RESUMO
OBJECTIVE: To summarize the current literature on the surgical management of cavernous malformations of the cerebellopontine angle in accordance with the experience at our institution. METHODS: A systematic literature review on cavernous malformations of the cerebellopontine angle yielded 14 case reports relevant to the disease. In addition, the authors include their own report of a 16-year-old girl with such a lesion cured by surgical resection. RESULTS: The most common clinical signs associated with this tumor are hearing loss (86.7%), followed by facial paresis (53.8%). Symptoms may be rapidly progressive. Cavernous malformations range from isointense to hyperintense to brain on noncontrasted T1 magnetic resonance imaging. In general, outcomes for patients with this tumor are favorable, with most patients cured by surgical resection. CONCLUSION: One of the rarest lesions of the cerebellopontine angle is a cavernous malformation. An understanding of the clinical and radiographic differences between this lesion and a vestibular schwannoma helps to minimize perioperative morbidity. Surgical resection should be performed with special attention to preserving facial nerve function.
Assuntos
Neoplasias Cerebelares/cirurgia , Ângulo Cerebelopontino/patologia , Ângulo Cerebelopontino/cirurgia , Malformações Arteriovenosas Intracranianas/patologia , Malformações Arteriovenosas Intracranianas/cirurgia , Procedimentos Cirúrgicos Otológicos , Adolescente , Neoplasias Cerebelares/patologia , Ângulo Cerebelopontino/anormalidades , Paralisia Facial/etiologia , Feminino , Perda Auditiva Neurossensorial/etiologia , Humanos , Imageamento por Ressonância Magnética , Neuroma Acústico/patologia , Complicações Pós-Operatórias/epidemiologia , Resultado do TratamentoRESUMO
A wide range of pathology involving the external, middle, and inner ear contribute to conductive and sensorineural hearing loss. Diagnostic imaging plays a critical role in the evaluation and management of hearing loss. High resolution computed tomography (CT) of the temporal bone and magnetic resonance imaging (MRI) are the preferred imaging modalities to evaluate the ear structures for causes of hearing loss, with the specific type of hearing loss and location of defect dictating which type of imaging is preferred. In general, the external auditory canal, middle ear space, mastoid, petrous apex, and otic capsule are best visualized with CT, whereas suspicion of retrocochlear pathology warrants MRI.
Assuntos
Diagnóstico por Imagem , Perda Auditiva/diagnóstico , Cóclea/patologia , Meato Acústico Externo/patologia , Otopatias/diagnóstico , Neoplasias da Orelha/diagnóstico , Orelha Interna/patologia , Orelha Média/patologia , Perda Auditiva/congênito , Perda Auditiva Condutiva/congênito , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Neurossensorial/congênito , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética , Processo Mastoide/patologia , Osso Petroso/patologia , Osso Temporal/patologia , Tomografia Computadorizada por Raios X/métodosRESUMO
BACKGROUND: Recent studies suggest that topical therapy is beneficial in many conditions underlying chronic sinusitis. Current literature has documented low aerosolized particle deposition efficiency into the paranasal sinuses. Mathematical modeling suggests that three factors influence the deposition efficiency: particle size, pressure gradient, and size of the sinus ostium. Ostium size is the most dominant factor. Therefore, we sought to determine if maxillary antrostomy and ethmoidectomy would increase the deposition efficiency. METHODS: Five cadavers underwent pre- and postoperative scintigraphy after administration of aerosolized Tc-99M. Images were obtained with a gamma-camera and regions of interest (ROIs) were drawn around the maxillary sinuses. Counts per minute in the pre- and postoperative ROIs were then compared using the paired t-test. RESULTS: Results indicated a significant increase in deposition of radioactivity in the maxillary sinuses in the postoperative state (p < 0.01). CONCLUSION: Topical therapy for chronic sinusitis may be more feasible in the postoperative population.