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12 records – page 1 of 2.

[10 years of translabyrinthine surgery for acoustic neuroma in Denmark]

https://arctichealth.org/en/permalink/ahliterature26058
Source
Ugeskr Laeger. 1987 Oct 19;149(43):2901-5
Publication Type
Article
Date
Oct-19-1987

Acoustic neuroma surgery: results of translabyrinthine tumour removal in 300 patients. Discussion of choice of approach in relation to overall results and possibility of hearing preservation.

https://arctichealth.org/en/permalink/ahliterature25628
Source
Br J Neurosurg. 1989;3(3):349-60
Publication Type
Article
Date
1989
Author
J. Thomsen
M. Tos
A. Harmsen
Author Affiliation
University ENT Department, Gentofte Hospital, Copenhagen, Denmark.
Source
Br J Neurosurg. 1989;3(3):349-60
Date
1989
Language
English
Publication Type
Article
Keywords
Denmark - epidemiology
Ear, Inner - surgery
Facial Paralysis - prevention & control
Hearing Loss - prevention & control
Hearing Tests
Humans
Middle Aged
Neuroma, Acoustic - epidemiology - surgery
Postoperative Complications - prevention & control
Abstract
The results from the Danish model of acoustic neuroma surgery are presented. In the period from 1976 to 1985, 300 patients with acoustic neuromas were operated upon using the translabyrinthine procedure. Only one small intrameatal tumour was encountered; 96 tumours were medium sized and 203 were larger than 25 mm. Of these 118 measured more than 40 mm. Mortality rate was 2%, CSF leaks occurred in 11%, and had to be closed surgically in 5%. Facial nerve function was postoperatively normal in 66%, slightly reduced in 17%, moderately reduced in 8% and abolished in 9%. Reconstruction, most often as a XII-VII anastomosis, was performed in only 6% of the patients. Cerebellar symptoms, which occurred in 45% preoperatively were present in only 7% after surgery. The preoperative hearing in both the tumour and non-tumour ear was analysed in 72 patients with tumours smaller than 2 cm. In the tumour ear, only four patients had a PTA of 0-20 dB and SDS of 81-100%; eight patients had a PTA of 0-40 dB and SDS of 61-100%; 14 had a PTA of 0-50 dB and SDS of 51-100%. This means that only a maximum of 5% of the patients, using the broadest criteria, could be candidates for hearing-conserving surgery. In all these patients the contralateral ear had hearing within normal limits (PTA 0-20 dB and SDS 95-100%). Since preservation of hearing would be achieved in only half of those subjected to suboccipital removal and since the hearing retained in patients with successful operations generally is poorer than the preoperative level, the number of patients obtaining serviceable hearing is so modest that preservation of hearing cannot be considered a valid argument in favour of suboccipital tumour removal. From a statistical point of view the risk of losing hearing in the opposite ear after tumour removal is negligible. The general morbidity after suboccipital surgery is higher than after translabyrinthine surgery, and hearing loss must be listed low among the other sequelae after tumour removal.
Notes
Comment In: Br J Neurosurg. 1989;3(6):741-32627290
Comment In: Br J Neurosurg. 1990;4(4):3562222886
PubMed ID
2789720 View in PubMed
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Clinical features and outcome in 48 patients with unruptured intracranial saccular aneurysms: a prospective consecutive study.

