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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reconstruction of the anterior cranial base after tumor extirpation must seal off the cranial cavity from the upper respiratory tract. The key to success is to use vascularized materials for the structural support of the brain. From October 1989 to July 1992, 10 patients underwent anterior cranial base reconstruction after basicranial tumor resection; the lesions were four meningiomas and six malignant tumors of the ethmoid, maxilla, and orbit. The malignant tumors included four recurrent tumors that had been previously treated by a transfacial approach. After tumor extirpation, the resultant bony defects in the anterior cranial base, involving the orbital roof as well as the cribriform plate, ranged from 4 x 3 to 6 x 7 cm in size. The materials used in reconstruction were the galeal frontalis myofascial flap and the outer table calvarial bone flap, which is based on the temporoparietal galeal flap. Both materials are known to have rich blood supplies. These flaps make a reliable separation between the cranial cavity and the respiratory tract in three layers: the galeal frontalis myofascial flap, the vascularized calvarial bone, and the temporoparietal galea. Postoperative complications included one subcutaneous hematoma and one temporary cerebrospinal fluid rhinorrhea. We think this reconstructive technique will be useful in selected circumstances, especially after resection of a recurrent malignant tumor.
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PMID:Reconstruction of the anterior cranial base with the galeal frontalis myofascial flap and the vascularized outer table calvarial bone graft. 759 3

We performed in two patients with macroprolactinoma, pituitary scintigraphy with 123 iodine-methoxybenzamide (IBZM), a dopaminergic antagonist that specifically binds to the D2 dopaminergic receptors. In a 34-yr-old woman with basal PRL levels of about 2000 ng/mL, 7.5 mg/day of Bromocriptine (Br) for a month neither reduced PRL levels nor affected tumor size; in this patient single photon emission tomography SPECT failed to show any pituitary accumulation of the tracer. In the other patient, a 27-yr-old man presenting with cerebrospinal fluid rhinorrhea, basal PRL levels were at 5000 ng/mL; magnetic resonance imaging (MRI) demonstrated a huge pituitary tumor, and SPECT showed a very intense concentration of IBZM at the level of the adenoma. PRL levels fell dramatically to 530 ng/mL with only 2.5 mg/day of Br after 4 days; after 6 days with 7.5 mg/day Br, PRL levels were 63 ng/mL, and the patient underwent surgery to correct cerebrospinal fluid leakage. We conclude that, in these two patients, the pituitary scintigraphy with IBZM has given information on the density of dopamine receptors on the adenoma and has correlated with the inhibitory effect of Br on PRL secretion. Whether this tool might be of value in identifying patients with pituitary tumors potentially responsive to Br treatment is still to be investigated.
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PMID:In vivo visualization of pituitary dopaminergic receptors by iodine-123 methoxybenzamide (IBZM) correlates with sensitivity to dopamine agonists in two patients with macroprolactinomas. 762 53

We report a case of mucosal melanoma of the nasal cavity, of amelanotic nature, in a fifty five years old white man. Clinical course started with nasal obstruction and bloodstained rhinorrhea. We want to emphasize the extreme uncommonness of this type of tumor, its bad prognosis, and its difficult diagnosis. The treatment offers long term remission to a limited number of patients. For all these reasons, we have carried out a literature search on this topic and this paper shows the results.
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PMID:[Amelanotic mucous melanoma of the nasal cavity. Report of a case]. 781 12

Nasopharyngeal carcinoma is a tumor that is uncommon in children and adolescents. Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy. The tumor is curable, but late diagnosis makes this possibility much less likely. Diagnosis of this tumor requires a high index of suspicion on the part of clinicians treating the pediatric population.
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PMID:Nasopharyngeal carcinoma: early warning signs and symptoms. 784 56

Bromocriptine therapy for macroprolactinoma induced cerebrospinal fluid (CSF) rhinorrhea in three patients. The tumor had extended well beyond the sella turcica and caused bony erosion in all the cases. All three patients responded to bromocriptine therapy rapidly. CSF fistula occurred concomitantly with the reduction of tumor size and caused meningitis in two of the patients. Withdrawal of bromocriptine resulted in cessation of the leakage. One of the patients underwent transsphenoidal repair. Two patients refused surgery. This potentially lethal complication encountered in these three cases demonstrates the need for close supervision of macroprolactinoma patients with skull base erosion placed under bromocriptine therapy.
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PMID:Bromocriptine-induced cerebrospinal fluid fistula in patients with macroprolactinomas: report of three cases and a review of the literature. 805 28

Cerebrospinal fluid rhinorrhea and otorrhea are rare complications of conservative and medical management of invasive macroprolactinomas. The slow shrinkage of the tumor during therapy is responsible for delayed rhinorrhea and otorrhea which carry the risk of meningitis. The operative procedure for closure of the fistulae is needed. We report the occurrence of CSF rhinorrhea in two patients with macroprolactinoma who were treated by bromocriptine. In one patient the fistulae is surgically treated and the treatment by bromocriptine is maintained. In the other patient the rhinorrhea is associated with otorrhea and the operation is not required because of the massive destruction of skull base. The CSF rhinorrhea and otorrhea stopped after diminution of bromocriptine doses.
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PMID:[Rhinorrhea and otorrhea: rare complications of the medical treatment in invasive prolactinomas]. 808 83

