phenylephrine-hydrochloride and Glioma

These tumours are rare, benign abnormalities including dermoids, gliomas and encephaloceles that result from aberrant embryologic development. They can cause severe deformity of the midface and nasal structures and may have an intracranial extension that requires neurosurgical consultation. Thus preoperative manipulations, i.e. biopsies, are contraindicated as it can lead to cerebrospinal fluid leak and meningitis. The treatment is surgical excision and should be performed early. Neuroimaging is essential in the evaluation of specific type, presence of intracranial extension and presurgical planning.

Topics: Biopsy; Child, Preschool; Contraindications, Procedure; Dermoid Cyst; Encephalocele; Glioma; Humans; Magnetic Resonance Imaging; Male; Nose; Nose Neoplasms

This paper focuses on the diagnosis and management of developmental anomalies of the skin that may be seen early in life. Common locations include the head, nose, preauricular area of the face, neck, and spine. Those that occur in or near the midline can be more serious because of possible intracranial connections. Radiologic imaging of the areas of involvement is often important; computed tomography (CT) scans can delineate bony defects; whereas, magnetic resonance imaging (MRI) more clearly defines intracranial connections. Occult spinal dysraphism can be suspected when certain cutaneous signs are present.

Topics: Choristoma; Dermoid Cyst; Ectodermal Dysplasia; Encephalocele; Female; Glioma; Humans; Infant; Infant, Newborn; Limb Deformities, Congenital; Male; Neck; Nose; Scalp Dermatoses; Spine; Thyroglossal Cyst

Midline congenital lesions are rare and commonly comprise nasal dermoids (NDs), encephaloceles, and gliomas. This article discusses the epidemiology of NDs. Management is also discussed, as well as prognosis.

Topics: Dermoid Cyst; Diagnosis, Differential; Encephalocele; Endoscopy; Glioma; Humans; Meningocele; Nose; Nose Neoplasms; Skull Base; Tomography, X-Ray Computed; Treatment Outcome

Topics: Glioma; Humans; Nose; Nose Diseases; Pharynx; Respiratory System Abnormalities

We previously developed a nose-to-brain delivery system using poly(ethylene glycol)-polycaprolactone block polymeric micelles modified by a cell-penetrating peptide, Tat (PEG-PCL-Tat). This system showed excellent delivery of the anti-cancer drug camptothecin to the brain and improved therapeutic efficacy in a brain tumor model. However, improvements are necessary to selectively deliver drugs to tumor sites once they enter the brain, and avoid toxic side effects to normal brain tissue. In this study, to develop tumor-selective novel polymeric micelles, mixed micelles consisting of Tat-conjugated polymer micelles and stearoyl-modified bombesin (Bom/PEG-PCL-Tat) were designed. The GRPR selectivity, cellular uptake, and cytotoxicity in C6 glioma cells as well as the intracerebral drug distribution and therapeutic efficacy of Bom/PEG-PCL-Tat mixed micelles after intranasal administration in C6 glioma orthotropic grafted rats were evaluated. Selective cellular uptake and marked cytotoxic effects against GRPR-expressing C6 glioma cells were observed, as well as C6 tumor tissue-specific accumulation in vivo. Rats treated with camptothecin subsequent to a brain tumor graft survived longer when the drug was delivered by Bom/PEG-PCL-Tat mixed micelles than by PEG-PCL-Tat micelles.

