Olfactory groove meningiomas

嗅沟脑膜瘤
  • 文章类型: Journal Article
    目的:该研究旨在研究嗅沟脑膜瘤(OGM)患者的基因组改变与术前嗅觉功能之间的可能相关性,由于嗅觉损害的频繁存在。
    方法:我们利用下一代测序来分析来自22名OGM患者的样本,以检测驱动突变。使用术前成像评估肿瘤形态,而嗅觉功能是使用Sniffin\'棒检查的。
    结果:在22名OGM患者的研究中,突变如下:10与SMO/SUFU,7与AKT1,5为野生型。75%的患者存在蝶骨扁平骨肥厚症(PSH),显示突变的显著变异(p=0.048)。肿瘤体积,平均25cm3,组间差异显著。PSH负面影响嗅觉,特别是影响气味阈值,歧视,identification,和全球嗅觉表现评分(TDI)(p值范围为<0.001至0.003)。周围水肿与较低的TDI(p=0.009)和阈值评分改变(p=0.038)相关。65岁以上的年龄和女性性别与较低的阈值和歧视得分有关(p=0.037和p=0.019)。
    结论:这项研究强调了PSH和周围水肿对OGM患者嗅觉功能的显著影响,但发现嗅觉障碍和肿瘤突变之间没有联系,可能是由于样本量小。这表明年龄和性别影响嗅觉障碍。需要对更多参与者进行更多研究,以探索OGM驱动突变对嗅觉表现的影响。
    OBJECTIVE: The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment.
    METHODS: We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin\' Sticks.
    RESULTS: In a study of 22 OGM patients, mutations were as follows: 10 with SMO/SUFU, 7 with AKT1, and 5 as wild type. Planum sphenoidale hyperostosis (PSH) was present in 75% of patients, showing significant variation by mutation (p = 0.048). Tumour volumes, averaging 25 cm3, significantly differed among groups. PSH negatively impacted olfaction, notably affecting odour threshold, discrimination, identification, and global olfactory performance score (TDI) (p values ranging from <0.001 to 0.003). Perifocal oedema was associated with lower TDI (p = 0.009) and altered threshold scores (p = 0.038). Age over 65 and female gender were linked to lower thresholds and discrimination scores (p = 0.037 and p = 0.019).
    CONCLUSIONS: The study highlights PSH and perifocal oedema\'s significant effect on olfactory function in OGM patients but finds no link between olfactory impairment and tumour mutations, possibly due to the small sample size. This suggests that age and gender affect olfactory impairment. Additional research with a larger group of participants is needed to explore the impact of OGM driver mutations on olfactory performance.
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  • 文章类型: Journal Article
    鼻腔的原发性异位脑膜瘤是罕见的肿瘤,因此,经常不能正确诊断和治疗。在这个病例报告中,我们将讨论我们对涉及双侧鼻腔的原发性鼻脑膜瘤的诊断经验,管理和组织病理学特征。一名28岁女性在过去1年中出现鼻塞和鼻涕,在过去8个月中右侧面部肿胀。患者在全身麻醉下通过内窥镜和外部方法联合进行手术切除。组织病理学评估证实了WHO1级移行性脑膜瘤的诊断。手术后一周重复鼻内窥镜检查,没有显示任何残留肿瘤的证据。由于异位脑膜瘤相对较不常见,因此必须始终排除中央脑膜瘤的存在,这使得放射性调查在这种情况下是必须的。由于原发性脑膜瘤具有不可预测的行为,本研究应进一步帮助这些肿瘤的诊断和治疗.
    Primary ectopic meningiomas of the nasal cavity are rare tumours and thus, often not diagnosed and treated properly. In this case report we are going to discuss about our experience with a primary nasal meningioma involving bilateral nasal cavity with its diagnosis, management and histopathological features. A 28 year old female presented with nasal obstruction and nasal discharge for the past 1 year and swelling over right side of face for the past 8 months. Patient underwent surgical resection by a combined endoscopic and external approach under general anaesthesia. Histopathological evaluation confirmed the diagnosis of Transitional meningioma WHO grade 1. A repeat nasal endoscopy done one week after surgery, showed no evidence of any residual tumour. Due to ectopic meningiomas being relatively less common one must always exclude the presence of a central meningioma, which makes radiological investigations a must in such cases. As primary extra-cranial meningiomas have an unpredictable behaviour, this study should further aid in diagnosis and management of these tumours.
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  • 文章类型: Clinical Trial
    目的:评估Cyberknife®放疗(CKRT)治疗嗅沟脑膜瘤(OGMs)的安全性和有效性。
    方法:回顾性分析2005年9月至2018年5月在我院接受CKRT治疗的13例OGM患者。9例患者主要接受CKRT治疗,3用于切除后的残留病,1表示疾病复发。
    结果:5例患者接受了立体定向放射外科(SRS)治疗,6采用大分割立体定向放射治疗(HSRT),和2分次立体定向放射治疗(FSRT)。中位肿瘤体积为8.12cm3。SRS的中位处方剂量为14.8Gy,HSRT为27.3Gy,FSRT为50.2Gy。递送的中值最大剂量为32.27Gy。治疗后中位随访时间为48个月。13例患者中有12例获得了100%的区域控制率,中位肿瘤体积减少了31.7%。12名患者中有6名肿瘤体积减少,而其他6名没有变化。第十三例患者有明显的放射性水肿,需要手术减压。在审查时,十二名患者还活着并且在神经系统上稳定。一名患者死于与CKRT治疗无关的肺炎。
    结论:CKRT对于OGM的治疗似乎是安全有效的。
    OBJECTIVE: To assess the safety and efficacy of CyberKnife® radiotherapy (CKRT) for the treatment of olfactory groove meningiomas (OGMs).
