PubMed Health⌕ Search

Biomedical subjects

R Kazan

Publications and source records attributed to R Kazan.

5 recordsLinked to original sources
PubMed1994

Chondrosarcoma of the jugular foramen.

Chondrosarcoma, although uncommon, must be included in the differential diagnosis of skull base tumors. The potential for morbidity and mortality, similar to other lesions located at this anatomic site, is related to compromise of adjacent vital neurovascular structures. Optimal surgical management is controversial and reliant on adequate tumor exposure. A case of myxoid chondrosarcoma of the jugular foramen is presented with a review of the common presenting signs and symptoms along with the radiographic and histologic features of these lesions. The surgical approach to chondrosarcoma and other lesions at this location has undergone an evolution in technique in recent years. This report details the approach used by the authors, which allows for reconstruction of the skull base with subsequent normal anatomic contour and functional hearing. The technique employs hydroxylapatite for reconstruction, which has not been previously described in skull base applications.

Adult↗
PubMed1989

Age considerations in acoustic neuroma surgery: the horns of a dilemma.

Experience has shown that early removal of acoustic tumors results in less morbidity because the rate of surgical complications increases with tumor size. Nevertheless, acoustic tumors are benign and grow slowly--facts that support conservatism in elderly patients. We managed 21 patients with acoustic tumors over the age of 65. Eleven patients underwent immediate surgical excision. Ten patients were monitored clinically and with serial magnetic resonance imaging (MRI) or computed tomographic (CT) scans. To date, two of these patients have required surgical excision because of continued tumor growth. Our experience managing these patients both surgically and with "watchful waiting" is the subject of this report.

Adolescent↗
PubMed1982

Skull base mapping.

Early experience with medium to large tumors of the temporal region has re-emphasized the value of radiologic preoperative plotting of these space occupying lesions in the sagittal, coronal, and horizontal planes. Attention to probable pathology, neurovascular structures and patient's medical status has been important in determining resectability. A standard format of the interior and exterior of the skull base and cervical spine has been employed to map these lesions. Such devices have been used by otolaryngologists in the past to depict laryngeal lesions; and provide for the skull base surgeon a common base of comparison of tumor size, chart documentation, and a means to facilitate communication among other specialists. Experience with 36 cases of skull base tumors seen since July 1979 has emphasized the occult manner in which these lesions may present.

Adult↗
PubMed1981

An holistic approach to Ménière's disease. Medical and surgical management.

A review of the medical and surgical management of 195 patients with Meniere's disease is presented. In order to avoid a piecemeal approach to the problem of Meniere's disease, the "whole" patient must be treated. Psychological counseling, medical management, and when indicated selective surgical management is advocated. The diagnosis of Meniere's must be confirmed through careful history, physical, neurological evaluation and selective testing. The majority of patients can be controlled medically; however, in this study 52 (26%) patients underwent surgical therapy. Twenty-eight patients underwent some type of saccus surgery for Meniere's disease with overall relief of 71%; however, better relief of vertigo was seen with labyrinthectomy and nerve section. The most common indication for surgery was disabling vertigo. However, fluctuating progressive sensorineural loss, may be an important reason to advise surgery. Surgical techniques for Meniere's disease continue to evolve. A graduated approach is preferred, starting with endolymphatic-mastoid shunt, proceeding to middle fossa vestibular nerve section when medical status and hearing and adequate. When hearing is socially inadequate, labyrinthectomy with or without vestibular nerve section is preferred. A good working relationship with a neurosurgeon is advised for otolaryngologists performing middle fossa surgery.

Counseling↗