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Biomedical subjects

P Ciappetta

Publications and source records attributed to P Ciappetta.

At least 55 records · Page 3Linked to original sources
PubMed1992

Primary tumors of the cervical spine: surgical experience with 38 cases.

Thirty-eight primary tumors of the cervical spine were operated on in the Section of Neurosurgery, Department of Neurological Sciences, "La Sapienza" University of Rome between 1954 and 1988. Of these, 23 were malignant and 15 benign. The aims of surgical treatment in every case were tumor removal, decompression of the spinal cord, and conservation or restoration of vertebral stability. In no case was surgery confined to biopsy. Surgical stabilization was performed in 12 patients. Bone fusion was obtained with autologous bone (iliac crest, fibula) in benign tumors, whereas synthetic material (acrylic and metal) was used in malignant tumors. Past experience and greater awareness of the concrete possibilities of treating these tumors have led us to evolve the following strategy: 1. For aggressive benign tumors (osteoblastoma, giant cell tumors) and for malignancies in patients with fair life expectancy (solitary myeloma, chordoma): radical removal. 2. For benign tumors with low neoplastic potential and for malignant tumors in patients with poor life expectancy: conservative removal. Long-term results were gratifying in all benign lesions and low-grade malignancies even though two patients with chordomas needed reoperations. Sarcomas had relatively poor results.

Adult↗
PubMed1992

Surgical strategies in the treatment of symptomatic osteomas of the orbital walls.

We present a series of 19 surgically treated osteomas involving the orbital walls. Eight were localized at the junction of the frontal sinus and orbital roof, three were frontoethmoidal, two were of the orbital roof, one of the lateral wall, one of the orbital floor, and four involved all the walls of the orbit and were termed panorbital. All tumors at the junction of the frontal sinus and the orbital roof as well as those originating from the orbital roof proper were removed by frontal craniotomy. In the three that were frontoethmoidal, osteotomies were performed. Lateral and inferior orbitotomies were done when the corresponding orbital walls were affected. The four panorbital osteomas required large frontotemporal craniotomies in association with superolateral orbitotomy and zygomatic and/or malar osteotomy, when necessary. Satisfactory cosmetic and functional results were obtained in all but two cases of panorbital osteomas, in which the neurological deficit worsened after surgery. We discuss the choice of the various approaches described, with reference to the relevant literature.

Adult↗
PubMed1992

A two-step supraorbital approach to lesions of the orbital apex. Technical note.

A two-step supraorbital approach to lesions of the orbital apex is described. This technique is easy and allows a satisfactory exposure of the region. In addition, the reconstruction resulting from the procedure is anatomically perfect. The authors report the operative results obtained in 20 patients and compare this two-step supraorbital procedure with similar surgical techniques described previously.

Humans↗
PubMed1992

Meningiomas of Meckel's cave.

A series of 16 patients with meningiomas of Meckel's cave is reported. Trigeminal neuralgia, typical or atypical, was the initial symptom in 10 patients (62.5%). At admission, trigeminal signs and symptoms were present in 15 patients (93.7%); in 7 patients (43.7%), trigeminal dysfunction was combined with the impairment of other cranial nerves. On retrospective analysis, these patients fall into two clinical groups that differ also in prognosis. Group 1 comprises eight patients with trigeminal signs and symptoms only. These patients had small meningiomas strictly affecting Meckel's cave. Total removal of the tumor was achieved in seven of eight patients, without adjunctive postoperative neurological deficits. In this group, there were no tumor recurrences. Group 2 comprises the other eight patients in whom trigeminal dysfunction was combined with impairment of other cranial nerves. These patients had large tumors arising from Meckel's cave and secondarily invading the cavernous sinus (five patients) or extending into the posterior fossa (two patients) or largely growing into the middle fossa (one patient). Total removal was achieved in only one patient, and a worsening of the preoperative neurological status was observed in four patients; there were three cases of tumor progression. A subtemporal intradural approach (used in the past in every case) is still used for the small tumors of Group 1 with good results. Since 1985, for tumors involving the cavernous sinus, we have employed a frontotemporal craniotomy with extradural clinoidectomy and superior and lateral approach to the cavernous sinus. When the tumor extends toward the posterior fossa, we use a combined temporosuboccipital-transpetrosal approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Benign osteoblastoma of the sphenoid bone.

Benign osteoblastoma is a rare tumour of bone with a predilection for the spinal column and appendicular skeleton. The skull is an unusual site. We report a case in which the lesion affected the lesser wing of the sphenoid bone and extended from the middle cranial fossa to the orbital region. We discuss the distinguishing features of the tumour, reviewing the literature, and the treatment.