    METHODS: A retrospective review was performed of 13 patients with OGM treated with CKRT from September 2005 to May 2018 at our institution. Nine patients were treated primarily with CKRT, 3 for residual disease following resection, and 1 for disease recurrence.
    RESULTS: Five patients were treated with stereotactic radiosurgery (SRS), 6 with hypofractionated stereotactic radiotherapy (HSRT), and 2 with fractionated stereotactic radiotherapy (FSRT). The median tumor volume was 8.12 cm3. The median prescribed dose was 14.8 Gy for SRS, 27.3 Gy for HSRT, and 50.2 Gy for FSRT. The median maximal dose delivered was 32.27 Gy. Median post treatment follow-up was 48 months. Twelve of 13 patients yielded a 100% regional control rate with a median tumor volume reduction of 31.7%. Six of the 12 patients had reduced tumor volumes while the other 6 had no changes. The thirteenth patient had significant radiation-induced edema requiring surgical decompression. Twelve patients were alive and neurologically stable at the time of the review. One patient died from pneumonia unrelated to his CKRT treatment.
    CONCLUSIONS: CKRT appears to be safe and effective for the treatment of OGMs.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    背景嗅沟脑膜瘤在手术上仍然具有挑战性。常见的显微外科手术方法遭受神经血管结构的晚期暴露。相反,翼点入路具有早期解剖后神经血管复合体的优势。方法回顾1991年至2010年间我科嗅沟脑膜瘤患者的治疗记录。共有61例患者通过翼点入路切除嗅沟脑膜瘤。其中包括58例原发性肿瘤和3例复发性肿瘤。平均总随访时间为122个月。结果颈内动脉早期暴露和夹层,大脑中动脉,大脑前动脉,视神经在所有情况下都是可行的。60例患者实现了肿瘤完全切除。发病率和死亡率分别为26%和1.6%。术后并发症包括癫痫发作(5例)和脑脊液(CSF)漏(2例)。随访期间,我们记录了3次肿瘤复发.结论翼点入路似乎是治疗嗅沟脑膜瘤的理想方法。它的主要优点是后部神经血管复合体的早期可视化。此外,它可以保留额窦和及时的肿瘤血管离断术,并避免过度的脑收缩。翼点视图是大多数神经外科医生所熟悉的,因此向这种技术的过渡相当简单。
    Background Olfactory groove meningiomas remain surgically challenging. The common microsurgical approaches suffer from late exposure of the neurovascular structures. Conversely, the pterional approach has the advantage of early dissection of the posterior neurovascular complex. Methods We reviewed the records of patients treated for olfactory groove meningioma in our department between 1991 and 2010. A total of 61 patients underwent removal of olfactory groove meningiomas via the pterional approach. These included 58 primary and 3 recurrent tumors. Mean overall follow-up time was 122 months. Results Early exposure and dissection of the internal carotid artery, middle cerebral artery, anterior cerebral artery, and optic nerve was feasible in all cases. Complete tumor removal was achieved in 60 patients. Morbidity and mortality rates were 26% and 1.6% respectively. Postoperative complications included epileptic seizures (five patients) and cerebrospinal fluid (CSF) leak (two patients). During follow-up, we recorded three tumor recurrences. Conclusions The pterional approach appears to be an excellent solution for the treatment of olfactory groove meningiomas. Its foremost advantage is early visualization of the posterior neurovascular complex. Moreover, it allows frontal sinus preservation and timely tumor devascularization and avoids excessive brain retraction. The pterional view is familiar to most neurosurgeons and therefore the transition to this technique is fairly straightforward.
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  • 文章类型: Case Reports
    BACKGROUND: Olfaction is commonly considered as secondary among the sensory functions, perhaps reflecting a lack of interest in sparing olfaction after surgery for the olfactory groove meningiomas (OGM). However, considering the repercussions of olfaction for the quality of life, the assessment of post-operative olfaction should be necessary. We retrospectively reviewed the olfactory outcome in patients with OGM and investigated the factors associated with sparing the post-operative olfaction.
    METHODS: Between 1993 and 2012, 40 patients with OGM underwent surgical resection and estimated the olfactory function using the Korean version of \"Sniffin\'Sticks\" test (KVSS). Variable factors, such as tumor size, degree of preoperative edema, tumor consistency, preoperative olfactory function, surgical approaches, patient\'s age, and gender were analyzed with attention to the post-operative olfactory function.
    RESULTS: Anatomical and functional preservation of olfactory structures were achieved in 26 patients (65%) and 22 patients (55%), respectively. Among the variable factors, size of tumor was significant related to the preservation of post-operative olfaction. (78.6% in size<4 cm and 42.3% in size>4 cm, p=0.035). Sparing the olfaction was significantly better in patients without preoperative olfactory dysfunction (84.6%) compared with ones with preoperative olfactory dysfunction (40.7%, p=0.016). The frontolateral approach achieved much more excellent post-operative olfactory function (71.4%) than the bifrontal approach (36.8%, p=0.032).
    CONCLUSIONS: If the tumor was smaller than 4 cm and the patients did not present olfactory dysfunction preoperatively, the possibility of sparing the post-operative olfaction was high. Among the variable surgical approaches, frontolateral route may be preferable sparing the post-operative olfaction.
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