Neurotologic Considerations in the Treatment of Advanced Clival Tumors
| Autor: | LI John, Peter G. Smith, O. Howard Reichman, John P. Leonetti, Ossama Al-Mefty |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Skull Neoplasms Postoperative Complications Clivus Swallowing Humans Medicine Child Radiation treatment planning Aged Diplopia Hypesthesia business.industry Skull Cranial nerves Cranial Nerves Middle Aged Magnetic Resonance Imaging Cranial Nerve Diseases medicine.anatomical_structure Otorhinolaryngology Female Surgery Radiology Brainstem medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | Otolaryngology–Head and Neck Surgery. 107:49-56 |
| ISSN: | 1097-6817 0194-5998 |
| DOI: | 10.1177/019459989210700108 |
| Popis: | Head and neck manifestations of advanced clival tumors result from subtle, yet progressive mass effect or direct involvement of multiple cranial nerves. Misinterpretation of clinical or radiographic findings in these patients may result in inappropriate treatment planning, increased patient morbidity, and probable tumor recurrence. Our combined experience in managing 21 patients with advanced clival tumors has shown that preoperative loss of vision, diplopia, or facial hypesthesia suggests superior parasellar disease. Facial twitching or neurotologic symptoms result from posterior central tumor growth, while inferior extension of disease leads to basal cranial nerve deficits with associated speech, voice, and swallowing dysfunctions. The purpose of this article is to correlate the complex anatomy of the clivus, brainstem, and cranial base and the various neurotologic findings associated with neoplasms in this region. Lateral skull base surgical procedures, based on preoperative clinicoradiographic assessment, will be detailed with particular emphasis on preservation of critical neurovascular structures. |
| Databáze: | OpenAIRE |
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