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Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
C2 root nerve sheath tumors management.
Mohamed H El-Sissy1, Mostafa Mahmoud
1Neurosurgery Department, Kasr Al Aini Hospital, Cairo University, Cairo, Egypt. mohamedelsissy@yahoo.com
Acta Neurochirurgica
|March 16, 2013
Summary
Surgical strategies for upper cervical nerve sheath tumors are tailored based on MRI. Personalized approaches improve outcomes for C2 root tumors, with most patients showing myelopathy improvement.
Area of Science:
- Neurosurgery
- Spinal Oncology
Background:
- Upper cervical nerve sheath tumors (NST) are uncommon, comprising 5-12% of spinal NSTs.
- These tumors, often arising from the C2 root, grow large due to the spinal canal's capacity before symptoms appear.
- Their unique presentation is influenced by the craniovertebral region's anatomy.
Purpose of the Study:
- To discuss surgical strategies for upper cervical nerve sheath tumors.
- To highlight the importance of anatomical considerations in surgical planning.
- To review outcomes of different surgical approaches for C2 root NSTs.
Main Methods:
- Eleven patients with C2 root nerve sheath tumors underwent surgery.
- Magnetic resonance imaging (MRI) guided the selection of surgical approaches.
- Approaches included extreme lateral transcondylar, laminectomy (complete/hemi), partial facetectomy, and suboccipital craniectomy.
Main Results:
- Common symptoms included spasticity (72.72%), tingling/numbness (54.54%), and weakness (54.54%).
- Total excision was achieved in 7 patients; residual tumors were left in 4 patients due to extraspinal or intradural components.
- Eight patients improved, two maintained their condition, and one deteriorated.
Conclusions:
- Surgical approaches for C2 root nerve sheath tumors must be individualized.
- Tailoring surgery based on MRI-determined spinal cord relationship is crucial.
- Personalized surgical strategies optimize outcomes for these complex tumors.