1/254. Facial neuromas in children: delayed or immediate surgery?OBJECTIVE: The objective of this study was to investigate the clinical characteristics and outcome of facial nerve neuromas in children. To date, no specific study has focused on children, and the management of these tumors is not codified. DESIGN AND SETTINGS: A review of case series treated in a tertiary care center of pediatric otolaryngology. SUBJECTS: The treatment and outcomes for 7 children (4 infants and 3 adolescents) were analyzed. RESULTS: Six patients underwent complete removal of tumor and immediate restoration of the nerve continuity. The grade of facial palsy improved in 4 of the 6 children, but did not get better than grade 3 (House classification). The remaining patient was managed conservatively and remained stable clinically and radiologically after 9 years follow-up. CONCLUSIONS: These findings support the reasonable strategy of combining conservative assessment of these slow-growing tumors with regular clinical and radiologic evaluations and radical surgery using various procedures. The choice depends on the age of the child, the extent and growth rate of the tumor, the grade of facial palsy, and the hearing function.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
2/254. Neuromas and prominent corneal nerves without MEN 2B.PURPOSE: We studied a family composed of 2 members with the characteristic phenotype of the MEN 2B and without RET protooncogene mutations in order to determine whether they had multiple endocrine neoplasia associated with MEN 2B in the 5-year follow-up. SUBJECTS AND methods: The family consisted of a 15 year old female complaining of burning eyes, examined ophthalmologically in 1992 and her mother and sister, who were examined later on in 1992. The proband and the mother were affected with multiple mucosal neuromas and visible corneal nerves. pentagastrin-stimulated serum calcitonin levels, catecholamines, serum calcium and phosphate levels were measured. Molecular genetic studies were performed on the 2 affected members to look for the specific RET mutation seen in MEN 2B. RESULTS: Endocrine neoplasia of the syndrome MEN 2B, medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism, were ruled out in the first examination and after 5-year follow-up. In the 2 cases no mutation at codon 918 for the RET proto-oncogene was found. CONCLUSIONS: We consider that familial multiple mucosal neuromas are a highly distinctive entity of MEN 2B.- - - - - - - - - - ranking = 0.4keywords = neuroma (Clic here for more details about this article) |
3/254. Treatment of a neuroma-in-continuity of the peroneal nerve with nerve bypass grafts--a case report.Treatment of neuroma-in-continuity involves neurolysis or resection with interposition nerve grafting of the involved segment. These techniques may be complicated by loss of remaining conduction through axons that were intact prior to surgical neurolysis or grafting. The authors have shown previously that axonal regeneration occurs in an autologous bypass graft in the rat model. They applied this technique to a neuroma-in-continuity of the peroneal nerve of a 22-year-old woman who sustained an injury to the peroneal nerve after arthroscopic surgery, with excellent results. Nerve bypass may be the procedure of choice for treatment of neuroma-in-continuity.- - - - - - - - - - ranking = 1.4keywords = neuroma (Clic here for more details about this article) |
4/254. Plantar fat pad atrophy after corticosteroid injection for an interdigital neuroma: a case report.A case of bilateral interdigital (Morton's) neuroma treated with steroid injection therapy developed plantar fat pad atrophy, shown on magnetic resonance imaging. Some pathologic changes at the site of injection (such as subcutaneous fat atrophy, depigmentation of the skin, and telangiectasias) are well known disadvantages of local steroid injection for the treatment of the Morton's neuroma. Scientific literature reports these problems (mainly as an aesthetic problem) in the dorsal aspect of the foot. In this work, the authors describe a case in which the steroid injection therapy has caused some changes in the plantar aspect of the feet, with serious functional problems. Fat pad atrophy is a serious problem in the foot and can cause a painful metatarsal syndrome with some important effects on the gait.- - - - - - - - - - ranking = 1.2keywords = neuroma (Clic here for more details about this article) |
5/254. Intra-operative localisation of skull base tumours. A case report using the ISG viewing wand in the management of trigeminal neuroma.Deep-seated skull base tumours provide as much a challenge to the surgeons' skills of localisation as to his technical abilities during the resection. These lesions are frequently inaccessible and lie adjacent to vital structures requiring extensive cerebral retraction for adequate exposure and direct visualisation. The ISG viewing wand is a newly developed image guidance system to aid direction of the operative approach and localisation of intracerebral pathology. We discuss its use in the management of a trigeminal neuroma.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
