1,721,009 research outputs found
L’impatto delle malformazioni cranio facciali in un grande ospedale pediatrico: “Dall’ambulatorio odontostomatologico alla chirurgia intracranica multi team”
No full textL'ipertensione endocranica e le anomalie cerebrali nelle sindromi cranio facciali complesse: strategie di trattamento
No full textL'ipertensione endocranica e le anomalie cerebrali nelle sindromi cranio facciali complesse
No full textCraniofacial surgery in fibrous dysplasia
No full textCranio-orbital fibrous dysplasia usually causes proptosis, visual loss, ocular motility impairment and cosmetic deformity. The goals of cranial fibrous dysplasia management are to preserve neurological functions and improve cosmesis. Strict neurological and ophthalmological follow-up and early cranio-facial surgery enables non-aggressive treatment without significant morbidity. Furthermore, good results are achieved thanks to new techniques and materials especially in children and adolescents. The aim of the present paper is to discuss surgical indications, techniques and outcomes of cranio-facial-orbital fibrous dysplasia on the basis of personal experience of 14 patients who underwent surgery
Endoscopic sinus and skullbase surgery in pediatric patients during the COVID-19 pandemic
No full text
Endoscopic endonasal skull base surgery in pediatric patients. A single center experience
No full textObject: At present, a minimally invasive endoscopic endonasal approach is considered an efficient option for lesions affecting the anterior and middle skull base with sellar and parasellar region involvement. In this study we will retrospectively analyze the pediatric patients that we have been treating in the same medical center for the past four years, using an endoscopic approach in the skull base. Methods: We performed a retrospective chart and imaging review of pediatric patients who underwent endoscopic endonasal skull base surgery (ESBS) at the Meyer Children's Hospital, (Azienda Ospedaliero Universitaria Meyer), in Florence, from January 2012 to July 2016. Results: Mean age was 12,5 years; 28 (65%) of the 44 patients were females. Skull base lesions were broadly classified as either bony abnormalities (4 cases) or skull base tumors (40 cases). The postoperative clinical follow-up duration ranged from 2 to 36 months. The two more frequently occurring diseases in our study were: craniopharyngioma and pituitary adenoma. Conclusions: After reviewing the international literature about pediatric endoscopic endonasal approach to skull base, we can affirm that our study is the world's second broadest work for number of records. While compiling this report, we have examined the first 40 consecutive pediatric patients to undergo ESBS at our institute. The appearance of postoperative complications is consistent with other international studies, confirming ESBS being feasible and safe even in the pediatric population. Level of evidence: 4
Surgery removes EEG abnormalities in patient with Chiari type I malformation and poor CSF flow
No full textOBJECTIVE: To study the outcome of EEG from patients with Chiari I malformations and nonspecific EEG abnormalities, after posterior fossa decompression and CSF flow normalization.
METHODS: Three 'apparently asymptomatic' children who had been diagnosed with Arnold-Chiari type 1 EEG abnormalities and who exhibited (a) a wide range of abnormalities according to common anatomical Chiari MRI classifications (Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology 1992;183:347-53), (b) a lack of specific, clinical signs of increased intracranial pressure, and (c) apparently unrelated, EEG-nonspecific abnormalities (focal intermittent rhythmic delta activity (IRDA)--solely in patients 1 and 3, and with focal IRDA plus spikes and spike waves of high voltage in patient 2). Standard EEGs were recorded before surgery and within one month of surgery, which was performed in conjunction with intraoperative echo-Doppler ultrasonography to control CSF flow. Subsequent EEGs and clinical follow-ups were performed within 6-12 months of surgery.
RESULTS: In all patients, intraoperative echo-Doppler ultrasonographic control demonstrated poor CSF flow, which was completely restored by posterior fossa decompression. In all patients, the EEG abnormalities disappeared within one month of surgery and the EEGs were normal at follow-up.
CONCLUSIONS: A new CNS symptom, identified as focal IRDA alone or focal IRDA plus spikes and spike waves of high voltage in the EEG, seems to be associated with poor CSF flow in 'apparently asymptomatic' patients with Chiari type I malformations.
SIGNIFICANCE: The identified, paroxysmal EEG abnormalities should be interpreted as an indirect sign of subtle CNS distress.
PMID:16545599[PubMed - indexed for MEDLINE
Management of orbital and brain complications of sinusitis: A practical algorithm.
No full textThe aim of this work was to present a practical management algorithm for orbital and brain complications of sinusitis. According to the inclusion criteria, a sample of 68 patients was collected between 2008 and 2018 (39 males and 29 females). Among them, 44 were adults, with a mean age of 50.46 years, and 24 were pediatric patients, with a mean age of 10.33 years. Oral or intravenous antibiotic therapy was administered to all patients. Pharmacological resolution was observed in 14 cases. Early surgical treatment within 48 hours was necessary in 10 cases. Surgery consisted of abscess drainage, associated or not with functional endoscopic sinus surgery. Delayed surgery within 15–30 days was performed in 44 patients. The core procedure was functional endoscopic sinus surgery. Subsidiary procedures were abscess drainage, tooth extraction or cranial base repair. The combination of two or more of these procedures was case selected. Median follow-up was of 46.36 months. Sinusitis complications necessitate rapid diagnosis and prompt treatment. Antibiotic therapy alone is enough for mistreated rhinosinusitis with no anatomical predisposing factor. Surgery is mandatory for altered nasal and paranasal sinus anatomy or odontogenic infections
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