Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko最新文献

{"title":"[Long-term postoperative outcomes in patients with lumbosacral spine synovial cysts].","authors":"N A Konovalov, E S Brinyuk, Yu M Poluektov, S V Kaprovoy, R A Onoprienko, B A Zakirov, D S Kim, V A Beloborodov, I A Stepanov, N I Bychkovskii","doi":"10.17116/neiro20248805138","DOIUrl":"https://doi.org/10.17116/neiro20248805138","url":null,"abstract":"<p><p>Searching of literature data revealed only a few reports devoted to long-term postoperative outcomes in patients with lumbosacral spine synovial cysts. These results are ambiguous and largely contradictory.</p><p><strong>Objective: </strong>To analyze the long-term postoperative outcomes in patients with lumbosacral spine synovial cysts.</p><p><strong>Material and methods: </strong>A retrospective observational cohort study was performed between January 2015 ando September 2022. The study included patients who underwent surgical treatment for lumbosacral spine synovial cysts with clinical and neurological manifestations. There were 94 medical records of respondents (36 (38.3%) men and 58 (61.7%) women aged 18-82 years). Mean postoperative follow-up period was 24.6±7.5 months.</p><p><strong>Results: </strong>Patients underwent various surgical interventions for synovial cysts. VAS scores of pain syndrome after 3, 6, 9, 12 and 24 postoperative months revealed significant pain relief in the lower back and extremities (<i>p</i><0.01). In long-term follow-up period, we observed significantly lower disability (Oswestry Disability Index) (<i>p</i><0.001). Adverse postoperative events occurred in 9 (9.6%) cases.</p><p><strong>Conclusion: </strong>Interlaminectomy with cyst wall resection and preservation or partial resection (no more than 1/3) of facet joint without segmental fusion is an effective and preferable surgical method with minimal incidence of adverse clinical events.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Nonspecific craniovertebral spondylitis].","authors":"I Yu Lisitsky, A V Lychagin, A Yu Zarov, A L Korkunov, V G Cherepanov, I A Vyzankin, E Yu Tselishcheva","doi":"10.17116/neiro20248803121","DOIUrl":"https://doi.org/10.17116/neiro20248803121","url":null,"abstract":"<p><strong>Objective: </strong>To analyze surgical strategy for nonspecific spondylitis of the craniovertebral region (CVR) taking into account clinical features and morphological signs of disease.</p><p><strong>Material and methods: </strong>Eight patients with nonspecific spondylitis of CVR underwent surgery (4 women and 4 men aged 31-75 years). Three patients had pain syndrome, 5 ones - conduction disorders. Combined interventions were performed in 5 patients with neurological disorders. Of these, 3 patients underwent transoral decompression with subsequent occipitospondylodesis. In other cases, stages of surgical treatment were reverse. Four patients underwent simultaneous interventions, 1 patient - with 7-day interval. Patients with pain syndrome underwent occipitospondylodesis.</p><p><strong>Results: </strong>In all patients, postoperative VAS score of pain syndrome decreased by 5-7 points (mean 5.5). Among 5 patients with conduction symptoms, regression of neurological disorders 1 year after surgery was achieved in 2 cases, and complete recovery was observed in 3 patients (Frankel E). In all cases, examination confirmed relief of inflammatory process and no compression of the spinal cord and medulla oblongata. One patient had a dehiscence of the wound edges of posterior pharyngeal wall, and another one had implant fracture in 3 years after surgery.</p><p><strong>Conclusion: </strong>Active surgical approach is reasonable for nonspecific spondylitis of CVR. Craniocervical fixation eliminates pain and risk of neurological complications following atlantoaxial instability. Conduction disorders require simultaneous transoral decompression and occipitospondylodesis in patients with nonspecific purulent craniovertebral lesions. Impaired head tilt complicates transoral stage. In this regard, it is more rational to carry out craniocervical fixation at the last stage.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prolonged spinal and sacral neurostimulation in children with pelvic organ dysfunction: preliminary analysis].","authors":"A G Timershin, D V Kreshchenok, S A Konovalov, P I Mironov","doi":"10.17116/neiro20248802131","DOIUrl":"10.17116/neiro20248802131","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of long-term spinal and sacral programmable neurostimulation for pelvic organ dysfunction in patients with myelodysplasia and chronic dysfunction of the bladder and rectum.</p><p><strong>Material and methods: </strong>A retrospective study included 32 children aged 1-17 years (mean 10.7) with myelodysplasia, pelvic organ dysfunction and ineffective therapy including botulinum therapy and exclusion of tethered spinal cord syndrome. All children underwent comprehensive urodynamic examination with analysis of bladder and residual urine volume, mean flow rate, intravesical pressure and total urine volume, as well as electromyographic examination. Examination was carried out before surgery, after 6, 12 and 36 months. We applied urinary diary, NBSS questionnaire and urodynamic examination data. All patients underwent neurological examinations (neurological status, magnetic resonance imaging of the spinal cord, computed tomography and radiography of the spine, electroneuromyography). The study was conducted at the neurosurgical department of the Republican Children's Clinical Hospital in Ufa between 2014 and 2022. There were 32 implantations of epidural neurostimulators for pelvic organ dysfunctions.</p><p><strong>Results: </strong><i>P</i>atients used epidural spinal and sacral stimulation up to 6 times a day for 10-15 min turning on the pulse generator. This method significantly increased urinary volume, decreased episodes of urinary leakage and fecal incontinence, residual volume after urination and number of periodic catheterizations compared to baseline data. Sixteen patients were very satisfied, 10 ones were moderately satisfied, and 2 patients were not satisfied with therapy. The number of bladder catheterizations per day decreased by 51.1%. Urine volume significantly increased from 131.5±16.1 to 236±16.7 ml, intravesical pressure decreased from 23.5±4.2 to 18.5±2.1 cm H₂O (by 20.3%).</p><p><strong>Conclusion: </strong>Chronic epidural spinal and sacral stimulation can improve the quality of life in patients with pelvic organ dysfunction. This technique may be effective for pelvic organ dysfunction caused by myelodysplasia.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[To the origins of surgery for acoustic neuromas].","authors":"V N Shimansky, I O Kugushev, A B Kadasheva, V K Poshataev, K V Shevchenko, S V Tanyashin","doi":"10.17116/neiro20248802187","DOIUrl":"10.17116/neiro20248802187","url":null,"abstract":"<p><p>Acoustic neuroma is one of the most common tumors of the posterior cranial fossa. Its removal is always a challenge for the neurosurgeon and the patient. The history of surgery for acoustic neuromas is inextricably linked with the history of neurosurgery in general. The modern surgical community must know history and be able to use it. Only then will the development of surgery lead to the preservation of the quality of life of patients. In the history of surgery for acoustic neuromas, the stages of its development are clearly visible from the description of the clinical picture through the study of the anatomy of the cerebellopontine angle to modern microsurgical removal.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Congenital basal encephaloceles involving functionally important structures].","authors":"N A Chernikova, L A Satanin, E V Shelesko, G V Danilov, S B Agrba, A N Shkarubo, N A Mazerkina, M L Satanina","doi":"10.17116/neiro202488051102","DOIUrl":"10.17116/neiro202488051102","url":null,"abstract":"<p><p>In rare cases, basal encephaloceles can include important brain structures (pituitary gland, chiasm, third ventricle walls, cerebral vessels).</p><p><strong>Material and methods: </strong>We reviewed 43 articles (78 cases) devoted to basal encephaloceles involving functionally important structures. Analysis included transsphenoidal and sphenoethmoidal hernias.</p><p><strong>Results: </strong>Nasal breathing disorders were found in 76.9% of cases, decreased visual acuity - 53.8%, endocrine disorders - 44.9%, nasal CSF leakage - 14.1%, meningitis - 10.3%. Concomitant malformations occurred in 85.9%. Severe respiratory disorders (52.6%, <i>p</i><0.05) and multiple concomitant malformations (71.7%, <i>p</i><0.05) were more common among patients with sphenoethmoidal encephalocele. Among 78 patients, 73.1% underwent surgery while follow-up was preferable in 26.9% of cases. There was progression of endocrine disorders (9.5%), visual impairment (4.8%) and nasal breathing disorders (4.8%) in follow-up period. Surgical treatment also has many risks. Transcranial, transnasal, transoral and combined approaches are currently used. It was not possible to establish the most effective surgical approach due to heterogeneous clinical data. Postoperative complications occurred in 47.4% of cases (endocrine disorders - 33.3%, CSF leakage - 8.8%, visual impairment - 1.8%, infectious complications - 14%). Mortality rate was 3.5%.</p><p><strong>Conclusion: </strong>Congenital basal encephalocele involving functionally important structures is an extremely rare developmental defect. Such patients often have concomitant anomalies. Comprehensive examination is necessary to estimate the structures included in hernial sac and concomitant diseases. Treatment strategy should be determined individually after thorough examination and comparison of all risks. Surgical treatment is associated with high risk of complications due to damage to the structures comprising encephalocele.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PET/CT with 11C-methionine in assessment of brain glioma metabolism].","authors":"N B Vikhrova, D B Kalaeva, A N Tyurina, A Yu Belyaev, G V Danilov, I N Pronin","doi":"10.17116/neiro20248801163","DOIUrl":"10.17116/neiro20248801163","url":null,"abstract":"<p><strong>Objective: </strong>To study 11C-methionine (MET) metabolism in gliomas using CNS tumor biobank imaging data.</p><p><strong>Material and methods: </strong>MRI and 11C-MET PET/CT were performed in 225 patients (49±14 years, M/F=84/101) according to standard protocols with analysis of 11C-MET accumulation index and volumetric parameters (V_FLAIR, V_PET and V_PET/FLAIR). These results were compared with molecular genetic testing and 2-year overall survival.</p><p><strong>Results: </strong>We examined 225 patients with gliomas (97 glioblastomas, 70 astrocytomas, 58 oligodendrogliomas). Accumulation index and volume of 11C-MET in glioblastomas were significantly higher in the general group (AI=2.90, Se 69%, Sp 76%, AUC 0.76; V_PET=24.3 cm³, Se 67%, Sp 60%, AUC 0.65; V_PET/FLAIR 0.46, Se 60%, Sp 69%, AUC 0.67) and within the group of astrocytomas (AI=2.93, Se 68%, Sp 89%, AUC 0.84; V_PET=8.06 cm³, Se 91%, Sp 35%, AUC 0.66; V_PET/FLAIR 0.27, Se 77%, Sp 60%, AUC 0.71). The median 2-year overall survival in patients with glioblastomas was 13 months that was significantly lower compared to IDH «+» gliomas (<i>p</i><0.0001). There was a relationship between high accumulation index of 11C-MET and shorter overall survival in patients with glioblastomas. Significantly higher AI >3.59 (Se 89%, Sp 67%, AUC 0.79) was additionally obtained in subgroup of patients with glioblastomas >50 years (<i>n</i>=34) for EGFR «+» tumors.</p><p><strong>Conclusion: </strong>We found variable 11C-MET metabolism in WHO 2021 gliomas and confirmed significant difference in metabolic activity and volume of 11C-MET accumulation in glioblastomas compared to IDH «+» gliomas. Moreover, we revealed the relationship between high accumulation index and shorter survival. Analysis of 11C-MET metabolism in patients over 50 years old revealed higher accumulation index in the EGFR «+» group. Further comparison of these imaging methods and assessment of other significant mutations are necessary to identify the anatomical and metabolic patterns of IDH «+» gliomas.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele].","authors":"N A Kalybaeva, A V Dimertsev, M V Mazalova, A K Kuzovkina, G E Altunina, M A Odeniyazova, A S Balatskaya, N P Utyashev, V G Bychenko, O Yu Bronov, N V Pedyash, M Yu Zemlyansky, D N Kopachev, A A Zuev, A L Golovteev","doi":"10.17116/neiro20248801139","DOIUrl":"10.17116/neiro20248801139","url":null,"abstract":"<p><strong>Background: </strong>In recent years, temporal lobe encephalocele has become more common in patients with focal drug-resistant epilepsy. Despite available experience, there are still no clear recommendations for choosing the extent of surgery in these patients.</p><p><strong>Objective: </strong>To evaluate the effectiveness of diagnosis and surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele.</p><p><strong>Material and methods: </strong>The study included 21 patients with focal temporal lobe epilepsy and temporal lobe encephalocele. All patients underwent continuous video-EEG monitoring and MRI of the brain. There were 12 (57.4%) selective encephalocele resections and 9 (42.6%) anterior temporal lobectomies. The median follow-up period was 31 months.</p><p><strong>Results: </strong>The overall effectiveness of surgical treatment with postoperative Engel class I was 76% (16 cases). Selective encephalocele resection was followed by postoperative Engel class I in 10 patients (83%). There were 6 (67%) patients with similar outcomes after temporal lobectomy. Mean volume of resected tissue adjacent to encephalocele was 8.3 cm³.</p><p><strong>Conclusion: </strong>Surgery is a highly effective treatment for patients with epileptic seizures following temporal lobe encephalocele. In our sample, favorable postoperative outcomes were achieved in 76% of patients (Engel class I). There were no significant differences in effectiveness between selective resection and temporal lobectomy. Further research is necessary for a clear protocol of surgical treatment of focal drug-resistant epilepsy associated with encephalocele.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intrathecal chemotherapy for leptomeningeal metastases in patients with breast cancer].","authors":"E A Moskvina, D M Belov, D R Naskhletashvili, L V Mekheda, A Kh Bekyashev, V A Aleshin, T G Gasparyan, A A Mitrofanov, N V Sevyan, E V Prozorenko, A A Tkhazeplov, K E Roshchina","doi":"10.17116/neiro20248803131","DOIUrl":"https://doi.org/10.17116/neiro20248803131","url":null,"abstract":"<p><p>Leptomeningeal metastases are lesions of brain and/or spinal cord sheaths by tumor cells. They occur in 5% of patients with solid tumors, although autopsies reveal these lesions much more often (10-20% of cases). Leptomengeal metastases are an unfavorable prognostic factor. Despite the modern NCCN treatment standards, including intrathecal therapy (ITT), such patients receive only irradiation of the entire brain and/or spinal cord in most cases.</p><p><strong>Objective: </strong>To evaluate the effectiveness of ITT in patients with leptomeningeal metastases in breast cancer.</p><p><strong>Material and methods: </strong>Twenty-five patients with breast cancer and leptomeningeal metastases underwent intrathecal administration of methotrexate between 2016 and 2022. Intrathecal chemotherapy was administered through lumbar puncture. We performed an intensive course (intrathecal methotrexate 15 mg 2 times a week for 1 month (8 injections), then intrathecal methotrexate 15 mg 1 time a week (4 injections), and then 15 mg 1 time a month until progression or unacceptable toxicity).</p><p><strong>Results: </strong>The median duration of ITT was 2.5 months. Complete neurological responses were observed in 3 out of 25 (12%) patients, partial neurological response - in 15 out of 25 (60%) patients, progression of neurological symptoms - in 7 (28%) patients. The number of complete cytological responses was observed in 6 out of 25 (24%) patients. The median overall survival after ITT was 6.7 months.</p><p><strong>Conclusion: </strong>Effectiveness of ITT is confirmed by higher quality of life (72% of patients), complete cytological responses (24%) and improvement in neuroimaging data. This is an important criterion for severe patients with limited treatment options. First-stage ITT before whole-brain irradiation is preferable, as this approach increases overall survival by 3 months. Undoubtedly, ITT is a treatment option that can be used in routine clinical practice for lesions of brain and spinal cord sheaths.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Electrophysiological diagnostics in choosing treatment strategy for neuropathies in children with transcondylar fractures].","authors":"E N Plastunenko, D S Kanshina, F U Kusova","doi":"10.17116/neiro20248803138","DOIUrl":"https://doi.org/10.17116/neiro20248803138","url":null,"abstract":"<p><strong>Background: </strong>A common complication of transcondylar fractures (TCF) in children is neuropathy requiring not only therapeutic but also surgical treatment. Despite numerous reports, clear criteria for selecting patients for surgical treatment have not been defined.</p><p><strong>Objective: </strong>To clarify the role of clinical and electrophysiological diagnostics in choosing treatment tactics for neuropathies in children with TCF.</p><p><strong>Material and methods: </strong>There were 20 patients with neuropathies after TCF between 2020 and 2022. Of these, 10 ones were selected for surgical treatment according to electrophysiological diagnostic data. Inclusion criteria: age 6-12 years, closed TCF within previous 3-12 months, symptoms of neuropathy confirmed by electroneuromyography (ENMG), no nerve disruption according to ultrasound data. Exclusion criteria: elbow joint contracture and post-traumatic ulnar nerve dislocation. All patients underwent needle myography with functional assessment of motor and sensory fibers, spontaneous activity in muscles, recruitment pattern and motor unit potentials. Intraoperative electrophysiological diagnostics included stimulation of motor fascicles with registration of M-responses from the target muscles. The follow-up period was 3-6 months.</p><p><strong>Results: </strong>The study included 20 patients aged 6-12 years without peripheral nerve disruption. A group of 10 patients who required surgical treatment was identified. The control group consisted of 10 patients who did not require surgical treatment. To choose treatment tactics, we considered ENMG data. Surgical procedure was determined according to intraoperative neuromonitoring (IONM) data.</p><p><strong>Conclusion: </strong>When choosing treatment strategy, surgeons should consider objective ENMG and IONM criteria, as well as fascicular anatomy.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transoral approach in surgery for chordomas extending into craniovertebral junction: a systematic review of the literature].","authors":"I V Chernov, A N Shkarubo, D A Konyashin, D N Andreev","doi":"10.17116/neiro202488031111","DOIUrl":"https://doi.org/10.17116/neiro202488031111","url":null,"abstract":"<p><p>To date, treatment of chordomas involves maximal tumor resection followed by proton therapy. Various approaches are used depending on location of tumor (transcranial and through natural anatomical openings (nose, mouth), as well as their combinations). Although transoral approach has been introduced into neurosurgical practice for a long time, it is routinely used in patients with chordoma only in certain hospitals in the world.</p><p><strong>Objective: </strong>To analyze postoperative outcomes in patients with chordomas of skull base and craniovertebral joint after transoral surgery.</p><p><strong>Material and methods: </strong>We analyzed literature data devoted to patients with chordomas of skull base and craniovertebral joint after transoral surgery or another approach combined with transoral access. Among 111 primary articles, we selected 38 manuscripts including description of 109 patients with skull base chordoma who underwent transoral surgery or combination of approaches including transoral one.</p><p><strong>Results: </strong>Gross total resection was achieved in 45.9% (<i>n</i>=50) of cases including 1 patient after en bloc resection. Subtotal resection was carried out in 28.4% of cases, partial - in 24.8%, biopsy - in 0.9% of cases. The complication rate in this group was 30%. The most common events were swelling of the tongue (10%) and diastasis of posterior pharyngeal wall sutures (8.2%) that required redo surgery. CSF leakage and meningitis were rare (1.8% and 3.6%, respectively).</p><p><strong>Conclusion: </strong>Transoral access allows for gross total resection of midline tumors with low incidence of severe complications. Combination of transoral and transcranial approaches is advisable to increase extent of resection.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}