being also partially restored on the side on the intervention. Among the anastomoses of the VII nerve with the XII and XI that with the XII is preferred.
