scholarly journals Early Diagnosis and Surgical Management of Acoustic Neuroma: Is it Cost Effective?

1989 ◽  
Vol 82 (6) ◽  
pp. 329-332 ◽  
Author(s):  
D A Moffat ◽  
D G Hardy
Keyword(s):  
Early Diagnosis ◽  
Surgical Management ◽  
Acoustic Neuroma ◽  
Surgical Intervention ◽  
Cost Effective ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Acoustic Neuromas ◽  
Acoustic Nerve ◽  
Microsurgical Techniques

Audiological and radiological advances and refinement of microsurgical techniques have facilitated the diagnosis and excision of very small acoustic nerve tumours with a low morbidity and mortality. Is this cost effective? In an attempt to answer this question, an analysis of 66 cases of surgically treated acoustic neuromas is presented. This represents a part of a series of otoneurosurgical procedures carried out at Addenbrooke's Hospital over the last five years. By studying the relative morbidity of early and late surgical intervention in these cases, and by costing the exercise, the justification for early diagnosis and treatment is presented both in financial and human terms.

Strategy and benefits of acoustic neuroma searching

1989 ◽  
Vol 103 (1) ◽  
pp. 51-59 ◽  
Author(s):  
D. A. Moffat ◽  
D. G. Hardy ◽  
D. M. Baguley
Keyword(s):  
Early Diagnosis ◽  
Skull Base ◽  
Acoustic Neuroma ◽  
Surgical Intervention ◽  
Cost Effective ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Acoustic Neuromas ◽  
Microsurgical Techniques

AbstractAdvances in audiological, radiological and microsurgical techniques have enabled otologists to diagnose and excise very small acoustic tumours with a low morbidity and mortality. Is this cost effective?In an attempt to answer this question, an analysis of 66 cases of surgically treated acoustic neuromas is presented. This represents part of a series of skull base procedures carried out at Addenbrooke's Hospital over the last five years. As a result of this work an investigative protocol is suggested. By studying the relative morbidity of early and late surgical intervention in these cases, and by costing the exercise, the justification for early diagnosis and treatment is presented both in financial and human terms.

Transmastoid extracranial repair of CSF leaks following acoustic neuroma resection

1989 ◽  
Vol 103 (9) ◽  
pp. 842-844 ◽  
Author(s):  
A. K. Robson ◽  
P. M. Clarke ◽  
M. Dilkes ◽  
A. R. Maw
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Management ◽  
Acoustic Neuroma ◽  
Complete Resolution ◽  
Sternomastoid Muscle ◽  
Translabyrinthine Approach ◽  
Suboccipital Craniectomy ◽  
Acoustic Neuromas ◽  
Good Access ◽  
Csf Leaks

AbstractAcoustic neuromas may be resected either by a suboccipital craniectomy or translabyrinthine approach; the latter gives good access without unduly traumatising the brainstem, but can lead to a higher incidence of cerebrospinal fluid (CSF) leaks. The surgical management of these leaks can be difficult; we describe a transmastoid extracranial technique using pedicled sternomastoid muscle that has produced complete resolution of the leak in all cases managed in this way.

Herpes Simplex Virus Encephalitis (HSE) after Allogeneic Hematopoietic Stem Cell Transplatation (alloHSCT): Impact of Early Diagnosis and Treatment on Outcome.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5002-5002
Author(s):  
Irene M. Cavattoni ◽  
Enrico Morello ◽  
Marco Casini ◽  
Norma Decaminada ◽  
Leonardo Pagani ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Early Diagnosis ◽  
Antiviral Therapy ◽  
Brain Mri ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Hematopoietic Stem ◽  
Simplex Virus ◽  
Hsv 1

