Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome.

BACKGROUND AND PURPOSE: Meningiomas of the upper and middle parts of the clivus and surrounding structures are removed using petrosal approaches: anterior, posterior, combined and complete. The purpose of this study is to show the results of treatment of these meningiomas and to present our interpretation of the treatment strategy. MATERIAL AND METHODS: Twenty-six patients (17 women, 9 men) were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of the treatment. The following measurements and data were collected and recorded: approximate volume of the treated lesion, its relation to large blood vessels, cranial nerves and the brainstem, as well as tumour consistency and vascularisation. RESULTS: Symptoms duration ranged from 1 to 60 months (median: 16 months). In 57.7% of patients, imbalance was the predominant sign. Less frequent symptoms were: head-aches, dysacusis and hemiparesis. Approximate volumes of the tumours ranged from 4 to 65 mL (mean: 32 mL). Total or subtotal resection was achieved in 73.1% of patients. The patients' performance improved postoperatively in 34.5%, remained unchanged in 46.2% and deteriorated in 11.5% of patients. Two (7.8%) patients died after the surgery. CONCLUSIONS: The use of petrosal approaches in the surgical treatment of meningiomas of the upper and middle parts of the clivus and the surrounding structures facilitates good or at least satisfactory neurological outcome with a high proportion of complete resections and relatively low mortality.

[A rare case of the thyroid tissue in the right carotid triangle]. / Rzadki przypadek odszczepionej tkanki tarczycowej umiejscowionej w trójkacie tetnicy szyjnej.

Authors have described a rare case of split of the thyroid tissue in the right carotid triangle in 41 years-old-man. They lay stress on difficulty with making right preoperative diagnosis. A growth in the right carotid triangle was surgically excised, and the microscopic examination of the specimen revealed thyroid tissue with collide goiter. Because this entity cannot be clinically distinguished from the others neck tumors, split of the thyroid tissue should be considered in the differential diagnosis.

[Prosthesis to reconstruction of transmissive system in the middle ear]. / Protezka do rekonstrukcji ukladu transmisyjnego w uchu srodkowym.

Authors have described prothesis to reconstruction of transmissive system in middle ear, which has received using patent no PL 54142 Y1.

[Laryngocele]. / Laryngocoele.

Author present four cases of mixed laryngocoele. Planocellular carcinoma of larynx was recognized at one of the four patients after 17 months from the operation of laryngocoele. A rare case of bilateral laryngocoele described by the authors was found in a woman, who was operated on in 1981 because of the internal laryngocoele at the left side. She was reoperated in 1995 a mixed laryngocoele at the right side was removed.