6/254. Traumatic neuroma as a cause of obstructive jaundice.A 70-year-old man with previous cholecystectomy developed progressive obstructive jaundice, 3 months before hospitalization. Intraoperatively, a 2 x 2 x 1.5-cm mass in the distal part of the right hepatic duct was excised to release complete obstruction. It was verified as traumatic (amputation) neuroma. Despite rarity, traumatic neuroma of the bile duct should be considered in patients who have antecedent surgical procedure of the biliary tract with subsequent occurrence of extrahepatic biliary obstruction.- - - - - - - - - - ranking = 1.2keywords = neuroma (Clic here for more details about this article) |
7/254. Bowler's thumb treated by translocation of the digital nerve.A case of neuroma of the ulnar digital nerve of the thumb in a bowler was treated successfully by translocation of the nerve beneath the adductor pollicis.- - - - - - - - - - ranking = 0.2keywords = neuroma (Clic here for more details about this article) |
8/254. Differential diagnosis of idiopathic inflammatory trigeminal sensory neuropathy from neuroma with a biopsy: case report.OBJECTIVE AND IMPORTANCE: Idiopathic inflammatory trigeminal sensory neuropathy (IITSN) is a disorder with the dominant clinical features of trigeminal sensory disturbance; this idiopathic condition follows a benign course in most cases. Recent reports have shown that transient abnormalities, which may mimic those of trigeminal neuromas, can be observed in magnetic resonance imaging scans. Presented here is a case of IITSN that was diagnosed, with cytological and histopathological verification, during the active inflammatory phase of the disease (the first such attempt, to our knowledge). CLINICAL PRESENTATION: A 20-year-old female patient was referred to our hospital with a 2-month history of numbness of the left side of her face, headache, and hemifacial pain attacks. Cranial magnetic resonance imaging scans revealed a mass above and below the foramen ovale, extending into the cavernous sinus. INTERVENTION: A percutaneous biopsy procedure through the foramen ovale was performed; the pathological examination revealed lymphocytes, macrophages, and endothelial cells but no evidence of neoplastic cells. A few days later, the patient was surgically treated using a cranial base approach, the gasserian ganglion was exposed, and the lesion was removed. Pathological examination of the specimens revealed inflammatory changes and fibrosis of the nerve fibers and ganglion cells. Disruption of the myelin around the nerve bundles was detected. Therefore, IITSN was pathologically confirmed during the early stage of the disease. During 3 months of follow-up monitoring, the patient experienced no serious clinical problems. CONCLUSION: IITSN should be suspected in cases of tumors involving the cavernous sinus, and a percutaneous biopsy through the foramen ovale should be performed as part of the differential diagnosis in such cases. This procedure might obviate unnecessary aggressive surgery. In the current case, no neoplastic cells were observed during the examination; only lymphocytes, macrophages, and endothelial cells were observed, on a background of erythrocytes. Lymphocyte-dominant inflammatory infiltration, fibrotic changes, and demyelinization are cardinal histopathological findings observed during the active phase of IITSN.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
9/254. Palisaded, encapsulated neuroma of the lip.A case of palisaded, encapsulated neuroma of the lower lip has been presented. To the best of our knowledge, this is the first reported instance in the dental literature. The lesion characteristically occurs on the skin of the face near the oral, nasal, and orbital mucocutaneous junctions and, therefore, is readily visible to the oral diagnostician. It occurs most often in middle-aged individuals and, although it may clinically mimic other lesions, the operative finding of an easily enucleated mass near a mucocutaneous junction should suggest this lesion in the differential diagnosis. Histologically, the lesion is characterized by three distinct zones--an outer compressed fibrous connective tissue capsule, an inner myxomatous zone, and a central zone of proliferating Schwann's cells arranged in interlacing fascicles with areas of palisaded cells and organoid structures. The lesion is treated by enucleation or excision and has no tendency to recur.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
10/254. Unusual complication of ligation of rudimentary ulnar digit.We report a case of rudimentary ulnar polydactyly of the hand of a 7-year-old female child. Histological examination revealed a central traumatic neuroma which branched into five digit-like projections covered with hyperkeratotic epidermis. We think this was a result of suture ligation during the postnatal period.- - - - - - - - - - ranking = 0.2keywords = neuroma (Clic here for more details about this article) |
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