Gamma knife radiosurgery in the management of endolymphatic sac tumors

Sinclair, Georges; Al-Saffar, Yehya; Brigui, M; Martin, Heather; Bystam, J.; Benmakhlouf, Hamza; Shamikh, Alia; Dodoo, Ernest

doi:10.4103/sni.sni_312_17

Cited by 8 publications

(1 citation statement)

References 21 publications

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“…The role of radiotherapy (stereotactic or fractionated) is still unclear and has been restricted by the limited available data. Radiotherapy should be considered in tumor recurrence, unresectable tumor, residual disease after subtotal resection, or in poor surgical candidates; in these cases, salvage radiotherapy might have a positive impact in terms of tumor control/tumor progression-free survival 10 .…”

Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

101

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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Section: Advancements and Open Issuesmentioning

confidence: 99%