Topics: Administration, Intranasal; Animals; Antineoplastic Agents; Bombesin; Brain; Brain Neoplasms; Camptothecin; Cell Line, Tumor; Cell-Penetrating Peptides; Drug Carriers; Glioma; Ligands; Male; Micelles; Nanoparticles; Nose; Particle Size; Polyesters; Polyethylene Glycols; Polymers; Rats; Rats, Sprague-Dawley

Primary watertight dural closure is the preferred method of postcraniotomy dural repair. However, even when ideal technique is implemented, postoperative infection, cerebrospinal fluid (CSF) leaks, pseudomeningoceles, and dural scarring are possible complications. For this reason, materials that augment the dura's ability to create a watertight seal, prevent disease transmission, and inhibit inflammatory response are sought. Dehydrated amniotic membrane (DAM) allograft appears to fulfil these requirements as it has several beneficial properties that aid wound healing, including promotion of epithelialization, scar tissue prevention, and inhibition of bacterial growth. We provide the literature's first description of the use of DAM allograft to supplement dural closures for craniotomies and transsphenoidal surgeries.. We conducted a pilot study, retrospectively reviewing our institution's database of craniotomies and transsphenoidal surgeries that utilized DAM to augment dural closure.. One hundred fifty-five cases, including 102 new craniotomies for supratentorial lesions, one re-do craniotomy for supratentorial recurrent glioma, 18 craniotomies for infratentorial lesions, 1 craniotomy for anterior skull base schwannoma, 32 transphenoidal surgeries, and 1 combined craniotomy and transnasal endoscopic surgery, used DAM allograft to augment dural closure. Only one complication occurred (0.6% complication rate), which was a superficial wound infection requiring washout without craniectomy. No CSF leaks occurred.. This pilot study demonstrates that dehydrated amniotic membrane allograft can be safely utilized as an adjunct during dural closures for craniotomies and transsphenoidal surgeries.

Topics: Adult; Aged; Aged, 80 and over; Allografts; Amnion; Brain Neoplasms; Cerebrospinal Fluid Leak; Cerebrospinal Fluid Rhinorrhea; Craniotomy; Dura Mater; Endoscopy; Female; Glioma; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neurilemmoma; Nose; Pilot Projects; Postoperative Complications; Reoperation; Retrospective Studies; Skull Base Neoplasms; Supratentorial Neoplasms; Wound Closure Techniques; Young Adult

Intramuscular lipomas are rare, benign, mesenchymal tumors occurring deep in the fascia, typically involving large muscle groups in adults. We report a case of an intramuscular lipoma occurring as a subcutaneous midline nasal mass in a 3-month-old infant. The differential diagnosis of a midline mass on the glabella of an infant is important and should include developmental anomalies such as nasal glioma, nasal dermoid cyst, and encephalocele, so neuroimaging is an essential first step in evaluating these lesions to exclude intracranial extension.

Topics: Biopsy, Needle; Dermoid Cyst; Diagnosis, Differential; Encephalocele; Follow-Up Studies; Glioma; Humans; Immunohistochemistry; Infant; Lipoma; Male; Neuroimaging; Nose; Risk Assessment; Skin Neoplasms; Subcutaneous Tissue; Tomography, X-Ray Computed; Treatment Outcome

The collection of the greatest possible amount of pathologic tissue is of paramount importance in neurosurgery to achieve the most accurate histopathologic diagnosis, to perform all of the necessary biomolecular tests on the pathologic specimen, and to collect biological material for basic or translational science studies. This problem is particularly relevant in pituitary surgery because of the possible small size and soft consistency of tumors, which make them suitable for removal through suction, reducing the amount of available pathologic tissue. To solve this issue, we adopted a filter connected to the suction tube, which allows the surgeon to collect all of the tissue aspirated during surgery.. Our experience of 1734 endoscopic endonasal procedures, performed adopting this device since 1998 to December 2015, has been revised to assess its advantages and limitations.. This system is easy-to-use, does not impair the surgical maneuvers, and does not add any relevant cost to the surgery. The tissue collected through the filter proved useful for diagnostic histologic and biomolecular analyses and for research purposes, without any relevant artifacts as a result of this method of collection.. The use of a filter has allowed us to obtain the greatest amount possible of pathologic tissue at each surgery. This surgical material has revealed to be helpful both for diagnostic and basic science purposes. The use of the filter has proven to be of particular importance for microadenomas, soft tumors, and supradiaphragmatic or skull base lesions with heterogeneous features, improving the accuracy of histopathologic diagnosis.

