Neurologia i Neurochirurgia Polska

Background: No gold standard has been developed for the therapy of intracanalicular vestibular schwannomas (IVS). Options for treatment include a conservative approach, microsurgery, or radiosurgery. Although the efficacy of these treatment has been well-documented, little is known about the determinants of outcome in IVSs following radiosurgery. Therefore, we examined the results in relation to age, gender, tumor volume, distance to fundus, microcyst existence, and radiosensitivity in this group. In addition, we investigated possible predictors of facial nerve function and hearing preservation. Methods: Ninety-four patients with unilateral IVS were included in the evaluation (52 women and 42 males). The patients were separated into younger and older age groups based on their median age (55 years). The median IVS volume was 138 mm ³ , microcysts were identified in 16 tumors, and 63 tumors were adjacent to the fundus. The data were analyzed using Statistica software package ver. 13.3. Results: At final follow-up, a statistically significant decrease in tumor volume and no statistically significant decline in hearing were noted, but no differences between age groups were found. The sex had no effect on overall tumor growth control, facial nerve preservation, or hearing preservation. Localization of IVS close to the fundus and the presence of tumor microcysts had no effect on the control of tumor growth, preservation of hearing, and sparing of facial nerve following radiosurgery. Cochlear dose had no influence on hearing preservation. Higher tumor volume was associated with its pseudoprogression during early follow-up and a greater risk of hearing loss. Conclusions: Age, sex, tumor volume, proximity to the fundus, and the existence of a microcyst were not predictive of radiosensitivity nor preservation of facial nerve function and hearing, based on the findings. There was no effect of cochlear dose on hearing. Initial greater tumor volume was associated with an increased probability of tumor pseudoprogression.

Introduction: The masticatory system has the remarkable ability to adapt to a changing biomechanical environment. However, due to the significant influence of the stomatognathic system on other ones, the impact of the craniotomy seems to be noteworthy.

Introduction: The human body posture takes a place in the mother’s womb and physically begins with the birth of the child. In literature, the assessed frequency of presence of postural defects depends on the method of assessment and the adopted criteria of correct body posture. The aim of the study was to assess the relationship between gender and body posture defects.Materials and Methods: The presented cross-sectional study includes 58 people, 29 boys and 29 girls, students of the secondary school. Assessment of body posture was based on visual analysis and palpation of the body in the sagittal and frontal planes. In addition, the following clinical tests were used: Thomas test, Ober’s test, Patrick’s test, and toe-floor functional test. The physical activity was also considered.Results: The results of research show there is relationship between the sex of the participants and the occurrence of body posture defects in the sagittal plane.Conclusions: 1. The gender of adolescents may predispose to a specific posture defect.2. Insufficient amount of physical activity can be a contributing factor of posture defects.

Introduction: The different theories concerning the perinatal sternocleidomastoideus muscle problems are discussed in numerous reviews. Perinatal injuries of mentioned muscle have been the subject of controversy since they were first postulated by Stromeyer in 1838. Sternocleidomastoideus characterized by fibrosis, result in a shortening and consequent limited neck motion. When left untreated, may result in progressive limitation of head movement which may cause eye movement disorder, craniofacial asymmetry, neck pain and compensatory asymmetrical spine curvature that worsens with age. Aim: This research presents a very rare case of perinatal sternocleidomastoideus muscle injury with gentle torticollis and neck swelling in a 4-week-old girl treated with manual therapy. Case report: The patient with normal spontaneous vaginal delivery. Born at 38 weeks gestational age with 3710 g weight, 58 cm of birth height, scored at 10 APGAR. Head tilt was observed since birth and the lump occurred at 1 week after. USG examination showed a lesion 33.6 x 14.9 mm of the SCM. The baby underwent three manual treatment units, a one week apart. Results: Resolve of swelling and restore a full passive and active range of motion in the cervical spine was achieved after the treatment. USG examination reveal image corresponded to reorganization and healing of muscle fibers. Conclusions: Manual therapy with proper care can be an effective strategy of perinatal SCM injury treatment.