1/9. Cochleo-vestibular manifestations of jugular foramen pathologies.patients presenting pathologies of the jugular foramen are presented, for whom the main symptoms are of cochleo-vestibular nature. A classification of the various pathologies is attempted, the anatomy reviewed and hypotheses capable of producing the symptom elaborated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/9. Epithelial sheath neuroma: a new entity.The authors describe four examples of a peculiar cutaneous lesion characterized histopathologically by a proliferation of enlarged nerve fibers ensheathed by squamous epithelium involving the superficial dermis. The perineural epithelial sheaths were composed of uniform squamous epithelium with evidence of cornification in the form of dyskeratotic cells or resulting in orthokeratotic basket-weave corneocytes. Immunohistochemical studies confirmed the epithelial and neural nature of the two components of the lesions, with the nerve fibers expressing immunoreactivity for S-100 protein, neurofilaments, CD57, and nerve growth factor receptor, whereas the perineural epithelial sheaths showed immunoreactivity for cytokeratins. The authors propose the term "epithelial sheath neuroma" for this lesion and believe that it is a distinct and a previously undescribed benign neoplasm of both cutaneous nerves and epithelial elements.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/9. Palisaded encapsulated neuroma (solitary circumscribed neuroma of skin) of the eyelid: report of two cases and review of the literature.BACKGROUND/AIMS: Palisaded encapsulated neuroma of the skin (PEN) is an uncommon benign neural tumour that occurs on the head and neck, including the eyelid, but is unfamiliar to many ophthalmic clinicians. For the first time in the ophthalmic literature, the clinical and histopathological features of two patients with PEN of the eyelid are described. methods: Two cases of PEN were identified in the archives of the Department of pathology, Institute of ophthalmology, london. Clinical details were derived by a case note review and the histopathological features defined using standard methods including immunohistochemistry. RESULTS: Two cases of PEN are described, from the eyelids of patients aged 43 and 70 years. The tumours were virtually identical in nature, being painless solid masses composed of a mixture of S100 positive schwann cells and scattered neurofilament positive nerve fibres. An incomplete thin fibrous capsule, which contains EMA positive perineural cells, partially surrounded each lesion. The lesions were distinguishable from other more common eyelid lesions only on histopathological examination. Both tumours were completely excised with no evidence of recurrence. Neither patient had signs of any associated systemic disease. CONCLUSION: PENs are usually solitary, firm, non-pigmented, dome-shaped lesions that are found on the face of patients usually over the age of 40 years. Most often these lesions are diagnosed clinically as basal cell carcinomas, dermal naevi, or skin adnexal tumours. Histologically, PENs must be differentiated from other neural tumours that may be associated with systemic syndromes, such as neurofibromas or mucosal neuromas.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/9. Hemifacial pain and headache in gasseroma.A case of severe disabling hemofacial pain in a Tanzanian African caused by gasseroma which was successfully removed is presented and the nature of the illness outlined. Intractable ticdouloureux is mainly due to vascular compression on the fifth cranial nerve or secondary to conditions to the nerve. diagnosis of gasseroma is mainly by clinical history and examination.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/9. Lesion of the common peroneal nerve during arthroscopy.Arthroscopic knee surgery has been well accepted worldwide and has become an important part of orthopaedic surgery. The use of arthroscopy has reduced the duration of hospitalization, overall costs, and time required for the patient to return to sports activities or work. However, because of the closed nature of the procedure and proximity of neurovascular structures to instruments, substantial risk of injuries exists. Significant anatomic variability in the nerve course has not been reported in previous literature as a cause of a knee arthroscopy complication. We present a case of complete transection of an unusually located common peroneal nerve during a knee arthroscopy for lateral meniscal repair in a 22-year-old football player.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/9. Chorda tympani neuroma masquerading as cholesteatoma.facial nerve neuromas occur throughout the course of the facial nerve and its branches, however lesions occurring on the chorda tympani branch are exceptionally rare. We present a case where the diagnosis was made intra-operatively; the patient was pre-operatively thought to have had a cholesteatoma. Total resection is the treatment of choice for these cases. Early diagnosis, aided by high resolution computed tomography (CT) scanning, will facilitate complete excision without damage to the facial nerve itself or the ossicular chain. The slow growing nature of the neuroma is likely to allow compensatory mechanisms to occur without the patient experiencing dysgeusia. As with any rarity the diagnosis can only be made with a high index of suspicion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/9. Extracranial tumor vascularity: determination by dynamic CT scanning. Part II: The unit approach.Twenty-eight patients had combined conventional drip infusion CT scans. The information about the anatomic location of the lesion, its configuration, its cross-sectional appearance, its vascularity (as determined by dynamic signature curves), and its clinical presentation were considered as a single overall unit. This diagnostic approach allowed a diagnosis to be made on virtually all of these enhancing lesions without resorting to either a digital venous imaging study or angiographic procedure. In 17 of these cases, such an invasive second procedure was performed either to confirm the CT impression as part of this study or as part of a therapeutic embolization procedure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/9. Surgery of the skull base.Tumors involving the base of the skull are often occult and may become quite large before detection is possible. Symptomology varies depending upon the nature of the tumor and its placement. These neoplasms have frequently been considered inoperable simply because of their location, but in recent years microsurgical technique and high speed air drills have allowed the modern temporal bone surgeon to gain improved access to the skull base. A wide variety of surgical approaches to tumors in this area have been described in the past 20 years: translabyrinthine, middle fossa, transcochlear, retrolabyrinthine, retrosigmoid, transpalatal-transclival, and through the jugular bulb. The purpose of this paper is to review the indications, complications, and results of each of these procedures in relation to specific tumors involving the skull base. case reports illustrate the diagnosis and surgical management of a variety of unusual neoplasms, including an extradural meningioma of the temporal bone and clivus, a low grade squamous cell carcinoma on the tegmen in a radical cavity, a large primary cholesteatoma, an osteoblastoma of the temporal and occipital bones, an XIth nerve neuroma in the jugular bulb area, and an osseous hemangioma involving the facial nerve at the geniculate ganglion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/9. The abductor digiti minimi muscle flap: a salvage technique for palmar wrist pain.In a series of 12 patients incapacitated by persistent or recurrent pain in the palmar aspect of the hand and wrist, successful rehabilitation was aided by employing an abductor digit minimi muscle flap. It is emphasized that this muscle flap was utilized as an adjunct to microsurgical internal neurolysis and neuroma resection. Eleven of the 12 patients (92 percent) achieved good to excellent results in terms of relief of pain, plus either return to their previous job or vocational rehabilitation. The "salvage" nature, donor-site morbidity, and technical demands of the procedure are emphasized.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |