PubMed Health⌕ Search

Biomedical subjects

M Samii

Publications and source records attributed to M Samii.

At least 19 recordsLinked to original sources
PubMed1992

Experience with 36 surgical cases of petroclival meningiomas.

Thirty-six patients with petroclival meningiomas underwent surgery between 1978 and 1990. The tumours accounted for 13% of a total of 284 skull base meningiomas operated upon during the same time period. The most frequent neurological signs related to cranial nerve deficits, mainly of the 8th, 5th, and 7th nerves respectively. The approaches to the petroclival region were: retromastoid, pterional, subtemporal, and combined retromastoid-subtemporal. In 12 patients we used a modification of the retromastoid-subtemporal approach with preservation of the sigmoid and transverse sinus (presigmoid approach). "Total" tumour removal was achieved in 27 cases (75%). There was no postoperative death, and in 83% of cases no severe morbidity. With careful pre-operative evaluation, improved operative approaches and microsurgical techniques the treatment of petroclival meningiomas has been considerably improved.

Adolescent↗
PubMed1992

Acoustic neurinoma in the elderly: factors predictive of postoperative outcome.

The authors present the results of acoustic neurinoma surgery in 61 elderly patients (age, > or = 65 years). All the patients were operated upon via the lateral suboccipital approach. Complete tumor removal was achieved in all but two patients. There was no operative mortality. Fifty-seven patients (93%) were independent of nursing assistance at the time of discharge from the hospital. Preservation of the facial nerve was achieved in 95% of the patients, and hearing was preserved in 41%. A risk analysis identified three factors exerting a significant influence on the outcome in these cases: the American Society of Anesthesiology score, the preoperative Karnofsky score, and the size of the tumor. The patients' age was not correlated with the postoperative outcome. These results suggest that, in the majority of elderly patients with acoustic tumors, complete tumor removal can be achieved safely and with minimal postoperative morbidity. Preoperative clinical, neurological, and radiological factors can be helpful in the selection of patients for surgical treatment and may predict postoperative outcome.

Activities of Daily Living↗
PubMed1992

Meningeal melanocytoma of the C8 nerve root: case report.

A case of a meningeal melanocytoma involving the C8 nerve root is presented. The clinical symptoms and the radiological investigations resembled a neurinoma of the spinal nerve root. Intraoperatively the tumor was seen to be firmly attached to the dural covering of the dorsal nerve root. By using microsurgical technique, complete removal of the tumor with preservation of the ventral nerve root was accomplished. Histological examination revealed a typical meningeal melanocytoma as described by Limas and Tio in 1972. Ten additional cases of previously reported spinal meningeal melanocytomas are reviewed. The importance of differentiating this benign lesion from meningeal malignant pigmented tumors is stressed.

Adult↗
PubMed1992

The significance for postoperative hearing of preserving the labyrinth in acoustic neurinoma surgery.

Among 186 patients with preoperative hearing, a total of 189 acoustic neurinomas were removed through a lateral suboccipital approach with anatomical preservation of the cochlear nerve. Functional hearing was preserved in 92 (49%) of these patients; despite anatomical preservation of the cochlear nerve, deafness was the result in 51% of the series. Many factors have been considered to cause hearing loss in patients whose cochlear nerve was intact after surgery; these include nerve retraction, nerve or cochlear ischemia, overheating and vibration damage to the nerve, and opening of the labyrinth. To evaluate the significance of injury to the labyrinth in postoperative hearing loss, a prospective study was undertaken. High-resolution computerized tomography studies through the inner ear with bone algorithm were performed pre- and postoperatively. The postoperative status of the labyrinth was classified into three patterns: intact, fenestrated, and widely opened. Injury to the labyrinth occurred in 30% of the cases. The most frequently injured labyrinth structures were the crus commune of the posterior and superior semicircular canals (52%), the posterior semicircular canal (23%), the vestibule (21%), and the superior semicircular canal (4%). A statistically significant relationship was found between injury to the labyrinth and deafness, elevated thresholds, and lower discrimination values at pure-tone audiograms and speech audiometry (p < 0.0001). The degree of the injury (comparison between fenestration and wide opening of the labyrinth) was also significantly related to postoperative deafness (p < 0.0001). Disturbance of the inner-ear fluids was considered to be the cause of the hearing loss. In 12 patients labyrinth injury was not associated with deafness. This finding may support the existence of mechanisms of cochlear protection. The homeostatic function of the endolymphatic sac was considered to play an important role in recovery of damaged hearing in these 12 cases.

Adolescent↗
PubMed1992

[Turcot syndrome illustrated by two clinical cases].