Topics: Adenoma; Central Nervous System Cysts; Central Nervous System Neoplasms; Chondrosarcoma; Chordoma; Cranial Fossa, Posterior; Craniopharyngioma; Glioma; Humans; Hypothalamic Neoplasms; Meningeal Neoplasms; Meningioma; Natural Orifice Endoscopic Surgery; Neuroendoscopy; Nose; Pituitary Neoplasms; Plasmacytoma; Retrospective Studies; Skull Base Neoplasms; Suction

Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated via the endoscopic endonasal approach. Methods Consecutive cases of hypothalamic gliomas treated since 2007 via an endoscopic endonasal approach were reviewed. Preoperative and postoperative neuroimaging as well as endocrinological, neurological, and visual symptoms were analyzed to assess the surgical outcome. Signs and symptoms of hypothalamic dysfunction including body mass index (BMI), memory, sleep-wake rhythm, and polyphagia were prospectively collected pre- and postoperatively to assess hypothalamic function. Quality of life was evaluated using the Katz scale. Results In the initial phase the endoscopic endonasal approach was adopted in 3 cases with a palliative intent, to obtain a biopsy sample or for debulking of the mass followed by radio- or chemotherapy. In 2 later cases it was successfully adopted to achieve gross-total tumor resection. Complications consisted of 2 postoperative CSF leaks, which required an endoscopic endonasal reintervention. Visual deficit improved in 3 cases and normalized in the other 2. Four patients developed diabetes insipidus, and 3 an anterior panhypopituitarism. All patients had a moderate increase in BMI. No patients presented with any other signs of hypothalamic damage, and their quality of life at follow-up is normal. Conclusions Despite the limitations of a short follow-up and small sample, the authors' early experience with the endoscopic endonasal approach has revealed it to be a direct, straightforward, and safe approach to third ventricle astrocytomas. It allowed the authors to perform tumor resection with the same microsurgical technique: dissecting the tumor with 2 hands, performing a central debulking, and controlling the bleeding with bipolar coagulation. The main limitations were represented by some anatomical conditions, such as the position of the chiasm and the anterior communicating artery complex and, finally, by the challenge of watertight plastic repair. To definitively evaluate the role of this approach in hypothalamic gliomas, a comparison with transcranial series would be necessary, but due to the rarity of these cases such a study is still lacking. The authors observed that more

Topics: Adolescent; Adult; Body Mass Index; Endoscopy; Female; Glioma; Humans; Hypothalamic Neoplasms; Magnetic Resonance Imaging; Male; Neurosurgical Procedures; Nose; Postoperative Complications; Retrospective Studies; Young Adult

Nasal glioma is a rare congenital midline malformation composed of heterotopic masses of neuroglial tissue. We report a case of fetal nasal glioma diagnosed by sonography at 22 weeks' gestation as a vascular hypoechoic mass located on the left nasal bone. Fetal MRI excluded an underlying bone defect. At birth, the lesion appeared as a reddish mass. Post natal imaging confirmed the vascularisation within the lesion with an arterial low-flow velocity and a high-resistance spectrum, consistent with a glioma. The child underwent surgery at 5 months and final diagnosis was made on pathological examination. Therefore, a vascular lesion and a clinical aspect mimicking a haemangioma should not be considered sufficient to reach the final diagnosis.

Topics: Adult; Female; Fetal Diseases; Glioma; Humans; Nose; Nose Neoplasms; Pregnancy; Prenatal Diagnosis; Treatment Outcome; Ultrasonography

