Sphenoid wing meningioma pre operative session
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Sphenoid wing meningiomas are complex tumors that involve the anterior circulation and visual pathways. They have a high risk of recurrence, morbidity, and mortality. There are two types - globoid tumors with a nodular shape and en plaque tumors that fill the Harvershian system and invade bone. Imaging shows bone erosion, hyperostosis, involvement of structures like the optic canal and carotid artery. The tumors are classified based on their location in the inner, middle, or outer third of the sphenoid wing. Treatment involves surgical resection graded based on the Simpson scale, with the goal of maximal safe resection while preserving neurological function.
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This document provides an outline on sinonasal tumours. It discusses the relevant anatomy, epidemiology, classification, clinical features, investigations, staging, treatment and complications of sinonasal tumours. It notes that sinonasal tumours comprise a diverse group of benign and malignant neoplasms that often present non-specifically, leading to delays in diagnosis and management. The document outlines the different tumour types, their characteristics, staging systems used and multidisciplinary treatment approaches involving surgery, radiotherapy and chemotherapy. Early detection and management is emphasized for improving patient outcomes.
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Dr. Usman Haqqani presented on craniopharyngioma, a rare benign tumor that behaves malignantly. It most commonly occurs in children and presents a bimodal age distribution. On imaging, craniopharyngiomas often show calcification and can be classified based on location, consistency, and histology. Surgical resection is the primary treatment but the approach depends on tumor anatomy and location. Post-operatively, patients require monitoring and management of complications such as diabetes insipidus, hormone deficiencies, and obesity. Long term follow up involves imaging and endocrine evaluations.
Acm Power Pressed
Arnold Chiari malformation is a group of congenital anomalies affecting the posterior fossa. There are four types of Chiari malformation classified based on the degree and contents of herniation through the foramen magnum. Type I involves herniation of the cerebellar tonsils, while Type II involves herniation of the cerebellar tonsils and contents of the posterior fossa into the foramen magnum. Posterior fossa decompression is the main surgical treatment, involving enlarging the posterior fossa volume and establishing CSF flow, to relieve compression of neural structures. Complications can include CSF leaks, recurrent syringomyelia, and persistent neurological deficits.
intraocular tumours
Intraocular tumours can arise from the uveal tract (choroid, ciliary body, iris), retina, or optic nerves. Tumours of the uveal tract include benign lesions like naevi, hemangiomas, and melanocytomas, as well as malignant melanomas. Retinal tumours include neuroblastic tumours and angiomata. The most common intraocular tumour is malignant melanoma of the choroid, which presents as an orange pigmented lesion and can lead to vision loss, glaucoma, or extraocular spread. Retinoblastoma is the most common eye tumour in children and appears as a white pupillary reflex or squint. It is diagnosed by examination under anesthesia
Tumours of External Auditory Canal and Middle Ear
1. Benign tumours of the external ear include preauricular sinus or cyst, sebaceous cyst, dermoid cyst, keloid, hemangioma, papilloma, exostoses, osteoma, ceruminoma, and sebaceous adenoma.
2. Malignant tumours of the external ear include squamous cell carcinoma, basal cell carcinoma, and malignant melanoma.
3. Benign tumours of the middle ear include glomus tumours, also known as paragangliomas, which arise from the glomus bodies along the tympanic branch of the facial nerve.
4. Malignant tumours of the middle ear are rare but include
Benign neck mass
This document discusses several benign neck diseases including branchial cleft cysts, branchial sinuses and fistulas, thyroglossal cysts, cystic hygromas (lymphangiomas), hemangiomas, and sebaceous cysts. It describes the anatomy of the neck and classification of neck diseases. For each condition, it covers pathogenesis, clinical features, investigations including imaging, and treatment options which generally involve medical management for infections and surgical excision for definitive treatment.
Congenital anomalies of larynx
This document discusses various congenital anomalies of the larynx that can occur due to errors in embryogenesis. It begins with an overview of laryngeal development from the 4th to 6th week of gestation. It then describes several supraglottic anomalies such as laryngomalacia, laryngeal or saccular cysts, and lymphangiomas. Glottic anomalies discussed include laryngeal webs, atresia, and vocal cord paralysis. Subglottic anomalies like congenital subglottic stenosis and subglottic hemangiomas are also covered. The document concludes with descriptions of genetic and central nervous system anomalies that can involve the larynx, such as Cri du Chat syndrome and
TUMORS OF EAR
Tumors of ear including external canal, auricle, middle canal (GLOMUS TUMOR), inner ear ( ACOUSTIC NEUROMA).
Description includes definition, etiological factors, clinical menifestations and management including medical management, surgical management and nursing management.
abc hdat.pdf
The document discusses hydatid cyst of the liver caused by the larva of the dog tapeworm Echinococcus granulosus. It summarizes the life cycle, pathology, clinical features, investigations including imaging techniques, and treatment options for hydatid cyst. Treatment options include medical treatment with albendazole, percutaneous drainage using the PAIR technique, endoscopic management for biliary involvement, and surgical options. PAIR involves puncturing the cyst under imaging guidance, injecting a scolicidal agent, and reaspirating the contents.
Endoscopic skull base surgery level iii
This document discusses different levels and approaches for endoscopic skull base surgery. It focuses on the transcribriform and transplanum approaches. The transcribriform approach involves removing the cribriform plate to access the anterior skull base. It is used for anterior skull base meningiomas and esthesioneuroblastomas. The transplanum approach removes the planum sphenoidale and tuberculum sellae to reach lesions in the suprasellar region, such as pituitary adenomas and craniopharyngiomas. Both approaches aim to devascularize the tumor early and resect attachments to the skull base. Care must be taken to avoid critical neurovascular structures during resection.
