In this case report, we describe a 53-year-old woman who presented with a slow-growing lower lid mass in her right eye. On gross examination, a remarkable lower lid bulging was noted. On palpation, a subcutaneous oval-shaped mass with a firm consistency, measuring about 2cm, was noted. The uncorrected visual acuities of the patient were 20/20 (by Snellen chart) bilaterally, and the examinations of the anterior and posterior segments of both eyes were unremarkable. On the orbital Computed Tomography scan of the patient, a solitary and homogenous solid globular mass with the same density of the brain tissue was obvious. The patient underwent surgical excision. Microscopic assessment of the lesion revealed a biphasic hypercellular area (Antoni A) and myxoid hypocellular areas (Antoni B), containing slender cells with tapered ends, interspersed with collagen fibers, consistent with a diagnosis of schwannoma. In addition, some foci of nuclear palisading around the fibrillary process (Verocay bodies) could frequently be found throughout the highly cellular regions. Schwannomas rarely occur in the eyelids, but have clinical and paraclinical indicators which indicate the probable diagnosis. In conclusion, we suggest that eyelid schwannoma be considered as an element of the differential diagnoses list for subcutaneous lesions of the eyelid.

• Klíčová slova
• eyelid, mass, schwannoma, tumor, tumour,
• MeSH
• diferenciální diagnóza MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurilemom * diagnóza   chirurgie   patologie   MeSH
• oční víčka patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVES: This study aimed to assess vestibular function in 39 patients who underwent neurectomy for vestibular schwannoma. METHOD: Semicircular canal reactivity was measured by video head-impulse test using high-frequency passive head acceleration. Response gain was calculated as a ratio between the areas under the eye-velocity curve and the head-velocity curve. STATISTICAL ANALYSIS: Student t-test was used for to compare quantitative variables. ANOVA was used to test inter-group differences in categoric variables. RESULTS: In all cases, surgery-side gain on head impulse test was low, with increased gain asymmetry. A subgroup of 7 patients (18%) showed relatively high gain in vestibulo-ocular reflex on the surgery side. Caloric reaction was absent in all cases. These findings indicate that residual vestibular function can be conserved following vestibular schwannoma extirpation. CONCLUSION: Cases with moderate vestibulo-ocular reflex gain were a subgroup with partial conservation of vestibular nerve fibers. Whether this is a predictor of better functional prognosis remains to be elucidated. Higher gain correlated with less extensive surgery and sparing of the inferior vestibular nerve. Low gain correlated with complete vestibular neurectomy. This information may guide rehabilitation strategy following surgery.

• Klíčová slova
• Head-impulse test, Neurectomy, Vestibular schwannoma, Vestibulo-ocular reflex,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nervová vlákna MeSH
• neurochirurgické výkony metody   MeSH
• pooperační komplikace patofyziologie   MeSH
• pooperační období MeSH
• prognóza MeSH
• pulsní rotační test MeSH
• senioři MeSH
• vestibulární aparát patofyziologie   MeSH
• vestibulární funkční testy MeSH
• vestibulární schwannom patofyziologie   chirurgie   MeSH
• vestibulookulární reflex MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Schwannomas are a group of well differentiated benign tumors originating from the Schwann cells of the peripheral nervous system. Their localization in the pelvis is very rare. Schwannomas with expansive growth can cause wide neurologic symptoms or oppression of pelvic organs. CASE REPORT: The authors present a case study of a 60-year-old woman with a large, symptomatic deep pelvic schwannoma. The patient underwent robotic-assisted surgery resulting in complete tumor extirpation. The patient's postoperative course was uneventful with a total of two hospitalization days. The diagnosis of a schwannoma was confirmed by histopathologic analysis. At 11-month follow-up surveillance the patient did not present any neurological deficit or other symptoms. CONCLUSION: Robotic-assisted surgery allows safe and effective surgical treatment in difficult-to-access anatomical areas. Magnetic resonance imaging is required for preoperative imaging of neurogenic tumors. Histological verification is not recommended in cases where evidence of a schwannoma is found. Multidisciplinary cooperation of a dedicated team experienced in minimally invasive pelvic surgery is necessary.

