Carcinoma, Verrucous ; diagnosis ; Humans ; Skull Base ; pathology

OBJECTIVE: Despite advance in the surgical treatment of the skull base lesions, reaching the ventral brain stem is not familiar to us yet. No traditional complex skull base approaches have a value not only in treating complex and unusual skull base pathology but also in providing a better and safer exposure to traditional pathology. However, a more widespread use of these complex skull base approaches is predicated on a clear understanding of the topographical areas of the skull base exposed and on how these complex approaches can improve the exposure afforded by more conventional surgical routes. PATIENTS AND METHODS: The study was performed on 43 surgical dissection with 20 embalmed cadevaric heads in which the cephalic vascular system had been injected with colored silicone material. RESULTS AND CONCLUSIONS: This paper provides an visual anatomical understanding of the areas of the skull base exposed by the approaches examined using the same cues(CT and MRI) that the surgeons use in selecting an approach when confronted with a real lesion and makes them to apply to the clinical situations properly and intimately for the optimal treatment. In addition, with the modular concept, the neurosurgeon may better understand how complex skull base approaches are derived and modified from, and improve the exposure of basic, well known conventional neurosurgical approaches as building block.
Brain Stem ; Head ; Humans ; Pathology ; Silicones ; Skull Base* ; Skull*

An encepholocele is defined as a herniation of cranial contents through a defect in the skull. Encephaloceles are classified accroding to their contents and location. Encephalocele is a useful general term to refer to common features of the various forms of anomaly, but considerable differences exist in the pathology, treatment and prognosis of encephaloceles at each anatomical location. Improved neuroimaging facilities, especially MRI, make it easy not only to detect the encephalocele including its contents and location, but also to get preoperative informations. We have reviewed a total of 22 patients with encephalocele whom we have experienced from 1986, July to 1990, June. Twelve were at occipital location, six at cranial vault, three at cranial base, one at frontoethmoidal location. The size of cranium bifidum and herniating sac of the cranial vault and occipital location is larger than that of frontobasal location. The incidence of associated hydrocephalus is in order of occipital, cranial vault, frontobasal form, and its prognosis is also better in frontobasal form than in occipital of cranial vault form.
Encephalocele* ; Humans ; Hydrocephalus ; Incidence ; Magnetic Resonance Imaging ; Neuroimaging ; Pathology ; Prognosis ; Skull ; Skull Base

Humans ; Nasopharyngeal Carcinoma/pathology* ; Osteoradionecrosis/pathology* ; Skull Base/surgery* ; Nasopharyngeal Neoplasms/pathology* ; Head

Humans ; Nasopharyngeal Carcinoma/pathology* ; Neoplasm Recurrence, Local/pathology* ; Skull Base/surgery* ; Nasopharyngeal Neoplasms/pathology* ; Head

OBJECTIVE: To describe the most appropriate treatment to parapharyngeal space tumors with skull base involved. METHOD: From March 2000 to July 2004, a retrospective review of 36 patients with tumors of parapharyngeal space with skull base involved and treated surgically procedure was performed. Analyze the clinical characteristics of different tumors of parapharyngeal space with skull base involved. To the various tumors in this series, several surgical approaches were selected: the transcervical (n=15) and transcervical-transparotid approaches (n=10) were the most commonly performed surgical procedures followed by the transmaxillary swing approach (n=5), the transmandible swing approach (n= 4), and transorbitozygomatic-middle fossa approach (n=2). RESULT: In the 36 cases, 5 cases were malignant carcinoma and the others (n=31) were benign. All benign tumors in 31 cases had complete resection with no recurrence. Of the 5 patients with malignant tumors, 2 had SCC (squamous cell carcinoma) of nasopharynx infra-mucous membrane with metastasis in the parapharyngeal space and skull base lesions, after the pathologic identification by the surgical management of transcervical approach, both had undergone post-operative radiotherapy, 1 had disease free with a 3-year follow-up; the other after a follow-up of 5 years, was still alive with disease. Of the other 3 patients, 1 patient with the skull base lesions of malignant neurofibroma had recurrence after a 3-year follow-up, died without therapy at the end; 1 with malignant schwannomas and skull base lesions was alive with no evidence of disease after a follow-up of 2 years; 1 patient with mucoepidermoid carcinoma in deep lobe of parotid gland had operation done 3 months ago, was still under followed. In the 36 cases, post-operative hoarseness occurred in 3 cases; Horner's syndrome occurred in 4 cases; 2 patients had glossal deviation, and it had recovered 3 months later. CONCLUSION Different tumors of parapharyngeal space with skull base involved have different clinical characteristics. Therefore, we should depend on its characteristics to choose the most appropriate treatment.
Adult ; Female ; Humans ; Male ; Middle Aged ; Pharyngeal Neoplasms ; pathology ; surgery ; Pharynx ; pathology ; Retrospective Studies ; Skull Base ; surgery ; Skull Base Neoplasms ; pathology ; surgery

UNLABELLED: The patient chiefly complained about headache and facial pain with recurrent epistaxis during the past two months. The pain started from the teeth and intermittent pinching headache especially on the left side. She also had mild epistaxis which healed itself. Later on the epistaxis became severe which couldn't be easily cured. Her nasopharyngoscopy examination showed a mass in nasopharynx while cranial CT scan indicated a huge mass in nasopharynx with erosion of skull base. Enhanced CT scan showed significant thickness in nasopharynx, upwards which became a huge mass breaking through skull base especially on the left side. Adjacent parapharyngeal space and paranasal sinuses and skull base were widely involved with the enlargement of neck lymph nodes. The chronic mastoiditis, ethmoiditis and maxillary sinusitis were also found. DIAGNOSIS nasopharyngeal nonkeratinizing squamous cell carcinoma (T4N2M0 stage IV).
Carcinoma ; Child ; Female ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; pathology ; Skull Base ; pathology

Necrotizing otitis externa is a progressive infectious disease involving the external auditory canal and even the skull base, which can lead to serious complications and even death if not treated in time. In this paper, the latest advances in etiology, pathogenesis, clinical manifestations, diagnosis and treatment were reviewed based on previous literature, providing reference for clinical diagnosis, treatment and future research.
Humans ; Otitis Externa/therapy* ; Skull Base/pathology* ; Ear Canal/pathology* ; Head

A rare case of telangiectatic osteosarcoma of the sphenoid bone was reported. The patient was a 27-year-old male and had suffered from left eye protrusion and diplopia for three months. Radiologically, a lobulated osteolytic lesion was located between sphenoid and left temporal bone. Pathologically, the tumor had multiloculated blood filled cystic vascular spaces and osteoid formation by malignant spindle osteoblast cells. The differential diagnosis of this rare entity from aneurysmal bone cyst was important radiologically and pathologically. This case is the second case of telangietatic osteosarcoma of the sphenoid bone followed by a case of Whitehead RE and Melhem ER in 1998.
Adult ; Aneurysm ; Bone Cysts ; Diagnosis, Differential ; Diplopia ; Humans ; Male ; Osteoblasts ; Osteosarcoma* ; Pathology ; Skull Base* ; Skull* ; Sphenoid Bone ; Temporal Bone

Humans ; Jaw Neoplasms ; pathology ; surgery ; Mouth Neoplasms ; pathology ; surgery ; Pharyngeal Neoplasms ; pathology ; surgery ; Skull Base ; pathology ; surgery