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Otolaryngology: Cervical neurinoma — Surgical resection. Treatment

Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor of the nasopharynx, which is characteristic mainly for boys and young men. Structurally, it is composed of the fibrous tissue and thin-walled vessels, which are bleeding from time to time. The tumor is characterized by an aggressive course. Depending on the growth direction, over time it grows into the nasal cavity, paranasal sinuses and skull base, creating a threat to the patient’s life. The major treatment option is surgery. In some cases, the radiation techniques may be used.
Surgery

The choice of the surgical technique depends on the formation size:

  1. For small tumors, surgery can be performed endoscopically through the natural orifices (mouth or nose). Such an intervention can minimize the tissue trauma.
  2. Another option of removing small JNA is through the palate. The surgeon makes a horseshoe-shaped incision on the upper edge of the gums, excises a portion of the palate on the affected side, and then resects the tumor. Such an access provides a broad overview of the nasopharynx.
  3. Medial tumors, which invaded the nasal cavity or orbit, are removed through the maxillary sinus. The incision in this case is made under the upper lip.
  4. Large JNA, invading the base of the skull, are dissected through the infratemporal fossa.

The day before surgery, the angiography is performed, which allows the embolization (occlusion) of blood vessels feeding the tumor and reduces the risk of bleeding.

JNA is removed to the fullest extent possible. If the total resection is not possible, the formation is excised partially, and the patient is prescribed radiation therapy after surgery. The following techniques are well-proven for angiofibromas:

  1. Stereotactic surgery (Gamma Knife). The tumor residue is affected by a high dose of radiation, which leads to the tumor cell death. The flows of radiation particles are formed so that most of the energy was targeted at the pathological focus. Thus, the healthy tissue is almost not subjected to irradiation. The procedure is performed only once. The effect is manifested over the next 6 to 24 months.
  2. Conformal radiotherapy. The tumor is irradiated precisely from different angles. Consequently, the major impact is targeted exactly at the pathological focus. The surrounding tissues are damaged to a lesser extent than upon conventional irradiation techniques. The sessions are repeated daily for several weeks.

For inoperable JNA, the radiation techniques may be indicated as the main treatment option.

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Hospital Neuwerk Maria von den Aposteln Moenchengladbach

10/10 from 8 Votes

Department of Spinal Surgery

Surgical treatment of cervical neurinoma #368172

The Department of Spine Surgery at the Hospital Neuwerk “Maria von den Aposteln” was founded in 2012. The Department is headed by Dr. med. Andrej Bitter. A key to success in treatment also lies in an effective combination of drugs, heat treatment and targeted mobility processes. .


location_onCountry: Germany
location_searchingCity: Moenchengladbach

Hospital Waldbrol Oberberg

9.7/10 from 23 Votes

Department of Orthopedics and Trauma Surgery, Hand and Foot Surgery and Reconstructive Surgery

Surgical treatment of cervical neurinoma #368353

The Department of Orthopedics and Trauma Surgery, Hand and Foot Surgery and Reconstructive Surgery offers the full range of medical services in accordance with the latest scientific achievements of medicine.


location_onCountry: Germany
location_searchingCity: Waldbrоl

University Hospital Cologne

9.8/10 from 82 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #381411

The Department of Neurosurgery is the center of excellence in research and patient care. The department consists of two sections: the Section of General Neurosurgery specializing in the treatment of diseases of the nervous system and the Section of Stereotactic and Functional Neurosurgery.


location_onCountry: Germany
location_searchingCity: Cologne
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St. Vincentius Clinic Karlsruhe

9.8/10 from 23 Votes

Department of Orthopedics and Pediatric Orthopedics

Surgical treatment of cervical neurinoma #375704

The Department of Orthopedics and Pediatric Orthopedics specializes in the diagnosis and treatment of all congenital and acquired diseases of the musculoskeletal system.


location_onCountry: Germany
location_searchingCity: Karlsruhe

HELIOS Clinic Krefeld

9.7/10 from 38 Votes

Department of Adult and Pediatric Neurosurgery

Surgical treatment of cervical neurinoma #388667

The Department of Adult and Pediatric Neurosurgery offers the full range of services in this medical field.


