Gleeson M.,The National Hospital for Neurology and Neurosurgery
Operative Techniques in Otolaryngology - Head and Neck Surgery | Year: 2016
The prerequisites for surgical resection of tumors arising in the jugular foramen are adequate access, control of the major vessels, and the ability to move the facial nerve safely of the operative field if necessary. Without it the surgeon risks catastrophic hemorrhage, cranial nerve palsies that might have been avoided, and insufficient access to remove the whole tumor. The aim of this article is to help the surgeon select the best approach for their patient and summarize the key steps in each. Consideration of a staged approach is prudent for paragangliomas that have significant intracranial extension, Fisch Di tumors. Paragangliomas confined to the temporal bone and intimately related to the internal carotid artery (ICA), Fisch C2-4, are better resected through a type A infratemporal fossa approach. Small jugular paragangliomas, Fisch C1, can be removed using a Fallopian bridge technique though limited rerouting of the facial nerve may sometimes be required. © 2016 Elsevier Inc.
Choi D.,The National Hospital for Neurology and Neurosurgery
ArgoSpine News and Journal | Year: 2012
Surgery for spine tumours can be challenging, and due to the increased complexity of surgery, the dura may be transgressed either for purposeful resection of tumour margins or by inadvertent breach whilst removing extradural tumour. If leakage of CSF occurs, this may affect the patient's quality of life, at a time when maintaining function and good outcome is paramount. Surgical planning should aim to minimise the risk of CSF leakage, but if dural breach does occur, the defect should be repaired by using sutures, dural patch techniques and application of tissue adhesives. We outline and illustrate the methods of dural closure that can be used to prevent leakage of CSF during surgery for spine tumours. © 2012 ARGOS and Springer-Verlag France.
Keenan E.,The National Hospital for Neurology and Neurosurgery
Nursing times | Year: 2010
Specialist nurse roles appear to beunder threat in the UK and the role of the clinical nurse specialist has been subject to scrutiny recently. A trust developed a database so that data on the CNS workload and contribution to patient care could be collected and analysed. This showed the components of the role and the dear benefits to patient care.
Schreiber B.E.,Royal Free Hampstead NHS Trust |
Agrup C.,University College London |
Haskard D.O.,Imperial College London |
Luxon L.M.,The National Hospital for Neurology and Neurosurgery
The Lancet | Year: 2010
Sudden sensorineural hearing loss is usually unilateral and can be associated with tinnitus and vertigo. In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed. A careful examination is needed to exclude life threatening or treatable causes such as vascular events and malignant diseases, and patients should be referred urgently for further assessment. About half of patients completely recover, usually in about 2 weeks. Many treatments are used, including corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments. Although no treatment is proven, we recommend a short course of oral high-dose corticosteroids. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management. © 2010 Elsevier Ltd. All rights reserved.
Agency: GTR | Branch: Innovate UK | Program: | Phase: European | Award Amount: 183.04K | Year: 2009
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