Turcot syndrome denotes the association between either familial polyposis coli (FPC) or sporadic non-familial polyposis coli, and primary neuroepithelial tumors of the central nervous system (CNS). The clinical and morphological intestinal features in both FPC and Turcot syndrome are the same: the histological picture shows typical (tubular) adenomas, often with adenocarcinomatous transformation. As associated CNS tumors astrocytomas, glioblastomas, spongioblastomas, and medulloblastomas are reported. As a modification of ITOH's classification of 1985 we distinguish between four groups: patients with fewer than 100 polyps (group I); patients with fewer than 10 polyps (group II); patients with FPC or sporadic non-familial polyposis (group III); patients with either CNS tumors or FPC with a direct relative with Turcot syndrome and/or FPC (group IV). In patients belonging to the fourth group the diagnosis of Turcot syndrome should not be made. We report on two patients belonging to group II and group IV respectively, and depict the clinical features as well as the heterogenic appearance of Turcot syndrome as outlined in the literature.

Adenomatous Polyposis Coli↗
PubMed1991

Management of intracavernous tumours: an 11-year experience.

Seventy-one patients with tumours involving the cavernous sinus (CS) were operated upon between 1979 and 1989. Fifty-four patients underwent a direct approach to the CS. The average age of these latter patients was 47 (9-69) years. The lesions included 51 benign tumours (26 meningiomas, 16 [7 invasive] pituitary adenomas, 3 trigeminal neurinomas, one chordoma, one chondroma, one craniopharyngioma, one epidermoid tumour, and one cavernous haemangioma), and 3 malignant tumours (one chondrosarcoma, one adenoid cystic carcinoma and one metastatic adenocarcinoma). Dissecting tumour away from the carotid artery was the management of choice for intracavernous tumours which involved the internal carotid artery, except when the carotid artery had already pre-operatively presented with advanced narrowing or occlusion by encasing tumour. Microsurgical technique facilitated dissection and preservation of the cranial nerves. Patients treated radically by direct CS surgery had improvement of their symptoms and signs more frequently than those patients treated by subtotal tumour removal. However, operative complications in direct CS surgery were higher than in subtotal tumour removal without CS entry.

Adenoma↗
PubMed1991

The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism.

The sitting position for operations in the posterior fossa remains controversial in both adults and children, primarily because of the risk of air embolism. The reports on the incidence of this complication are varied. We retrospectively reviewed the data on 704 patients (age range 1-82 years) operated on in a lounging position for varied posterior fossa pathology from January 1984 up to December 1989. As diagnostic monitoring, we uniformly employed a Doppler ultrasound device, an atrial catheter, and capnometry. In 37 adults (5.5%) and 9 children (9/34) air embolism was diagnosed, without either morbidity or mortality. A lounging position, together with adequate infusion therapy and ventilation with PEEP, considerably reduces the risk of air embolism.

Adolescent↗
PubMed1991

Intraventricular cavernous angioma. A survey.

Since the availability of CT diagnosis 23 cases of intraventricular cavernous angioma (IVCA) have been published in the literature. Three additional cases have been operated upon in our Department. Based on these 26 cases the clinical data, radiological findings, treatment and outcome of IVCAs are reviewed.

Adult↗
PubMed1991

Peritumoral blood flow in intracranial meningiomas.

Blood flow was measured in intratumoral tissue, the cerebral hemispheres and particularly in the peritumoral area of 12 patients with intracranial meningiomas using the stable xenon-enhanced computed tomographic scan. Tumor blood flow frequently showed a heterogeneous pattern of enhancement with high flow at the tumor periphery and a central area of hypoperfusion. Blood flow values were on average 28% lower in the peritumoral area than in the ipsilateral cerebral hemisphere. In individual cases, blood flow values in the peritumoral edematous area were very low. These findings suggest that the hypodense area surrounding meningiomas does not solely represent vasogenic edema, but may actually represent tumor pressure ischemia.

Adult↗
PubMed1991

Intracanalicular acoustic neurinomas.

The cases of 16 patients with acoustic neurinomas confined to the intracanalicular area are presented. These represent 2.7% of the 600 patients with acoustic neurinomas consecutively operated upon at the Neurosurgical Clinic at Nordstadt Hospital during the last 8 years. The comparatively earlier onset of vestibular symptoms and signs was characteristic of this group and precipitated diagnosis. The diagnostic reliability of magnetic resonance imaging was at least equivalent to that of air computed tomographic cisternography. Complete tumor removal was accomplished via the suboccipital approach in all patients, with 100% preservation of facial nerve and facial function; the cochlear nerve was preserved anatomically in 100% of the patients and functionally in 57%. No recurrence has occurred during follow-up periods of up to 8 years in all 16 patients. A broad spectrum of the current literature is considered, and purely intracanalicular acoustic neurinomas are discussed with regard to clinical characteristics, diagnostic steps-including neuroradiological and neurophysiological approaches-and surgical treatment and results.