location_onCountry: Germany
location_searchingCity: Krefeld

Vivantes Neukölln Hospital Berlin

10/10 from 23 Votes

Department of Adult and Pediatric Neurosurgery

Surgical treatment of cervical neurinoma #366826

The Department of Adult and Pediatric Neurosurgery offers the full range of services in this medical field. The department specializes in the detection and surgical treatment of all diseases, malformations, injuries and other lesions of the central and peripheral nervous system.


location_onCountry: Germany
location_searchingCity: Berlin

University Hospital Rechts der Isar of the Munich Technical University

10/10 from 70 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #364990

The Department of Neurosurgery at the university hospital Klinikum rechts der Isar is a part of the newly established “Neuro-Kopf-Zentrum” since March 2007.


location_onCountry: Germany
location_searchingCity: Munich
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University Hospital Oldenburg

10/10 from 33 Votes

Department of Adult and Pediatric Orthopedics, Trauma Surgery

Surgical treatment of cervical neurinoma #371420

The Department of Adult and Pediatric Orthopedics, Trauma Surgery offers full range of services in the corresponding areas. More than 2,500 planned and emergency surgeries are conducted in this department.


location_onCountry: Germany
location_searchingCity: Oldenburg

St. Remigius Hospital Opladen Leverkusen

9/10 from 23 Votes

Department of Spine Surgery

Surgical treatment of cervical neurinoma #369662

The Department of Spine Surgery covers the entire spectrum of conservative and surgical treatment of degenerative diseases, injuries and spinal deformities. Due to a large number of treatment methods and techniques provided by experienced surgeons, every patient is sure to receive a suitable treatment program.


location_onCountry: Germany
location_searchingCity: Leverkusen

University Hospital Frankfurt am Main

10/10 from 97 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #366250

The Department of Neurosurgery specializes in the diagnosis and treatment of neurosurgical diseases. The department has state-of-the-art neurosurgical equipment and a team of highly qualified doctors.


location_onCountry: Germany
location_searchingCity: Frankfurt am Main
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Werner Wicker Clinic Bad Wildungen

9.8/10 from 27 Votes

Department of Scoliosis and Spinal Surgery

Surgical treatment of cervical neurinoma #375379

Werner Wicker Clinic is one of the largest centers of its kind in Europe, which has been maintaining an excellent international reputation for decades. Each year, more than 1,500 patients come here for major spinal surgeries. It uses the entire spectrum of modern spine surgery tools.


location_onCountry: Germany
location_searchingCity: Bad Wildungen

Academic Hospital Bogenhausen Munich

9.2/10 from 43 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #366443

The department of neurosurgery d specializes in the diagnosis and treatment of brain and spine diseases. Performing about 2500 surgeries annually, the department is considered one of the leading centers of neurosurgery in Germany.


location_onCountry: Germany
location_searchingCity: Munich

Charite University Hospital Berlin

9/10 from 95 Votes

Department of Neurosurgery and Pediatric Neurosurgery

Surgical treatment of cervical neurinoma #381461

The Department of Neurosurgery and Pediatric Neurosurgery at the University Hospital Charite deals with the treatment of the peripheral and central nervous systems.


location_onCountry: Germany
location_searchingCity: Berlin
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Academic Hospital Schwabing Munich

8.5/10 from 7 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #366450

The Department of Neurosurgery in Schwabing treats diseases in the brain and spine. The most modern high-tech micro-surgery is used. In order to distinguish the tumour optimally, intraoperative fluorescence microscopy will be used during surgery.


location_onCountry: Germany
location_searchingCity: Munich

Academic Hospital Asklepios Barmbek Hamburg

9.5/10 from 23 Votes

Department of Orthopedics and Trauma Surgery

Surgical treatment of cervical neurinoma #375749

The Department of Orthopedics and Trauma Surgery offers the full range of services in these medical fields. The department specializes in the treatment of injuries of the musculoskeletal system, spine, pelvis, as well as the treatment of diseases and injuries of the joints.


location_onCountry: Germany
location_searchingCity: Hamburg

PAN Clinic Cologne

9/10 from 14 Votes

Department of Neurosurgery

Surgical treatment of cervical neurinoma #364769

The Department of Neurosurgery at the PAN Clinic is staffed by top-class specialists in the field of diagnosis and treatment of acute and chronic neurosurgical diseases.


location_onCountry: Germany
location_searchingCity: Cologne




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