PubMed · 6256599
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H Rosenwasser. 1981. Honored guest's address.. https://doi.org/10.1288/00005537-198101000-00002
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OBJECTIVE: Glomus jugulare tumors and neuromas frequently affect the jugular foramen area and necessitate special surgical approaches. It is often essential to stop blood flow by occluding internal jugular vein from below and the sigmoid sinus from above. Obviously, injury to the venous structures without proximal and distal control results serious haemorrhage. We describe here, a different technique for the closure of sigmoid sinus during infratemporal approach and compare it with the other techniques. METHODS: During the infratemporal approach, for closing the sigmoid sinus, we removed the bone over the sinus and from the posterior fossa dura located anteriorly and posteriorly to the sigmoid sinus. Then a 2/0 atraumatic silk suture was passed horizontally through dura which is behind and in front of the sinus. A muscle graft was then placed between the suture and sigmoid sinus. RESULTS: We used that technique in 7 patients who had a glomus jugulare tumor. In that technique, the blood flow was completely stopped without penetrating the sinus. CONCLUSION: Sigmoid sinus can be closed without incision of the sinus or the dura. This decreases the chances of injury to the sinus and dura resulting in less bleeding and less chances of CSF leak.
Jugulotympanic paragangliomas are the most common tumors of the middle ear and temporal bone. Although these larger tumors can prove to be formidable, the advent of microscopic and skull base surgical techniques has greatly enhanced the ability to treat and manage these tumors.
Essential approaches to the regional metastasizing rubric in TNM system were analyzed. Basing on summary of the results of 466 operations, performed for the thyroid gland cancer including intervention on cervical lymph nodes, the subgroup N alteration in international classification TNM was proposed, permitting to reflect individual clinical situation full to the brim and to achieve significant practical gain in further management of patient. The grading proposed corresponds to general principle, according to which every subsequent rubric must determine more severe affection without combining several types of affection in individual patient.