Chirurgie des Felsenbeins (außer Mittelohr) Tumoren und Pseudotumoren

Stennert, E.; Thumfart, Walter F.

doi:10.1007/978-3-642-83357-1_4

Cited by 8 publications

(9 citation statements)

References 397 publications

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“…After nerve resection, graft ing can be done either immediately or later on. It should be mentioned that the chance of re-innervation decreases over time due to degeneration of the muscle end plates [9,10]. For nerve reconstruction in the facial and neck region, either the greater auricular nerve [11,12] or the suralis nerve can be used [10,13] with similar results.…”

Section: Discussionmentioning

confidence: 84%

Diagnostic and Clinical Outcome of Neurogenic Tumours in the Head and Neck Area

Kempf

Becker²,

Weber

et al. 1995

ORL

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A retrospective analysis of diagnostic procedures and clinical outcome of patients with neurogenic tumours of the head and neck region was performed. There were 25 patients – 16 with neurinoma, 5 with neurofibroma and 4 with neurogenic sarcoma – who presented with a mass in the head and neck area. In 13 patients, the neurinoma originated from the facial nerve, 2 of them were located in the middle ear and mastoid and showed facial palsy. Four patients presented with neurofibromatosis type 1. Twenty-three patients were operated on to remove the tumorous masses. Eighteen tumours were assigned intraoperatively to a cranial nerve main trunk, whereas 7 tumours originated from small branches or showed diffuse growth in neurofibromatosis. All benign neurogenic tumours were removed totally without relapse. One of 2 auricular nerve autografts in middle-ear facial nerve neurinoma resulted in a sufficient muscle tonus of the face. Three patients with malignancies died within 12–24 months showing local recurrencies (n = 1) and/or pulmonary metastasis (n = 2). As expected, neurogenic tumours are unusual neoplasms of the head and neck regions. On the other hand, neurogenic malignancies exhibit diagnostic problems as well as uncertain chances for long-term survival. Tumour staging, determined by extension and critical for treatment decisions, is well evaluated by CT scan and MRI. A multimodal therapy regimen with operation and radiation is recommended for neurogenic sarcoma also when developing in neurofibromatosis. However, in main trunk neurinomas, nerve autografting with interposition is the therapy of choice with a good chance of functional recuperation.

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Section: Discussionmentioning

confidence: 84%

Diagnostic and Clinical Outcome of Neurogenic Tumours in the Head and Neck Area

Kempf

Becker²,

Weber

et al. 1995

ORL

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“…Im petrösen Anteil ist die A.carotis hingegen vollständig in einen stützenden Knochenkanal gebettet, der aneurysmatische Aussackungen verhindert. Malformationen können sich hier nur entwickeln, wenn die Knochenbedeckung der A. carotis interna anlagebedingt atypisch dünn oder resorbiert ist [1,6,9,11,14,18]. Deshalb sind Aneurysmen der petrösen A. carotis interna echte Raritäten.…”

Section: Diskussionunclassified

“…Die klinische Symptomatik leitet sich aus Kompressionseffekten ab und kann Hörstörungen, pulsatilen Tinnitus, Schwindel, Otalgien, aber auch Dysphagien und periphere Facialisparesen beinhalten [1,7,10,[16][17][18][19][20]. Spontanrupturen führen aufgrund der extraduralen Lokalisation der Gefäßmiß- Der Otoskopie kommt zweifelsohne eine Schlüsselfunktion für die rechtzeitige Erkennung der Gefäßmißbil-dung zu.…”

Section: Diskussionunclassified

“…Vor der definitiven Ausschaltung des Aneurysmas ist die sorgfältige, angiographische und ggf. neurophysiologische Analyse der intracerebralen Gefäßversorgung nötig [5,18,20]. In Abhängigkeit von deren Ergebnis kann ein Aneurysma verschlossen werden durch: q intravasale Ballonokklusion q Gefäßclipping q "vascular trapping" (stufenweise Ligatur der A. carotis distal und proximal des Aneurysmas, ggf.…”

Section: Diskussionunclassified

“…Allerdings ist zu betonen, daß klinische Symptomlosigkeit sowohl bei einem Aneurysma als auch bei einem tympanalen Fehlverlauf der A. carotis interna nicht ungewöhnlich ist [3,18]. …”

Section: Introductionunclassified

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Die Aneurysmablutung als Komplikation der Paracentese

Delank

Stoll

Schuierer

et al. 1998

HNO

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Aneurysms of the temporal part of the carotid artery are unusually rare. The literature contains only a few previous reports dealing with hemorrhage from such malformations. In the present case massive bleeding occurred from a right-sided intrapetrous aneurym after myringotomy, which was performed as treatment for bilateral secretory otitis media. Due to the absence of any specific symptoms and the masking effect of middle ear glue preoperative identification of the aneurysm was not possible. Subsequent angiography showed the large fusiform extension of the intrapetrous aneurysm as well as multiple intracranial aneurysms. Leakage from the aneurism was closed definitively with muscle, fascia lata and a gelatin-resorcin-formalin-glue (Cardial). In order to apply the tissue patch the hypotympanic site of the aneurism was exposed using a posterior otosurgical approach. Due to extensive intracranial collateralization to the vertebral arteries bleeding persisted even after ligation of both carotid arteries. Temporary cardiac asystole was then induced to allow safe closure of the aneurysm. Following surgery the patient sustained loss of hearing in her ear and a partial peripheral facial palsy.

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Funktionelle und elektrophysiologische Diagnostik bei Dysphagie

Thumfart¹

1990

Teil I: Referate

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Chirurgie des Felsenbeins (außer Mittelohr) Tumoren und Pseudotumoren

Cited by 8 publications

References 397 publications

Diagnostic and Clinical Outcome of Neurogenic Tumours in the Head and Neck Area

Diagnostic and Clinical Outcome of Neurogenic Tumours in the Head and Neck Area

Die Aneurysmablutung als Komplikation der Paracentese

Funktionelle und elektrophysiologische Diagnostik bei Dysphagie

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