• Klíčová slova
• case report, deep pelvic tumors, neurinoma, robotic surgery, schwannoma,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurilemom * diagnostické zobrazování   chirurgie   MeSH
• pánev patologie   MeSH
• roboticky asistované výkony * MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

AIM: To evaluate the most important factors of quality of life in patients after vestibular schwannoma surgery. MATERIALS AND METHODS: Patients with unilateral sporadic occurrence of vestibular schwannoma who underwent surgery via suboccipital-retrosigmoid approach were included in the prospective study (2018-2021). Patients after previous Leksell gamma knife irradiation (or other methods of stereotactic radiosurgery) were excluded. Quality of life was assessed using 10 validated questionnaires that were distributed preoperatively, 3 months and 1 year after the surgery. RESULTS: A total of 76 patients were included in the study, complete data were analysed in 43 of them (response rate 57%). Grade III and IV represented up to 70% of all tumors. Patients with larger tumors had a significantly higher risk of postoperative facial nerve paresis, liquorrhea and lower probability of hearing preservation. Patients with smaller tumors and those, who suffered from headaches before surgery had more frequent and severe headaches after surgery. Postoperative headaches were associated with higher incidence of anxiety and tinnitus. More frequent anxiety was also identified in patients with preoperative serviceable hearing who became deaf after surgery. Nevertheless, tinnitus and hearing impairment appeared to have less impact on overall quality of life compared to headaches and facial nerve function. CONCLUSION: According to our results, tumor size, postoperative function of the facial nerve and occurrence of postoperative headaches had the greatest influence on the overall postoperative quality of life in patients after vestibular schwannoma surgery.

• Klíčová slova
• Quality of life, Questionnaire, Surgery, Vestibular schwannoma,
• MeSH
• bolesti hlavy MeSH
• kvalita života MeSH
• lidé MeSH
• prospektivní studie MeSH
• tinnitus * MeSH
• vestibulární schwannom * chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Schwannomas (neurilemmomas) are common tumors originating in the sheaths of peripheral nerves. The tumor may have the appearance of a reddish-brown or pale papule that is painful or itching. The surface is usually smooth but may be ulcerated or verrucous. Malignant reversal is rare. The authors present the case of a twenty-year-old patient with a malignant schwannoma of the plantar portion of the heel. They describe the surgical approach, the results of histopathological examination and subsequent follow-up.

• MeSH
• chirurgické laloky MeSH
• dospělí MeSH
• lidé MeSH
• nemoci nohy (od hlezna dolů) chirurgie   MeSH
• neurilemom chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

A case of retroperitoneal schwannoma with histological features of gastrointestinal (GI) schwannoma occurring in a 67-year-old woman is reported. The tumor was composed of spindle cells with focal pseudoatypism and it showed several features typical of gastrointestinal-type schwannoma such as lymphocytic infiltration, peripheral cuff of lymphocytes, lack of Antoni A pattern, and absence of thick walled vessels. Immunohistochemically, the tumor showed diffuse reactivity for S100 protein and glial fibrillary acidic protein. The authors discuss a phenotypical similarity of the lesion with GI schwannoma as well as the possible existence of GI-type schwannoma outside the tubal GI tract.

• MeSH
• diferenciální diagnóza MeSH
• gastrointestinální nádory diagnóza   patologie   MeSH
• lidé MeSH
• neurilemom chemie   diagnóza   patologie   MeSH
• retroperitoneální nádory chemie   diagnóza   patologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: Vestibular schwannoma surgery leads to acute unilateral vestibular loss. In some patients, however, the process of post-operatively initiated central compensation proceeds more rapidly than in others. This study aimed to evaluate post-operative vestibular function and correlate it with morphological findings of MRI scans. METHODS: The study included 29 patients who underwent surgery for vestibular schwannoma. Vestibular function was analysed post-operatively by video head impulse test (vHIT). Subjective symptoms were evaluated using validated questionnaires. All patients underwent MRI 3 months post-operatively, and the presence of the facial and vestibulocochlear nerves in the internal auditory canal was assessed. RESULTS: The vestibulo-ocular reflex gain measured by the vHIT correlated positively with audiological findings. Subjective perception of vestibular disorder did not correlate with objectively measured vestibular impairment or with MRI findings. CONCLUSIONS: After the resection of vestibular schwannoma, some patients may still have preserved vestibular function as measured by vHIT. The preserved function does not correlate with subjective symptoms. Patients with partially deteriorated vestibular function showed lower sensitivity to combined stimuli.

