Cranial base approaches to inaccessible intracranial tumors

Monfared, Ashkan; Agrawal, Sumit; Jackler, Robert K.

doi:10.1097/wco.0b013e3282f1a043

Cited by 7 publications

(6 citation statements)

References 40 publications

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“…Its application in various skull base procedures, either as a sole visualizing tool or as an adjunct to the microscope, is constantly expanding [1]. The endoscope provides superior illumination and magnification, as well as possibility "to look around the corner", thus allowing for more radical but safe surgeries [2].…”

Section: A C C E P T E D Article In Pressmentioning

confidence: 99%

An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

Gerganov

Giordano

Herold

et al. 2010

European Journal of Surgical Oncology (EJSO)

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ARTICLE IN PRESS

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Section: A C C E P T E D Article In Pressmentioning

confidence: 99%

An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

Gerganov

Giordano

Herold

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…In present endoscopic surgery instruments must avoid vital vessels and avert damage to tissue around the wound. 58,59) Here we choose the 0.7 mm needle, which is close to the mainstream diameter endoscope adopt by clinical surgery 60) and we did not observe any side-effect conditions, such as haemorrhage and death. Previous studies suggested that all kinds of trauma could influence neural function in a certain extent.…”

Section: Discussionmentioning

confidence: 99%

Osthole Enhances the Therapeutic Efficiency of Stem Cell Transplantation in Neuroendoscopy Caused Traumatic Brain Injury

Tao

Gao

Yan

et al. 2017

Biological & Pharmaceutical Bulletin

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Neuroendoscopy processes can cause severe traumatic brain injury. Existing therapeutic methods, such as neural stem cell transplantation and osthole have not been proven effective. Therefore, there is an emerging need on the development of new techniques for the treatment of brain injuries. In this study we propose to combine the above stem cell based methods and then evaluate the efficiency and accuracy of the new method. Mice were randomly divided into four groups: group 1 (brain injury alone); group 2 (osthole); group 3 (stem cell transplantation); and group 4 (osthole combined with stem cell transplantation). We carried out water maze task to exam spatial memory. Immunocytochemistry was used to test the inflammatory condition of each group, and the differentiation of stem cells. To evaluate the condition of the damaged blood brain barrier restore, we detect the Evans blue (EB) extravasation across the blood brain barrier. The result shows that osthole and stem cell transplantation combined therapeutic method has a potent effect on improving the spatial memory. This combined method was more effective on inhibiting inflammation and preventing neuronal degeneration than the single treated ones. In addition, there was a distinct decline of EB extravasation in the combined treatment groups, which was not observed in single treatment groups. Most importantly, the combined usage of osthole and stem cell transplantation provide a better treatment for the traumatic brain injury caused by neuroendoscopy. The collective evidence indicates osthole combined with neural stem cell transplantation is superior than either method alone for the treatment of traumatic brain injury caused by neuroendoscopy.

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“…In this analysis, the patterns of recurrence included local (78%), surgical pathway seeding (5%), regional nodal (3%) and/or metastases (20%). Total or near-total resection is accepted as being an important factor for local control of chordomas; however, the aggressive surgical treatment has sometimes been associated with increased patient morbidity and mortality rates [7][8][9] resulting in lower quality of life for survivors. 10 Therefore, the combination of maximal surgical resection within a safe range and optimal post-operative radiotherapy is very important for preventing local tumour recurrence and maintaining patients' performance status (Figure 7).…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4 Although the surgical removal of skull base chordomas remains the mainstay of treatment, complete removal is often difficult because of the location 1,5,6 and aggressive surgical treatment has sometimes been associated with increased patient morbidity and mortality. [7][8][9] Patients with a skull base chordoma who underwent surgery and/or radiotherapy were reported to have a lower quality of life than normal population mainly because of neurological deficits. 10 In addition, even if gross total removal is achieved, the local recurrence rate is high because of common infiltration to the surrounding bony tissue along the lines of least resistance.…”

Section: Introductionmentioning

confidence: 99%

Hyperfractionated high-dose proton beam radiotherapy for clival chordomas after surgical removal

Hayashi¹,

Mizumoto²,

Akutsu³

et al. 2016

BJR

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Yasutaka Hayashi and Masashi Mizumoto contributed equally to this article.Objective: To evaluate the hyperfractionated high-dose proton beam therapy (PBT) for patients with clival chordomas. Methods: Records for 19 patients with pathologically verified clival chordomas treated with surgery followed by hyperfractionated PBT were retrospectively reviewed. The first 9 consecutive patients were treated with 77.44 cobalt gray equivalents (CGEs) in 64 fractions, and the latter 10 patients were treated with 78.4 CGE in 56 fractions. Results: The median follow-up period of all 19 cases was 61.7 months with a range from 31.5 to 115.4 months. At 5 years, the local control, cause-specific and overall survival rates for all 19 cases were 75%, 94% and 83.2%, respectively. Whereas the 5-year local control, cause-specific and over all survival rates of the latter 10 cases were 100%, 100% and 88.9%, respectively, with a median follow-up period of 59.5 months. One of the first nine patients demonstrated bilateral temporal lobe radiation necrosis, who were successfully treated conservatively. In the latter cohort, two cases showed transient neurological symptoms probably due to brain stem ischaemia, but both cases recovered completely with conservative treatment. Conclusion: The hyperfractionated high-dose scheme combined with maximum surgical removal was shown to be efficient for patients with clival chordomas. Advances in knowledge: High-dose proton beam radiotherapy using a hyperfractionation scheme yielded a more favourable outcome than previous reports.

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Cranial base approaches to inaccessible intracranial tumors

Abstract: Operative trajectories created through the cranial base, although technically demanding, have led to substantially improved outcomes for a wide variety of inaccessible intracranial lesions.

Cited by 7 publications

References 40 publications

An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

Osthole Enhances the Therapeutic Efficiency of Stem Cell Transplantation in Neuroendoscopy Caused Traumatic Brain Injury

Hyperfractionated high-dose proton beam radiotherapy for clival chordomas after surgical removal

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