Because of its potentially serious sequelae, cerebrospinal fluid (CSF) leakage following surgery for lesions of the cranial base is given immediate attention by neurosurgeons. Despite a multitude of approaches used to prevent its occurrence, CSF leakage complicates up to 30% of difficult skull-base tumor operations. The authors describe the cases of 11 patients who developed a syndrome, not previously described in the literature, termed "pseudo-CSF rhinorrhea." This syndrome occurs after surgery of the cranial base, usually involving dissection or removal of the petrous or cavernous carotid artery, the greater superficial petrosal nerve, and the pericarotid sympathetic plexus. It is characterized by nasal stuffiness and nasal hypersecretion and is sometimes accompanied by facial flushing. The symptoms are characteristically exacerbated by exertion or by elevated ambient room temperatures. Lacrimation is typically absent ipsilateral to the pseudo-CSF rhinorrhea. It is believed that pseudo-CSF rhinorrhea developed in these patients because of a relative imbalance of the regulatory autonomic supply of the nasal mucosa.
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PMID:Pseudo-cerebrospinal fluid rhinorrhea. 793 38

Cerebrospinal fluid (CSF) leak has been a constant and unresolved complication of acoustic tumor surgery. This study retrospectively reviews 381 primary acoustic tumor surgeries performed by a single, senior, neurotologist and neurosurgeon team from 1979 through 1991. There were 68 cerebrospinal fluid leaks in 66 patients (66/381; 17%). There was no significant difference in the incidence of CSF leak between the translabyrinthine group (21%) and the retrosigmoid transmeatal group (16%). Translabyrinthine leaks were evenly divided between rhinorrhea and the postauricular wound while retrosigmoid transmeatal leaks were predominantly rhinorrhea. Eleven of 14 translabyrinthine wound leaks responded to pressure dressing and suture. The remaining 3 ceased with continuous lumbar cerebrospinal fluid drainage. Ten of 14 cases of translabyrinthine rhinorrhea responded to continuous lumbar cerebrospinal fluid drainage, and those in whom it failed were cured with revision of the mastoidectomy/labyrinthectomy cavity. Twenty-one of 28 cases of retrosigmoid transmeatal rhinorrhea responded to continuous lumbar cerebrospinal fluid drainage, and those in whom it failed were cured with extracranial, transmastoid revision. The incidence of cerebrospinal fluid leak was not influenced by age, sex, size of tumor, postoperative hydrocephalus, or the intraoperative use of autologous fibrin glue. Meningitis was an unusual complication, occurring in 3% of all patients.
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PMID:Cerebrospinal fluid leak following acoustic neuroma removal. 829 55

A split-calvaria osteoplastic rotational flap to repair the anterior fossa floor after tumor excision was devised and tested clinically. At surgery, the flap is outlined between the glabella and the vertex. After the pericranium between the glabella and the flap's anterior pole is elevated to form its pedicle, a full-thickness craniotomy is performed to expose the diploic aspect of the bone graft donor site (when the graft is relatively wide, bifrontal craniotomies may be advantageous). The diploic space is split in situ, taking care to protect the pedicle and its attachments to the osseous segment. Linear osteotomies in the outer table are created to mobilize the flap. With the flap rotated frontally, the craniotomy is completed. After tumor extirpation, the margins of the osseous segment of the flap are shaped to conform to the defect of the anterior fossa floor. Transverse osteotomies are performed so that the graft's convex curve conforms to that of the anterior fossa floor. The flap is then rotated into position. Follow-up evaluation in two patients at 22 and 30 months demonstrated bone integrity of the anterior fossa floor with graft preservation. Transient postoperative cerebrospinal fluid (CSF) rhinorrhea, which occurred in Case 1, was avoided in Case 2 by placing the osseous segment of the graft coplanar with the bone floor of the fossa. Neither patient had late meningitis or CSF rhinorrhea. The split-calvaria osteoplastic rotational flap may represent an advance toward the ideal reconstruction of the anterior cranial fossa floor.
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PMID:Split-calvaria osteoplastic rotational flap for anterior fossa floor repair after tumor excision. Technical note. 781 25

The authors present 2 cases of tumours of third ventricle with intracranial hypertension and cerebrospinal fluid rhinorrhea. The cause of the CSF rhinorrhea most often was thinning of lamina ethmoidalis and dura mater and rarely intussusception of arachnoidea into the intrasellar space in patients with oval orifice for the stalk of pituitary body due to prolonged intracranial hypertension. Efficacious treatment of CSF rhinorrhea comprises not only removing of the tumor but also introducing the valve and in some cases tightening of the base of the anterior and middle fossa.
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PMID:[Two cases of colloid cysts of the third ventricle with nasal rhinorrhea]. 850 51


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