Intracranial sarcoma in a patient with neurofibromatosis type 2 treated with gamma knife radiosurgery for vestibular schwannoma.

OBJECTIVE: To discuss the possible relationship between stereotactic radiation therapy and the development of a meningosarcoma. STUDY DESIGN: Retrospective case review. PATIENT: A 19-year-old woman with bilateral vestibular schwannomas (neurofibromatosis type 2). One large tumor was removed totally by the translabyrinthine approach; the other smaller tumor was treated with stereotactic radiation (SRT). Six years after SRT, a malignant tumor (meningosarcoma) developed at the exact site of radiation. The patient subsequently died of this tumor. OUTCOME MEASURE: On the basis of literature surveys, the possibility and risk of postirradiation neoplasia after SRT is discussed. Furthermore, the possible causal association between SRT and the development of the meningosarcoma in this case is evaluated. CONCLUSION: On the basis of statistical considerations, the development of the reported mesenchymal sarcoma was most likely caused by the stereotactic radiation therapy.

[First branchial cleft anomaly]. / Første brankialfure anomali.

Anomalies of the first branchial cleft are rare. Two cases of first branchial cleft anomalies are presented. The embryogenesis, diagnosis and surgical management of these lesions are discussed in this paper.

[Prominent ears. Normal distance between the auricular edge and the side of the head]. / Auriculae alatae. Normalafstand mellem aurikelkant og hovedets sideflade.

The desire of the patients or their parents for surgical correction of protruding ears is not always in accord with the degree of deformity. As complications can not only ruin a good result but can make the situation worse, some degree of deformity must be present. In order to achieve some guidance in this evaluation we have measured the maximum distance between the side of the head and the helix border in 102 girls and 81 boys, aged 6-16 years. We found a range of ten to thirty-three. The mean value increased with age, and the distance in males was 2.89 mm greater than that found in females.

[Aspiration of a broken silver cannulas into the trachea]. / Aspiration af knaekket tracheal sølvkanyle.

A case in which a silver cannula broke and was aspirated into the trachea is presented. Examination of the silver cannula in the Institute of Technology in Jutland revealed that the soldering of the throat plate was defective. In addition, the cannula was made of nickel silver plated with silver. It is proposed that only cannulae made of precious metal should be employed and that the construction of cannulae made if precious should be altered e.g. the throat plate could be surrounded with muff a 4-5 mm in height which would provide a greater soldering area and thus increase the strength of the connection. An example of poor soldering with increased risk of breaking is shown so that the stocks of cannulae can be inspected and sorted out.

[Goiter of the tongue base and bilateral perceptive impairment of hearing]. / Struma baseos linguae og bilateral perceptiv hørenedsaettelse.

A women aged 24 years with congenital perceptive impairment of hearing, was referred to an ear, nose and throat department on account of dysphonia. It was found that the only functioning thyroid tissue was in the midline at the base of the tongue. The combination of congenital perceptive impairment of hearing and goitre at the base of the tongue has only been described once previously and was, on that occasion, associated with mental retardation. The present author's patient was of normal intelligence.