Developmental nasal midline masses in children are rare lesions. Neuroimaging is essential to characterise these lesions, to determine the exact location of the lesion and most importantly to exclude a possible intracranial extension or connection. Our objective was to evaluate CT and MRI in the diagnosis of developmental nasal midline masses. Eleven patients (mean age 4.5 years) with nasal midline masses were examined by CT and MRI. Neuroimaging was evaluated for (a) lesion location/size, (b) indirect (bifid or deformed crista galli, widened foramen caecum, defect of the cribriform plate) and direct (identification of intracranially located lesion components or signal alterations) imaging signs of intracranial extension, (c) secondary complications and (d) associated malformations. Surgical and histological findings served as gold standard. Nasal dermoid sinus cysts were diagnosed in 9 patients. One patient was diagnosed with an meningocele and another patient with a nasal glioma. Indirect CT and MRI signs correlated with the surgical results in 10 of 11 patients. Direct CT findings correlated with surgery in all patients, whereas the direct MRI signs correlated in 9 of 11 patients. In 2 patients MRI showed an intracranial signal alteration not seen on CT. Neuroimaging corrected the clinical diagnosis in 1 patient. One child presented with a meningitis. In none of the patients was an associated malformation diagnosed. Intracranial extension is equally well detected by CT and MRI using indirect imaging signs. Evaluating the direct imaging signs, MRI suspected intracranial components in 2 patients without a correlate on CT. This could represent an isolated intracranial component that got undetected on CT and surgery. In 9 patients CT and MRI matched the surgical findings. The MRI did not show any false-negative results. These results in combination with the multiplanar MRI capabilities, the different image contrasts that can be generated by MRI and the lack of radiation favour the use of MRI as primary imaging tool in these young patients in which the region of imaging is usually centred on the radiosensitive eye lenses.

Topics: Adolescent; Adult; Brain; Child; Child, Preschool; Dermoid Cyst; Female; Glioma; Humans; Image Processing, Computer-Assisted; Infant; Magnetic Resonance Imaging; Male; Meningocele; Neoplasm Invasiveness; Nose; Nose Neoplasms; Retrospective Studies; Tomography, X-Ray Computed

The fronto-orbitonasal malformations of encephaloceles, dermoid sinus cysts, and gliomas represent a continuum of neuroectodermal anomalies. The differentiation between them and other similar-appearing lesions is essential for effective management to proceed. Obtaining a reliable history, completing a careful physical examination, and obtaining accurate radiographic documentation represent the first steps. Establishing the timing, staging, and specific surgical techniques for management of a fronto-orbitonasal encephalocele remains as much an art as a science.

Topics: Child; Child, Preschool; Dermoid Cyst; Diagnosis, Differential; Encephalocele; Ethmoid Bone; Female; Frontal Bone; Glioma; Humans; Infant; Infant, Newborn; Male; Nose; Nose Neoplasms; Orbit; Osteotomy; Patient Care Planning; Plastic Surgery Procedures; Skull Neoplasms; Time Factors

Topics: Central Nervous System Neoplasms; Female; Glioma; Humans; Infant, Newborn; Nose

A case of extranasal glioma without other heterotopias of brain tissue is presented. The endonasal biopsy of this tumor presented histologic evidence of ectopic glial tissue surrounded by connective and mucosa tissue. Before any surgical procedure can be performed, radiographic (computed tomography and magnetic resonance imaging) examination is essential to rule out possible communication of the tumor with intracranial space. Surgical excision is necessary to prevent deformities of the nasal structure from occurring. Previously reported cases of nasal glioma are reviewed and problems in diagnosis and management are discussed.

Topics: Biopsy; Brain; Choristoma; Diagnosis, Differential; Female; Glioma; Humans; Infant; Magnetic Resonance Imaging; Neuroglia; Nose; Nose Neoplasms; Rhinoplasty

Despite the complex embryological development of the nose and surrounding structures, significant developmental nasal anomalies are rare. We therefore present our experience in the management of such anomalies (excluding choanal atresia) over the past 10 years. Fifty cases were surgically treated; two nasopharyngeal cysts, four hairy polyps, two meningoencephalocoeles, seven gliomata, 20 dermoids, two capillary haemangiomata, four fibromas, one fibromyxyoma, one mucocoele, one granuloma, one lipoma, two nasal aplasias, two nasal clefts and one nasal web. All cases presented with nasal obstruction and/or as a nasal mass. Computerized tomography and magnetic resonance imaging aided diagnosis determining the extent of intracranial involvement. Various surgical techniques were used ranging from simple excision to the lateral rhinotomy and Goodman's external rhinoplasty approach. Only five patients (10 per cent) suffered complications; two CSF leaks and three recurrences, all treated successfully.