UNLABELLED: Dopo chirurgia del neurinoma vestibolare la funzione vestibolare correla con dati oggettivi estratti dalla risonanza magnetica? OBIETTIVO: La chirurgia dello schwannoma vestibolare causa un deficit vestibolare unilaterale acuto. Tuttavia, in alcuni pazienti il processo di compenso centrale post-operatorio progredisce più rapidamente rispetto ad altri. Il presente studio è finalizzato a valutare la funzione vestibolare post-operatoria e correlarla con i dati morfologici della risonanza magnetica. METODI: Lo studio analizza 29 pazienti sottoposti a chirurgia per schwannoma vestibolare. La funzione vestibolare è stata analizzata nel post-operatorio con il “video head impulse test” (vHIT). I sintomi soggettivi sono stati indagati mediante questionari validati. Tutti i pazienti sono stati sottoposti a risonanza magnetica 3 mesi dopo l’intervento, e su questo esame è stata determinata la presenza dei nervi facciale e vestibolo-cocleare nel canale uditivo interno. RISULTATI: Il riflesso vestibolo-oculare misurato con il vHIT correla positivamente con i dati audiologici. La percezione soggettiva dei sintomi vestibolari non correla né con i dati oggettivi di deficit vestibolare né con le immagini della risonanza magnetica. CONCLUSIONI: Dopo la resezione di uno schwannoma vestibolare i pazienti possono ancora preservare la funzione vestibolare, come è stato misurato con il vHIT. L’entità della funzione preservata non correla con i sintomi soggettivi. I pazienti con una funzione vestibolare parzialmente deteriorata mostrano una minor sensibilità agli stimoli combinati.

• Klíčová slova
• magnetic resonance imaging, unilateral vestibular lesion, vestibular function, vestibular schwannoma, video head impulse test,
• MeSH
• lidé MeSH
• pulsní rotační test MeSH
• vestibulární aparát * MeSH
• vestibulární nemoci * MeSH
• vestibulární schwannom * MeSH
• vestibulookulární reflex fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Summary Schwannomas represent about 8 % of all intracranial tumours, however, ventricular location of schwannomas is extremely rare. If they occur, they are located mostly in the lateral ventricle. To our knowledge there was only one case of third ventricular schwannoma described in the literature. Our case is the second one.

• Klíčová slova
• Intraventricular schwannoma, third ventricle,
• Publikační typ
• kazuistiky MeSH

Skull base tumors and, in particular, vestibular schwannoma (VS) are among the etiological reasons for single-sided deafness (SSD). Patients with SSD have problems in understanding speech in a noisy environment and cannot localize the direction of sounds. For the majority, this is the handicap for which they try to find a solution. Apart from CROS hearing aids, Baha is one of the most frequently used systems for SSD compensation. 38 patients with single-sided deafness after retrosigmoid removal of a vestibular schwannoma underwent testing with a Baha softband from September 2010 to August 2014. Sixteen patients (42 %) finally decided to accept Baha implantation. Subjective experience with the Baha softband was evaluated by patients using the BBSS questionnaire immediately after testing. Objective evaluation of the effect was performed as a measurement of the sentence discrimination score in noise and side horizontal discrimination without a Baha and 6 weeks and 12 months after a sound processor fitting. There was a significant improvement in sentence discrimination in the 6 week (64.0 %) and 1 year (74.6 %) interval of follow-up in comparison with understanding without Baha (24.0 %, p = 0.001) in situations when sentences are coming from the side of the non-hearing ear and noise contralaterally with SNR -5 dB. Baha can significantly improve sentence discrimination in complex-listening situation in patients with SSD after the VS surgery.

• Klíčová slova
• Baha, Hearing in noise test, Retroauricular approach, Single-sided deafness, Vestibular schwannoma,
• MeSH
• dospělí MeSH
• jednostranná nedoslýchavost etiologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokalizace zvuku MeSH
• protézy a implantáty * MeSH
• senioři MeSH
• sluchové pomůcky * MeSH
• srozumitelnost řeči MeSH
• vestibulární schwannom komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Olfactory groove schwannomas (OGSs) are extremely rare tumours, particularly in the paediatric population. CASE REPORT: A 13-year-old girl presented with two epileptic seizures, papilloedema and incomplete binasal quadrantanopia. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a large heterogeneously enhancing tumour of the anterior skull base with a prominent dorsal pseudocyst. Interestingly, the pseudocyst embraced the right ICA bifurcation and displaced the optic tracts, optic chiasm and optic nerves and the ipsilateral basal ganglia. The patient underwent surgery via the frontolateral approach, and the tumour was completely removed. The pseudocyst was opened, and its wall was partially resected. It subsequently resolved completely. Histopathological examination yielded the rare diagnosis of schwannoma of the anterior skull base. CONCLUSION: Although extremely rare, olfactory groove schwannomas can be seen in paediatric patients. Our patient is the youngest ever reported with this histopathological diagnosis along with the formation of a large pseudocyst.

• Klíčová slova
• Anosmia, Anterior skull base, Bilateral nasal quadrantanopsia, Case report, Frontolateral approach, Olfactory groove schwannoma,
• MeSH
• capsula interna patologie   MeSH
• lidé MeSH
• mladiství MeSH
• nádory baze lební patologie   chirurgie   MeSH
• neurilemom patologie   chirurgie   MeSH
• tractus opticus patologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH