The level of success of neurovascular decompression in ponto-cerebellar angle for hemifacial spasm and trigeminal neuralgia has already established the reality of the pathology to explain such symptoms. However, cochlear nerve compression syndrome by vascular loop is still a controversial topic. We have performed a retrospective cases review with long-term follow-up (5-7 years) concerning the results of microvascular decompression surgery of the cochlear nerve via an endoscopy assisted retrosigmoid approach on 15 patients suffering from unilateral incapacitating tinnitus with abnormal auditory brainstem response and an offending vessel on magnetic resonance imaging. During the surgery, a vascular compression was found on every patient. In a long-term follow-up, 53.3% (8 cases) of our tinnitus cases improved and 20% (3 cases) of them were completely cured. The ABR returned to normal in all patients who had good clinical results (diminished or disappeared tinnitus). When a vertebral artery loop (5 cases) was concerned we obtained 80% of good clinical results. No one showed amelioration or sudden aggravation of their hearing. Three cases required surgical correction of cerebrospinal fluid leak and one case developed spontaneously regressive swallowing problems. Such microvascular decompression surgery of the cochlear nerve appears to be successful in treating incapaciting tinnitus in particular when a vertebral artery loop is observed. Therefore, in such a case, one might recommend neurovascular decompression surgery, keeping in mind that the complications of this surgery should be minimized by a careful closure of the retrosigmoid approach. In order to ensure a better selection of patient more accurate cochlear nerve monitoring and functional MRI should be a promising assessment.
Background: Oropharyngeal cancer is the most common type of head and neck cancers, with a 5-years survival of 64.7%. In the last 40 years risk factors and etiology changed, from the incidence associated mostly with tobacco and alcohol to HPV infection in 70% of the cases. Treatments that are standard of care for OPSCC include chemotherapy, radiotherapy or combination of surgery and radiotherapy have a high chronic treatment-related toxicity and functional loss. These therapies have significant impact on the quality of life (QOL) of survivors of oropharyngeal squamous cell carcinoma (OPSCC). Objectives: The objective of this study is to review literature on 1-year evolution of quality of life of patients treated for OPSCC with standard of care. Methods: A comprehensive search of the literature of treated OPSCC patients assessed with EORTC QLQ-30 EORTC H&N-35 at pre-treatment 12-month post treatment. Results: The first study showed that standard of care treatment produces chronic side effects, such as xerostomia, poor oral and dental health, dysphagia, feeding tube dependency in, and other fibrotic changes likely caused by radiotherapy or combination of surgery and radiotherapy. Conclusions: Standard of care treatment produces chronic side effects, such as xerostomia, poor oral and dental health, dysphagia, feeding tube dependency in, and other fibrotic changes.
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