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Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report

Endolymphatic sac tumors (ELSTs) are rare neuroectodermal neoplasms arising within the posterior petrous bone. We present a case of a 21-year-old man who presented with a 6-month history of intermittent morning headaches, fatigue, diplopia, and gait ataxia. Imaging and surgical pathology identified...

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Autores principales: Guha, Daipayan, Menard, Cynthia, Evans, Wayne, Gentili, Fred, Zadeh, Gelareh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743603/
https://www.ncbi.nlm.nih.gov/pubmed/23984214
http://dx.doi.org/10.1055/s-0031-1284207
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author Guha, Daipayan
Menard, Cynthia
Evans, Wayne
Gentili, Fred
Zadeh, Gelareh
author_facet Guha, Daipayan
Menard, Cynthia
Evans, Wayne
Gentili, Fred
Zadeh, Gelareh
author_sort Guha, Daipayan
collection PubMed
description Endolymphatic sac tumors (ELSTs) are rare neuroectodermal neoplasms arising within the posterior petrous bone. We present a case of a 21-year-old man who presented with a 6-month history of intermittent morning headaches, fatigue, diplopia, and gait ataxia. Imaging and surgical pathology identified an adenocarcinoma of the endolymphatic sac compressing the cerebellum and brain stem. The tumor and multiple metastases were treated with surgery, radiation, and radiosurgery. Following insertion of a ventriculoperitoneal shunt for hydrocephalus, he developed symptomatic tension pneumocephalus secondary to radionecrosis of his petrous bone, requiring flap reconstruction and use of a programmable shunt valve complemented by hyperbaric oxygen (HBO) therapy. We document here a young patient with a rare adenocarcinoma of the endolymphatic sac. This case is unique for its initial presentation without any vestibuloauditory symptoms. Metastatic spread of ELSTs is also rare. While osteoradionecrosis (ORN) of the temporal bone has been reported previously in patients with nasopharyngeal carcinoma, this is the first time it has been presented in the context of an ELST. Tension pneumocephalus is a rare complication of skull base ORN. This is the first reported use of a programmable shunt valve and HBO therapy in the management of tension pneumocephalus.
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spelling pubmed-37436032013-08-27 Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report Guha, Daipayan Menard, Cynthia Evans, Wayne Gentili, Fred Zadeh, Gelareh Skull Base Rep Article Endolymphatic sac tumors (ELSTs) are rare neuroectodermal neoplasms arising within the posterior petrous bone. We present a case of a 21-year-old man who presented with a 6-month history of intermittent morning headaches, fatigue, diplopia, and gait ataxia. Imaging and surgical pathology identified an adenocarcinoma of the endolymphatic sac compressing the cerebellum and brain stem. The tumor and multiple metastases were treated with surgery, radiation, and radiosurgery. Following insertion of a ventriculoperitoneal shunt for hydrocephalus, he developed symptomatic tension pneumocephalus secondary to radionecrosis of his petrous bone, requiring flap reconstruction and use of a programmable shunt valve complemented by hyperbaric oxygen (HBO) therapy. We document here a young patient with a rare adenocarcinoma of the endolymphatic sac. This case is unique for its initial presentation without any vestibuloauditory symptoms. Metastatic spread of ELSTs is also rare. While osteoradionecrosis (ORN) of the temporal bone has been reported previously in patients with nasopharyngeal carcinoma, this is the first time it has been presented in the context of an ELST. Tension pneumocephalus is a rare complication of skull base ORN. This is the first reported use of a programmable shunt valve and HBO therapy in the management of tension pneumocephalus. Thieme Medical Publishers 2011-07-21 2011-11 /pmc/articles/PMC3743603/ /pubmed/23984214 http://dx.doi.org/10.1055/s-0031-1284207 Text en © Thieme Medical Publishers
spellingShingle Article
Guha, Daipayan
Menard, Cynthia
Evans, Wayne
Gentili, Fred
Zadeh, Gelareh
Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title_full Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title_fullStr Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title_full_unstemmed Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title_short Flap Reconstruction and Hyperbaric Oxygen Therapy in the Management of Temporal Bone Osteoradionecrosis in an Endolymphatic Sac Tumor: Case Report
title_sort flap reconstruction and hyperbaric oxygen therapy in the management of temporal bone osteoradionecrosis in an endolymphatic sac tumor: case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743603/
https://www.ncbi.nlm.nih.gov/pubmed/23984214
http://dx.doi.org/10.1055/s-0031-1284207
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