Abstract Introduction: HSE is a rare but very severe central nervous system (CNS) infection caused by Herpes simplex virus type 1 (HSV-1) in almost all cases, and characterized by a high morbidity and mortality rate (97 and 70% without therapy, respectively). Immunosuppression, is a known risk factor and both early diagnosis and treatment are critical points for a good outcome in this setting. Hereby we reported two cases of HSE after alloHSCT. Patients: A 35-year-old female with relapsed multiple myeloma, underwent alloHSCT from a matched unrelated donor (MUD). On day +120, she developed an acute onset of fever, drowsiness, and generalized seizures. After 48 hours, a rapid deterioration of neurological symtoms was observed and the brain MRI showed acute encephalitis with high signal intensity in the temporal lobe and insula cortex (fig. 1). The HSV-PCR from cerebrospinal fluid (CSF) was positive for HSV-1, and a treatment with acyclovir 30 mg/Kg/d was initiated, 72 hours after the hospital admission. A 66 year-old male with high risk AML underwent MUD alloHSCT. Thirteen months after transplant, an acute sialoadenitis and HSV-1 gengivostomatitis occurred, followed by fever and focal seizures. Since typical lesions of HSE were demonstrated by brain MRI, antiviral therapy with aciclovir was promptly administrated, within 24 hours from the symptoms onset. HSV-PCR on CSF was performed two days later, and proved negative, probably due to ongoing antiviral therapy and delay to CSF analysis. After 21 days of antiviral treatment, both patients recovered from the acute phase, but in the first case we observed serious neurological sequelae that required prolonged unsuccessful cognitive rehabilitation. The second patient didn’t experienced significant residual neurological impairment, and didn’t require any other supportive measure. Both pts have had chronic GVHD and received prolonged courses of immunosuppressive therapy; they experienced recurrent CMV infections thereafter, and were under high dose foscarnet therapy at the diagnosis of HSE, but without HSV prophylaxis. Conclusion: the time from diagnosis-to-antiviral therapy, and the level of consciousness at the onset of symptoms are two major risk factors impairing morbidity and mortality of HSE. In heavily immunosuppressed alloHSCT pts with initial focal neurological signs, an early and aggressive diagnostic approach should be performed as emergency, even if they are under anti-CMV therapy; prompt acyclovir administration is therefore warranted in these settings, in order to prevent severe disability or mortality. Figure Figure

Meningococcal Meningitis in Patients with Falciparum Malaria

1996 ◽  
Vol 26 (4) ◽  
pp. 157-159 ◽  
Author(s):  
Dawit Wolday ◽  
Tsehaye Kibreab ◽  
Daraus Bukenya ◽  
Richard Hodes
Keyword(s):  
Early Diagnosis ◽  
Falciparum Malaria ◽  
Signs And Symptoms ◽  
Refugee Camp ◽  
Meningococcal Meningitis ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Field Hospital ◽  
Meningeal Irritation

Between October 1994 and January 1995 a field hospital saw nine cases of falciparum malaria associated with meningococcal meningitis among Rwandan patients residing in Kibumba refugee camp in Goma, Zaire. All except one presented with signs and symptoms suggestive of meningeal irritation; all but one responded to intravenous quinine and chloramphenicol or ampicillin. Two had recrudescence of malaria and responded to treatment with pyrimethamine-sulphadoxine (Fansidar). There were no sequelae seen. Meningococcal meningitis is uncommon but frequently fatal if it occurs in patients with falciparum malaria. Early diagnosis and treatment are urgent to decrease morbidity and mortality.

scholarly journals Updates in Diagnosis and Treatment of Acromegaly

2018 ◽  
Vol 14 (2) ◽  
pp. 57 ◽  
Author(s):  
Roula Zahr ◽  
Maria Fleseriu
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Early Diagnosis ◽  
Rare Disease ◽  
Diagnostic Criteria ◽  
Clinical Features ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Personalised Therapy ◽  
Gh Excess

Acromegaly is a rare disease, caused largely by a growth hormone (GH) pituitary adenoma. Incidence is higher than previously thought. Due to increased morbidity and mortality, if not appropriately treated, early diagnosis efforts are essential. Screening is recommended for all patients with clinical features of GH excess. There is increased knowledge that classical diagnostic criteria no longer apply to all, and some patients can have GH excess with normal GH response to glucose. Treatment is multifactorial and personalised therapy is advised.

scholarly journals Septic arthritis of the temporomandibular joint in an infant

2015 ◽  
Vol 5 (2) ◽  
Author(s):  
Raymond Chuk ◽  
John Arvier ◽  
Barbara Laing ◽  
David Coman
Keyword(s):  
Early Diagnosis ◽  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Clinical Features ◽  
Surgical Management ◽  
Relevant Literature ◽  
Clinical Suspicion ◽  
Morbidity And Mortality ◽  
Severe Morbidity ◽  
High Degree

Infantile temporomandibular joint septic arthritis is an uncommon paediatric infection, but one which carries the potential for severe morbidity and mortality. Early diagnosis and aggressive medical and possibly surgical management is indicated for the best outcomes. The presenting clinical features are non-specific in a neonate and an infant; as such a high degree of clinical suspicion is required. We present the case of an eleven-month-old boy who has made a full recovery from an acute temporomandibular joint septic arthritis and review the relevant literature.

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