RESUMEN

BACKGROUND: Cranionasal communicating tumors often originate from the extra-axial intracranial tissue, nasal cavity, and sinuses, and mostly invade the anterior skull base, leading to communication between the cranial and nasal cavities. Cranionasal communicating tumors are clinically rare and thus have been rarely reported in the literature. OBJECTIVE: To investigate the clinical outcomes of combined transcranial and endoscopic transnasal approaches in the surgical management of cranionasal communicating tumors. METHODS: We retrospectively analyzed patients with cranionasal communicating tumors treated at the Department of Neurosurgery, Jinhua Hospital, affiliated with Zhejiang University, from July 2017 to March 2020. All patients were surgically treated using combined transcranial and endoscopic transnasal approaches or the cranionasal dual approach, and skull base reconstruction was performed simultaneously. The postoperative gross tumor resection rate, perioperative complications, and postoperative efficacy were evaluated. RESULTS: Eleven patients with 14-37 months of follow-up were included. Eight patients underwent total resection, two patients underwent subtotal resection, and one patient was treated with partial resection. Postoperative pathological diagnoses revealed four olfactory neuroblastomas, three atypical meningiomas, two recurrent papilloma malignancies, one recurrent invasive pituitary tumor, and one recurrent invasive pituitary adenocarcinoma. Among the 11 patients, severe cerebral edema was observed postoperatively in one patient, and decompression craniectomy was performed. Intracranial infection was observed in two patients, including one with transient cerebrospinal fluid leakage, which was cured after symptomatic treatment. Moreover, postoperative ocular dysmotility and worse olfactory sensation were observed in one and two patients, respectively. The mean follow-up time of the 11 patients was (24.4 ± 5.7) months. The one-year survival rate of the patients was 100%; 10 patients (90.9%) had a favorable outcome (Glasgow Outcome Scale score of 4-5), and only one patient (9.1%) had a Glasgow Outcome Scale score of 3. Furthermore, during the last follow-up, tumor recurrence occurred in two patients (18.2%). CONCLUSION: Surgical treatment of cranionasal communicating tumors using the cranionasal dual approach and simultaneous skull base reconstruction improves the gross tumor resection rate with fewer postoperative complications and good short-term efficacy.

Asunto(s)

Adenocarcinoma , Neoplasias Nasales , Neoplasias de la Base del Cráneo , Humanos , Estudios Retrospectivos , Recurrencia Local de Neoplasia , Endoscopía , Base del Cráneo/patología , Base del Cráneo/cirugía , Neoplasias de la Base del Cráneo/cirugía , Neoplasias Nasales/cirugía , Resultado del Tratamiento

RESUMEN

In Situ transformed carbon fibers/Al2O3 ceramic matrix nanocomposites with Cao-MgO-SiO2 sintering agent were prepared by hot-pressed sintering technology in vacuum. In the sintering process, pre-oxidized polyacrylonitrile fibers (below named as pre-oxidized PAN fibers) were used as the precursors of In Situ transformed carbon fibers. The micro/nanostructure of composites and interface between In Situ transformed carbon fibers and matrix were investigated, as well as the properties of composites. The results showed that the composites could be sintered well at a relatively low temperature of 1650 °C. During the sintering, the precursors, pre-oxidized PAN fibers, were In Situ transformed into carbon fibers, and the In Situ transformed carbon fibers had the graphitelike structure along the fiber axial direction. The carbon atoms arrangement in the surface layer of the fiber was more orderly than the core. A typical diffraction peak of carbon fiber at 26°, which corresponded to the (002) crystal plane, was observed, and the inter-planar spacing was approximately 0.34 nm. The CaO-MgO-SiO2 sintering agent formed MgAl2O4 and CaAl2Si2O8 phases in the interface between In Situ transformed carbon fibers and matrix, therefore improving the interface bonding, and thereby modifying the mechanical properties of the composites.