Adult↗
PubMed1991

[Diagnosis and surgical treatment of craniocerebral trauma within the scope of polytrauma management].

Head trauma of different degrees is present in about two-thirds of multiple trauma patients admitted to hospital. As the primary brain damage is irreversible, our objective should be the recognition and specific treatment of both early and late complications. Stabilization of cardiorespiratory parameters must first be achieved. Secondly, only the diagnosis and treatment of life-threatening hemorrhages is of greater importance than the diagnostic and therapeutic measures undertaken by the neurosurgeon. Coma is assessed according to the Glasgow Coma Scale. The indications for CT investigation in trauma patients are: (1) loss of consciousness for more than 30 min (GCS score under 8); (2) manifest neurological deficit; (3) open head injury; (4) deterioration of clinical and neurological status after admission; (5) skull fracture. An algorithm for the management of head trauma, including the above-listed criteria and based on Schweiberer's "Graduated Schedule for Diagnosis and Treatment of Multiple Trauma" is presented. We also list the indications for urgent early neurosurgical intervention: (1) space-occupying intracranial hemorrhages, epi- or subdural, and intracerebral; (2) open head injury; (3) space-occupying impression fractures; (4) any combination of the above. In some cases neurosurgery may be performed after further stabilization, e.g., in: (1) fronto- and otobasal injuries (the latter often heal spontaneously); (2) small contusions; (3) not-space-occupying extracerebral hematomas with no tendency to increase; (4) not-space-occupying impression fractures. As soon as neurological deficit appears in the presence of one of the above, operative treatment is mandatory.

Brain Injuries↗
PubMed1990

Primary intraosseous meningiomas of the skull base.

Four cases of primary intraosseous meningiomas were seen among 373 cases of intracranial meningiomas operated upon in the Neurosurgical Clinic of the Krankenhaus Nordstadt, Hannover, FRG between January 1978 and December 1988. These 4 cases represent 1% of all intracranial meningiomas. Patients' age ranged between 21 and 66 years; 2 were females and 2 males. Presenting symptoms were localized orbital pain in 1 case, protrusion of the eye in 1 patient, pain in the orbit and forehead and protrusion of the eye in 1 patient, and peripheral facial palsy in 1 case. Symptoms lasted between 3 and 10 years. Two tumours were in the bony orbit, 1 in the bony orbit and in the frontal bone and 1 in the temporal bone. All tumours were surgically completely removed. All patients are clinically and computer tomography free of tumour 1 to 8 years after the operation.

Adult↗
PubMed1979

[Neurosurgical aspects of the treatment of acoustic neurinoma with special consideration of the facial nerve (author's transl)].

The decisive progress in the field of surgical treatment of acoustic neurinomas has occured after the introduction of the operating microscope. This is a survey of the microsurgical treatment of cerebellopontine angle tumors with special emphasis of the facial nerve and demonstration of individual cases. Moreover, the technique of the dissection and preservation of the continuity of the facial nerve during removal of a tumor is analysed. The possibilities of reconstructive surgery of an end-to-end suture or nerve graft in case of facial nerve lesions after removal of a tumor are discussed.

Cranial Nerve Neoplasms↗
PubMed1978

[Indication and treatment of frontobasal rhinoliquorrhoea from the ent-surgical and neurosurgical point of view (author's transl)].

This paper deals with some special questions based on joint neuro-rhinosurgical diagnostic and treatment of frontobasal injuries with rhinoliquorrhoea. The indications of the rhinosurgical transfronto-orbital approach with debridement of paranasal sinuses in the same stage are defined. Detailed technical instructions are given for treatment of "midline fractures". The transfrontal intradural approach of the neurosurgeon should be prefered: 1. If there is rhinoliquorrhoea combined with an extensive fracture of anterior skull base. 2. In cases of frontobasal liquor fistual--no matter of localisation and extension--with increasing spaceoccupation should the intracranial decompression be combined with duraplasty. Cerebral lesions with no progressive intracranial pressure should be treated first of all conservatively. The operative treatment of paranasal sinuses is not necessary in every case after transfrontal intradural surgery. X-ray controls have shown the spontaneous healing.

Cerebrospinal Fluid Rhinorrhea↗