https://arctichealth.org/en/permalink/ahliterature236053
Source
Br J Neurosurg. 1987;1(1):47-52
Publication Type
Article
Date
1987
Author
V. Eskesen
J. Rosenørn
K. Schmidt
J O Espersen
J. Haase
A. Harmsen
O. Hein
V. Knudsen
E. Marcussen
S. Midholm
Author Affiliation
Department of Neurosurgery, Copenhagen Municipal Hospital, Hvidovre, Denmark.
Source
Br J Neurosurg. 1987;1(1):47-52
Date
1987
Language
English
Publication Type
Article
Keywords
Denmark
Humans
Intracranial Aneurysm - epidemiology - mortality - surgery
Prospective Studies
Abstract
During a 5-year period (1978-1983) the clinical features and operative morbidity/mortality were registered prospectively for all patients in Denmark with an unruptured symptomatic (27 patients) or incidental (21 patients) intracranial saccular aneurysm. A follow-up examination was performed 2 years after diagnosis of the aneurysm. Thirty symptomatic aneurysms in 27 patients most frequently involved the visual pathways or ocular motility (66%). The median diagnostic delay for patients with impaired visual acuity was 7 months but only 14 days for patients with impaired ocular motility. The localisation of the 30 symptomatic and 23 incidental aneurysms were: internal carotid artery (73% approximately 35%), anterior communicating artery (3% approximately 26%) and middle cerebral artery (7% approximately 35%). The diameters of 73% of the symptomatic aneurysms were greater than 10 mm, while the diameter of 74% of the incidental aneurysms were below 10 mm. The total operative morbidity and mortality were 15% and 4%, respectively. The mortality rate in the follow-up period was 10-11% mainly due to fatal bleeding from unoccluded aneurysms. In 21 survivors, a normal mental status was found in 43% and mild dementia was found in another 43%. The impaired visual acuity was unchanged in 67% of patients, while the ocular motility had normalised in 75%. A normal daily functional capacity was enjoyed by 57% while 43% had a moderate reduction, mostly due to visual disturbances.
PubMed ID
3267278 View in PubMed
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Clinical features and outcome in 1076 patients with ruptured intracranial saccular aneurysms: a prospective consecutive study.

https://arctichealth.org/en/permalink/ahliterature236054
Source
Br J Neurosurg. 1987;1(1):33-45
Publication Type
Article
Date
1987
Author
J. Rosenørn
V. Eskesen
K. Schmidt
J O Espersen
J. Haase
A. Harmsen
O. Hein
V. Knudsen
S. Midholm
E. Marcussen
Author Affiliation
University Clinic of Neurosurgery, Copenhagen County Hospital, Glostrup, Denmark.
Source
Br J Neurosurg. 1987;1(1):33-45
Date
1987
Language
English
Publication Type
Article
Keywords
Denmark
Humans
Intracranial Aneurysm - epidemiology - mortality - surgery
Prospective Studies
Rupture, Spontaneous
Abstract
In a well-defined area, The Kingdom of Denmark, 1076 patients with ruptured intracranial aneurysms were admitted to the six Danish neurosurgical departments in a prospective consecutive study in the 5-year period 1978-1983. Follow-up examinations were accomplished 3 months and 2 years after the admission. A total of 674 women and 402 men with a median age of 49 years were included in the study. The localisation of the ruptured aneurysms were: internal carotid artery 285, anterior communicating artery and horizontal part of anterior cerebral artery 383, middle cerebral artery 291, basilar and vertebral arteries 83 and peripheral or other localisation 34. A significantly better outcome was seen in cases with internal carotid aneurysms compared to other localisations. 670 patients underwent operation. A highly significantly better outcome was found in operated versus non-operated patients in comparable clinical conditions. The advantage of microneurosurgery was well documented. Patients with vasospasm had a significantly worse outcome. Within the first 2 weeks a daily rebleeding rate from 0.2% to 2.1% was observed, and patients who rebled had a significantly worse outcome compared to patients, who did not rebleed. The overall outcome at 2-year follow-up was: normal 27.5%, mild dementia 15.8%, severe dementia 9.9%, vegetative 1.3% and mortality 45.5%.
PubMed ID
3267276 View in PubMed
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[Clinical findings and prognosis in 48 patients with non-ruptured intracranial saccular aneurysm. A prospective consecutive study].

https://arctichealth.org/en/permalink/ahliterature234569
Source
Ugeskr Laeger. 1987 Oct 19;149(43):2905-8
Publication Type
Article
Date
Oct-19-1987

Incidence and long term survival of children with intracranial tumours treated in Denmark 1935-1959.

https://arctichealth.org/en/permalink/ahliterature27553
Source
Br J Cancer. 1978 Sep;38(3):442-51
Publication Type
Article
Date
Sep-1978

Intracranial Saccular Aneurysms. Results of treatment in 851 patients.