Topics: Child; Cysts; Dermoid Cyst; Encephalocele; Female; Glioma; Hemangioma; Humans; Infant; Infant, Newborn; Male; Meningocele; Nasal Polyps; Nasopharyngeal Diseases; Nose; Nose Neoplasms; Skull

Topics: Child; Dermoid Cyst; Encephalocele; Foreign Bodies; Glioma; Histiocytoma, Benign Fibrous; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Neoplasms

Topics: Airway Obstruction; Classification; Cleft Lip; Dermoid Cyst; Encephalocele; Glioma; Humans; Infant; Infant, Newborn; Nasal Cavity; Nasal Septum; Nose; Nose Diseases

Topics: Child; Diagnosis, Differential; Female; Glioma; Humans; Infant; Infant, Newborn; Male; Middle Aged; Nose; Nose Neoplasms

Topics: Glioma; Humans; Infant; Nasal Cavity; Nose; Nose Neoplasms

Topics: Adult; Asian People; Cicatrix; Cleft Lip; Dermoid Cyst; Female; Glioma; Head; Humans; Hypertrophy; Japan; Male; Middle Aged; Nevus, Pigmented; Nose; Nose Deformities, Acquired; Nose Neoplasms; Pigmentation Disorders; Postoperative Care; Postoperative Complications; Rhinoplasty; Skin Neoplasms; Skin Transplantation; Transplantation, Autologous

Topics: Female; Glioma; Humans; Neoplasm Recurrence, Local; Nose; Nose Neoplasms

Topics: Diagnosis, Differential; Female; Glioma; Humans; Infant; Infant, Newborn; Male; Nose; Nose Neoplasms; Pregnancy

Topics: Child; Female; Glioma; Humans; Infant; Male; Nose; Nose Neoplasms; Photomicrography

Topics: Cysts; Dermoid Cyst; Diagnosis, Differential; Embryology; Encephalocele; Glioma; Humans; Nose; Surgical Procedures, Operative

Topics: Facial Neoplasms; Glioma; Humans; Infant; Nose; Nose Neoplasms

Topics: Chordoma; Glioma; Humans; Multiple Myeloma; Neoplasms; Nose; Nose Neoplasms; Paranasal Sinuses; Plasma Cells; Plasmacytoma

Topics: Child; Glioma; Humans; Infant; Infant, Newborn; Neoplasms; Nose; Nose Neoplasms

Topics: Glioma; Humans; Nasal Surgical Procedures; Nose; Nose Diseases; Nose Neoplasms

Topics: Child; Glioma; Humans; Infant; Nose; Nose Neoplasms; Rhabdomyosarcoma

Topics: Child; Glioma; Humans; Infant; Nose; Nose Neoplasms

Topics: Child; Glioma; Humans; Infant; Nose; Nose Diseases; Nose Neoplasms

Topics: Diagnosis, Differential; Encephalocele; Glioma; Humans; Nose; Nose Neoplasms

Topics: Glioma; Humans; Neurofibroma; Nose; Nose Neoplasms; Teratoma

Topics: Glioma; Humans; Nasal Cavity; Neoplasms; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms

Topics: Glioma; Humans; Neoplasm Recurrence, Local; Neoplasms; Nose; Nose Diseases

Topics: Glioma; Humans; Neoplasms; Nose

Topics: Glioma; Humans; Neoplasms; Nose; Nose Neoplasms

Topics: Glioma; Humans; Neoplasms; Neuroblastoma; Nose; Nose Neoplasms

Topics: Glioma; Humans; Mouth; Neoplasms; Nose; Nose Neoplasms