[Bone and cartilaginous tumours in the sino-paranasal region with intracranial extension. Peculiarities of surgical treatment].

The objective of the present work was to study peculiarities of diagnostics of bone and cartilaginous tumours in the sino-paranasal region with intracranial extension, to substantiate the choice of the strategy and methods for the surgical intervention for the treatment of these neoplasms. The study included 19 patients with various bone and cartilaginous neoplasms in the craniofacial region. Diagnostics was based on computed tomography allowing for 3D reconstruction of the structures of interest, magnetic resonance imaging (with amplification whenever necessary), and angiography. It is proposed to use the microsurgical and pneumatic techniques to ensure the maximally complete removal of the tumours with a minimal injury to the surrounding tissues. The extension of fascial approach is recommended for the management of intracranially spreading tumours. This technique was used for the treatment of 9 patients (7 undergoing anterior craniofacial resection, 1 lateral craniofacial resection, and 1 subcranial resection) in combination with Moure and Denker rhinotomy. The transcranial approach was employed in 8 patients one of whom underwent transoral surgery and another transnasal intervention. Also, the histological structure of the tumours needs to be taken into consideration when planning the approach and the extent of the surgical intervention. It is concluded that preliminary courses of chemo and radiotherapy do not significantly improve the outcome of surgical treatment; in contrast, they promote the development of complications during the postoperative period. The results of this study indicate that for the management of benign tumours characterized by the slow growth rate (osteoma, chondroma, chordoma) the traditional ENT approaches can be supplemented by transcranial surgery. Extensive interventions (anterior craniofacial reseaction, lateral craniofacial resection) are needed for the management of aggressive malignant tumours (ostesarcoma, chondrosarcoma) without serious injury the healthy tissues; moreover, such approach increases the survival rate of the patients.

[Free-radical perodixative reactions in the acute period of craniocerebral trauma]. / Svobodnoradikal'nye perekisno-okislitel'nye reaktsii v ostrom periode cherepno-mozgovoi travme.

The condition is analyzed of the pro-oxidant-antioxidant balance in patients in the acute phase of craniocerebral injury. The higher the degree of craniocerebral injury, the more enhanced are lipid peroxidation processes, the more apparent is the decline in the function of the bodily antioxidant system. Changes in metabolic processes were at their greatest in patients beyond forty four years of age, especially in women with severe craniocerebral injury. The authors recommend including natural and synthetic antioxidants into a complex of measures designed to treat craniocerebral injury.

[The activity of free-radical lipid-peroxidative reactions in the acute and late periods of severe craniocerebral trauma]. / Issledovanie aktivnosti svobodnoradikal'nykh perekisno-okislitel'nykh reaktsii v ostrom i otdalennom periode tiazheloi cherepno-mozgovoi travmy.

Severe craniocerebral injury is shown to result in intensification of processes of lipid peroxidation (LPO), decline in activity of the antioxidant system, which facts lead to further damage to the injured brain caused by products of LPO processes. Activity of LPO processes is recordable as is decline in activity of the antioxidant system after the treatment administered and in 12 and 24 months following the injury sustained as well. The authors recommend that natural and synthetic antioxidants be included into a complex of measures designed to treat severe craniocerebral injury.

[Free-radical and neuroimmune processes in primary and repeated craniocerebral trauma (in an experiment)]. / Svobodnoradikal'nye i neiroimmunnye protsessy pri pervichnoi i povtornoi cherepno-mozgovoi travme (v éksperimente).

The impact of primary and repeated brain injury (BI) (moderate contusion of the brain) on changes of pro- and antioxidative processes in the brain and blood, as well as on the body's neuroimmune responses during 30 days following injury were studied in an experiment on albino rats. The changes in the rate of lipid peroxidation (LPO) were shown to be significantly higher in repeated BI than in primary one. There was no correlation between the changes in the rate of LPO in the blood and in the brain tissue. Immune disorders, namely: the proliferative activity of T and B lymphocytes were slightly milder than in primary BI while in repeated BI, neurosensitization was detectable earlier, which was more pronounced. Thus, goal-oriented correction of free radical processes should be made in the brain and of neuroimmune disorders in BI.