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Following direct injection of doxycycline hyclate into the tumor, the schwannomas could increase in peripheral schwannoma size, according to Aims: To demonstrate change in peripheral schwannoma size following direct injection of doxycycline hyclate into the tumor. Nineteen neurofibromatosis type 2-associated peripheral schwannomas affecting peripheral cutaneous or subcutaneous schwannomas between 0. 5 cm and 4 cm in the longest diameter will be diagnosed medically, photographed for location, and injected with between 0. 1 ml and 4 ml of 10 mg/ml doxycycline hyclate from 0. 06 ml to 4 ml of 10 mg/ml doxycycline hyclate By an electronic caliper measurement of the largest tumor diameter, the tumor volume will be estimated. To reduce injection pain, injection of 1% lidocaine can be given pre-doxycycline. Outcome: The key outcome will be longitudinal change in tumor maximal diameter measured at 6-months and 1-year compared to baseline, which was a decrease of 25%.
Source link: https://clinicaltrials.gov/ct2/show/NCT05521048
Patients will be able to obtain triamcinolone acetonide intratympanically on the day before surgery. During surgery samples will be taken to determine how much triamcinolone acetonide translates into the perilymphatic fluid, the perilymph of the semicircular canals, and CSF. Patients undergoing middle fossa or retrosigmoid resection of the vestibular schwannoma will not be screened for perilymph. In these patients, cerebrospinal fluid will be tested to determine triamcinolone acetonide levels.
Source link: https://clinicaltrials.gov/ct2/show/NCT04658836
Background: A prospective randomized study focuses on patients undergoing microsurgical resection of a vestibular schwannoma. Prior research demonstrated promising results of nimodipine for nerve integrity preservation in these patients. During resection of vestibular schwannomas, a prospective, placebo-controlled double-blinded study will be conducted to determine the neuro-protective effects of locally administered nimodipine. During resection of a vestibular schwannoma, the number of patients will be administered locally to the facial and vestibulocochlear nerves. 30 Patients: During resection of a vestibular schwannoma, nimodipine will be delivered locally to the facial and vestibulocochlear nerves. Facial nerve function and hearing will be tested before and three months after surgery. The number of patients with postoperative serviceable hearing and non-serviceable hearing will be compared between both groups according to Gardner-Robertson's hearing scale and House-Brackmann's score for the assessment of facial nerve function will be determined. The number of patients with favorable postoperative outcomes and non-favorable postoperative results will be compared for the evaluation of facial nerve function. Potential risks/inconveniences: The use of nimodipine is associated with the following adverse effects: thrombocytopenia, allergic reactions, hypotension, diarrhea, and bradycardia, ileus, reversibly elevated liver enzymes; Potential risks/benefits: The use of nimodipine is a risk, but patients can profit from the use of nimodipine is avoidable, and patients can profit from elevated liver enzymes.
Source link: https://clinicaltrials.gov/ct2/show/NCT04801953
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