Carcinoma Buccal Mucosa- Anatomy to Management
This document provides information on carcinoma of the buccal mucosa, including its anatomy, epidemiology, risk factors, clinical features, diagnosis, staging, treatment, and prognosis. Carcinoma of the buccal mucosa is most common in India, Malaysia, and Taiwan, where it affects men more than women. Risk factors include tobacco and betel nut chewing. Treatment depends on the stage, with surgery or radiation typically used for early stages and chemoradiation for advanced stages. Prognosis depends on factors like tumor size and nodal involvement.
CP angle.pptx
This document discusses the anatomy, pathology, imaging characteristics, differential diagnosis, and surgical approaches related to the cerebellopontine angle. Key points include:
- The cerebellopontine angle contains 3 neurovascular complexes supplied by the superior, anterior inferior, and posterior inferior cerebellar arteries.
- Common pathologies include vestibular schwannomas, meningiomas, and epidermoids. Vestibular schwannomas are the most common tumor.
- Surgical approaches aim to remove the tumor while preserving hearing and facial nerve function. The retrosigmoid approach is most common but transpetrosal approaches are used for large tumors.
Complications of rhinosonusitis
Rhinosinusitis can lead to serious orbital, intracranial, and bony complications if not properly treated. The document describes the various classifications of orbital complications including preseptal cellulitis, orbital cellulitis, subperiosteal abscess, and orbital abscess. It also details intracranial complications such as meningitis, epidural/subdural empyema, brain abscess, and cavernous sinus thrombosis. Treatment involves antibiotics, surgical drainage if needed, and management of the underlying sinusitis. Failure to improve or clinical deterioration despite treatment indicates the need for more aggressive management.
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Sphenoid wing meningioma pre operative session
- 1. Sphenoid wing meningioma Dr.kalakoti chandra sekhar reddy
- 2. • The complexity of these tumours is due to the involvement of the anterior circulation, anterior visual pathways and oculomotor nerve. • High chance of recurrence,morbidity and mortality. • Two types 1. Globoid with nodular shape 2. En plaque • Enplaque type fills the Harvershian System and invades the adjacent bone ie pterion, malar bone, zygomaticotemporal, Superior orbital fissure , • Hyperosteotic reaction and causing exophthalmos and temporal bowing
- 3. Cushing and Eisenhardt classification: Inner third Spheno cavernous tumors involves oculomotor trigeminal and Carotid artery Clinoidal tumors Group I clinoidal meningioma Group l I clinoidal meningioma Group l l I Clinoidal meningioma. Middle third Outer third
- 4. • Group I originates from proximal to the Carotid cistern , Densely adherent to the carotid • Group II originates Anterosuperior to clinoid and extends into the Carotid mostly outside the Subarachnoid so easy resection • Grouplll these they originate at the optic foramen and extend both to optic canal and Sphenoid wing
- 6. Inner third • Nasal hemianopsia • Foster Kennedy syndrome • Sphenocavernous presents as Abducens palsy,hypoesthesia along V1,Exopthalmos due to venous compression
- 8. Middle third • Raised ICP • Headache and papilloedema • anosmia, • contralateral homonymous hemianopsia, • personality changes, • visual or olfactory hallucinations, • contralateral facial palsy and hemiparesis
- 10. Lateral third meningioma • Proptosis and chronic palpebral edema • Loss of visual acuty • Diplopia • Epiphora • Photophobia Globoid pterional meningiomas present with • hemicranial headaches, • seizures, • contralateral hemiparesis and • increased intracranial pressure
- 12. • CT brain show Bony erosion ,hyperostosisI involvemt of optic Canal, Superior orbital fissure • MRI Shows peritumoral edema due to pial vessel involvement • Presence of arachinoidal membrane Surrounding the tumor on T2 imaging Some times • Presence of feeding vessels • Involvement of opticnerve, oculomotor nerve, Cavernous involvement, Carotid sheath encroachment • CT Angiography:ICA encroachment NEURORADIOLOGY
- 13. Approach : presenting Symptoms CT brain inner third CT Angio ICA encroachment yes ICA reconstruction using venous graft No Cavernous Sinus involvement MRI brain Sphero cavernous originating within the Cavernous Gross total/Radiotherap/observationl extending into the Cavernous excision with repair of Cavernous extra cavernous intradural excision Group I Clinoidal ICA engulfed subtotal/ICA repair Group I I clinoidal complete excision Group 111 clinoidal Cranio orbito zygomatic middle third lateral third
- 14. middle third Simpsons I and I I Lateral third Simpsons I
- 16. Steps in Skull base Surgery • frontotemporal craniotomy; • Sphenoid ridge drilling; • limited posterior orbitotomy; • posterolateral orbital wall removal (or osseous decompression of the superior orbital fissure); • optic canal unroofing; • extradural complete anterior clinoidectomy and • optic nerve sheath opening.
- 17. Simpson-grading: • Grade I: totalresection with excision of infiltrated dura; • Grade II: total tumour resection and coagulation of dural attachments; • Grade III: gross total resection without excising dural attachment or extradural extension (e.g. infiltrated sinus or bone) and • Grade IV, subtotal tumour resection.
- 18. Muninathnamma • A 35 year old female has presented with cheif complaints of headache since 5 months intermittent associated with blurring of vision at the peak of headache • H/o occasional easy forgetfulness of recent activities present • On examination • Conscious and oriented • Lobar functions – Temporal lobe – Recent memory deficits noted • Cranial nerves and motor function - Normal
- 25. Nagamma