Cerebral Angiography↗
PubMed1991

Spinal glioblastomas: report of seven cases and review of the literature.

Intramedullary glioblastomas are uncommon tumors. They occur chiefly in the cervicothoracic segments, have a slight tendency to occur in the early decades of life, and have a short clinical history before diagnosis. We report seven cases and discuss the salient features of these tumors, particularly the pathological features and treatment, in light of the relevant literature.

Adult↗
PubMed1991

Primary intracranial actinomycosis. Report of a case and review of the literature.

Actinomycosis is a bacterial infection that affects chiefly the cervico-oro-facial area, the abdomen and lungs. From these sites it may sometimes spread to the central nervous system. Extremely rare, and controversial, is the possibility of a primary infection of the central nervous system. We report an odd case of apparently primary brain abscess caused by Actinomyces israeli and review the literature.

Actinomyces↗
PubMed1990

Intradiploic epidermoid cysts of the skull: report of 10 cases and review of the literature.

Intradiploic epidermoid cysts, fairly uncommon lesions in neurosurgical practice, are, as a rule, benign and slow-growing. Some attain great size, producing major neurological signs. Correct radiological assessment and complete removal of the tumour and its capsule are essential for adequate surgical treatment and good long-term prognosis. We report ten cases of intradiploic epidermoid cysts of the skull, three of which were giant lesions and one malignant, and analyze the clinicopathological and radiological features and treatment of these lesions in the light of the most important published data.

Adolescent↗
PubMed1990

Giant cell reparative granuloma of the skull base mimicking an intracranial tumor. Case report and review of the literature.

Giant cell reparative granuloma is an infrequent nontumoral lesion affecting particularly the maxillary and mandibular bones and only rarely the cranial bones. The etiopathogenesis is still controversial and differential diagnosis, especially from giant cell tumors of bone, is arduous. We report a case of giant cell reparative granuloma of the middle cranial fossa which behaved like an intracranial tumor and which we followed up for 15 years. We discuss the relevant literature and describe the essential features of this controversial lesion.

Adult↗
PubMed1990

Primary intracranial lymphomas.

We present 20 cases of primary intracranial lymphoma and review the most important published series on this subject. The clinical patterns and the differential diagnosis from other intracranial space-occupying lesions on the CT and angiographic evidence are discussed. Surgical treatment was given in 19 of our cases, followed in 17 cases by radiotherapy and in 4 by chemotherapy. One patient was treated by a ventriculo-peritoneal shunt. The effectiveness of the various modalities of treatment is discussed in the light of survival.

Adolescent↗
PubMed1989

Primary chiasmatic lymphoma.

We report a case of primary cerebral lymphoma in an unusual site, the chiasma, and with a unique combination of symptoms. We review the salient published data on lymphomas in this site.

Aged↗
PubMed1989

Neurological deficits secondary to spinal deformities: their treatment and results in 13 patients.

We report the results of surgical treatment in 13 patients operated on for compression of the spinal cord secondary to kyphosis or kyphoscoliosis between 1977 and 1985. In every case, an anterior decompression of the cord by transthoracic or thoracoabdominal route was followed in the same operation by anterior stabilization. Posterior fusion with Harrington's instrumentation was performed 15-20 days later. Neurological recovery was complete in 8 patients (61.5%) and partial in 4 (30.7%), while 1 patient died (7.6%). We review the relevant published work.

Adult↗
PubMed1989

[Miction disorders symptomatic of neurologic disease].

Urodynamic test has a main role in: 1) making a precise diagnosis in presence of urinary symptoms not clearly interpretable by other means; 2) assessing the characteristics of neurogenic bladder for a correct treatment; 3) detecting an underlying, previously not diagnosed neurologic disease in patients with voiding abnormalities. This report concerns 10 patients with urinary symptoms in whom the urodynamic tests allowed to suspect a neurogenic problem. Seven pts. showed an areflexic bladder with positive betanechol supersensitive test, 3 pts. had detrusor hyperreflexia, while in 2 cases there was a low compliant bladder. All the patients with detrusor hyperreflexia had also detrusor sphincter dyssynergia, while 5 out of 7 pts. with detrusor areflexia showed a denervated perineal floor. The final neurologic diagnoses were 4 protruded discs, 2 multiple scleroses, 1 cerebral tumor, 2 spinal tumors, 1 cervical spondylosis.

Adult↗