https://arctichealth.org/en/permalink/ahliterature41124
Source
Acta Neurochir (Wien). 1980;53(1-2):1-17
Publication Type
Article
Date
1980
Author
P. Rasmussen
H. Busch
J. Haase
J. Hansen
A. Harmsen
V. Knudsen
E. Marcussen
S. Midholm
R B Olsen
J. Rosenørn
K. Schmidt
B. Voldby
L. Hansen
Source
Acta Neurochir (Wien). 1980;53(1-2):1-17
Date
1980
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Female
Humans
Intracranial Aneurysm - diagnosis - mortality - surgery
Male
Methods
Middle Aged
Postoperative Complications
Abstract
The series studied comprises all 851 patients with symptom-producing intracranial saccular aneurysms admitted to the departments of neurosurgery in Denmark in the five-year period of 1970-1974. The series was divided into seven clinical stages according to Hunt's classification. More than half of the patients were grouped in stages IV and V (Hunt grade 2-3). Of the patients, 76% were found primarily suitable for operation. The mortality within the individual stages was to a great extent independent of the time of operation. A total of 94% of the aneurysms were localized within the region of the carotid artery, with a roughly equal distribution among the internal carotid, anterior communicating, and middle cerebral arteries. Multiple aneurysms were found in 19% of the patients subjected to panangiography. There was a distinct correlation between the severity of the spasms and the clinical condition. The course of operation was complicated in 49% of the patients, the complications being equally distributed within the various clinical stages. The mortality for the patients who underwent operation (total 567) was 32%, and 80% of the deaths were due to direct or indirect consequences of aneurysmal bleeding. At the follow-up performed two to seven years after operation, 52% of the survivors were fully capacitated, 20% were partly capacitated, and 28% were incapacitated. Based on a retrospective analysis, we have started a comprehensive prospective study with registration of available parameters in patients with saccular aneurysms admitted to all departments of neurosurgery in Denmark.
PubMed ID
7435277 View in PubMed
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Is preservation of hearing in acoustic neuroma worthwhile?

https://arctichealth.org/en/permalink/ahliterature25939
Source
Acta Otolaryngol Suppl. 1988;452:57-68
Publication Type
Article
Date
1988
Author
M. Tos
J. Thomsen
A. Harmsen
Author Affiliation
ENT Department, Gentofte Hospital, Copenhagen, Denmark.
Source
Acta Otolaryngol Suppl. 1988;452:57-68
Date
1988
Language
English
Publication Type
Article
Keywords
Adolescent
Aged
Audiometry, Pure-Tone
Cerebellopontine Angle - surgery
Denmark
Ear, Inner - surgery
Facial Paralysis - prevention & control
Female
Follow-Up Studies
Hearing Loss, Central - prevention & control
Hearing Loss, Sensorineural - prevention & control
Humans
Middle Aged
Neoplasms, Multiple Primary - surgery
Neuroma, Acoustic - surgery
Postoperative Complications - prevention & control
Tomography, X-Ray Computed
Abstract
In a series of 300 translabyrinthine removals of acoustic neuromas, comprising almost all tumours operated on in Denmark during a period of 10 years, the preoperative hearing in the tumour ear and in the contralateral ear was analysed in 72 patients with tumours smaller than 2 cm in extrameatal diameter. These patients constitute likely candidates for a hearing preserving operation via the suboccipital approach. In the tumour ear in 4 patients there was a pure-tone average (PTA) of 0-20 dB and a discrimination score (DS) of 81-100%. Applying this criterion to the whole series, 1% of the patients would be candidates for a hearing preserving procedure. Changing the criterion to a PTA of 0-40 dB and a DS of 61-100%, the number of candidates would increase to 8 patients (3%), and with a PTA of 0-50 dB and a DS of 51-100% 14 candidates (5%) would have been found. In all of these patients, contralateral hearing was normal (SRT 0-20 dB, DS 95-100%). Since preservation of hearing would be achieved in only half of those subjected to suboccipital removal and since the hearing retained in patients with successful operations is generally poorer than the preoperative level, the number of patients obtaining serviceable hearing is so modest that preservation of hearing cannot be considered an argument in favour of suboccipital tumour removal. It should be borne in mind that contralateral hearing is normal in these patients and that, according to most reports, the mortality rate is higher and paralysis of the facial nerve more frequent with the suboccipital approach than with the translabyrinthine procedure.
PubMed ID
3265256 View in PubMed
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12 records – page 1 of 2.