The use of current accesses to the tumors of the fourth ventricle, which fill and compress from the outside its cavity, was assessed in 28 patients. Original associated endomicrosurgical techniques were used. Two groups and five topographic types of fourth ventricle tumors are identified. Basic accesses — telovelar and supracerebellar — eliminate the necessity of dissecting the vermis cerebelli. The key endoscopic technique is to provide a simultaneous survey of the lower and upper poles of a tumor during its removal. The technique of trochlear removal of metastatic nodes from the fourth ventricle is shown. The benefits of endoscopic techniques are to early examine the vulnerable vascular and neural structures blocked by a tumor at the access step; to reduce the volume of an access itself and the traction of cerebellar and truncal structures; to completely survey the Sylvian aqueduct without additionally displacing or dissecting the vermis cerebelli; to maintain optical sharpness within sight of differently remote microstructures. Overall, incorporation of the endoscopic method realizes the principle of mini-invasive neurosurgery. 

In patients with kidney cancer (KC), the rate of metastatic brain involvement is 2-11%, is steadily growing, and is one of the important reasons for treatment failures in these patients. Surgery and radiotherapy, including radiosurgery, must be considered as optimal treatments for patients with KC and brain metastases. Systemic drug therapy has recently played a more and more increasing role in the treatment of patients with a progressive brain tumor process. At the same time, there are no exact pharmacokinetic data on drugs registered for the treatment of disseminated KC in respect to their concentration in the human central nervous when they are used in therapeutic doses. On the basis of the data of the literature review and the results of the authors’ studies, it may be concluded that while none of the target agents has still shown any significant advantage over others in treating KC patients with brain metastases. All the drugs have demonstrated their ability to achieve a clinical and X-ray verified objective effect (as stabilizations in most cases) in treating brain metastases. The most data are available on the therapeutic efficacy of sunitinib and sorafenib. In case of progressive brain tumor process, drug treatment should be individually discussed in each situation in accordance with standard approaches to treating patients with disseminated KC. 

Thyroid hormone administration after thyroid tumors surgery is a part of complex treatment strategy. In case of papillary, follicular and poor-differentiated carcinomas suppressive treatment regime is indicated with target TSH level ≤ 0.1 IU/l. Intensity and duration of TSH suppressive treatment regime depends on tumor recurrence risk group and presence of severe cardio-vascular disease. In case of medullary and anaplastic thyroid cancer require substitutive treatment regime as well as after benign tumor surgery. If patient has been undergone partial thyroid resection by reason of benign tumor the suppressive treatment necessity would be settled in terms of postsurgical TSH level. Thereafter on substitutive or suppressive L-thyroxine treatment patient has achieved target TSH level the further control of it is conducting half in year and annually later. 

The paper proposed a procedure that can prevent peristomal recurrences in patients with larynx cancer after laryngectomy (LE). In the period 2010 to 2011, LE was performed in 95 patients with III stage T3N0M0 larynx cancer (according to the conventional procedure in 52 cases of them), among whom periostomal recurrences were identified in 3 (5.7%) patients in the period 8 to 12 months. A study group comprised 43 patients in whom LE was combined with paratracheal fat removal on both sides — they are all currently observed without a tumor relapse and metastases. The above data may suggest that some patients with tumor spread to all 3 laryngeal segments and with fold part involvement and its transition to subfold one need paratracheal fat removal. 

The paper analyzes clinical observations of 40 patients with locally advanced and recurrent oropharyngeal cancer, who underwent multicomponent surgery with simultaneous removal of a primary tumor and cervical lymph outflow tracts, which was accompanied by discontinuity of the mandibular arch with concurrent tracheostomy.

In 1969–2012, prosthetic replacement was performed in 102 patients with postoperative maxillary defects, including 90 patients with complete secondary adentia and 12 with total maxillary defect. Procedures for fixation of immediate prostheses (protective plates) were improved; practical guidelines were elaborated to transform the protective plate into a primary permanent prosthesis with an obturator. The primary permanent (forming) prosthesis is recommended in the postoperative period (on days 10–15). 

A medicopsychological study of the time course of psychic changes was conducted in 88 cancer patients with defects of facial soft tissues (n = 38) and maxilla (n = 50). Since the patients’ visit to an oncologist, the diagnostic-stage depth of mental disorders was rather various: from mild asthenia to depression. Thus, 88 (100 %) patients were found to have an anxious feeling, 16 (18.2 %) had affective-shock reactions; 7 (7.9 %) had reactive depression. In the postoperative period, anxiety-depressive syndrome gave way to astheno-depressive one. After hospital discharge, the reactive state became less tense during psychosocial readaptation, the characteriological personality changes were increasingly more pronounced in the forefront in the patients. They became anxious, suspicious, unconfident about themselves, sensitive, tried to avoid difficult situations in life. The circle of interests was limited to thoughts on their own health. Combination therapy with psychotropic drugs was used to correct the mental status of patients with acquired maxillary defects in the study group. The dosage of the drugs was individually adjusted according to the degree of psychopathological manifestations. 

Speech recovery sessions were conducted in 63 patients with acquired maxillary defects. Assessment of speech quality in patients after auditory maxillary resection without a prosthestic has indicated 100 % significant rhinolalia, indistinct articulation. Prosthetic defect replacement completely corrects speech dysfunction and creates conditions for forming correct speech stereotypes. Speech therapy sessions and testing are aimed at increasing the performance of the speech apparatus and at improving the automatizaton of speaking skills. The techniques to remove nasal emission include: – articulation exercises (activation of the muscles of the lips, cheeks, tongue, pharynx, neck, and larynx); – speech respiratory gymnastics; – phonopedic (vocal) exercises. The elements of rational psychotherapy have extensive applications during each session and include suggestion, an emotional exposure to correct personality disorders, as well as pedagogical elements. 

Surgical damage of motor nerves is one of the serious complication which deteriorates patient’s life quality as well as being often a cause of disability. In the article are reflected the methodological aspects of intraoperative neuromonitoring. This method is auxiliary and not substituting the surgical visualization of nerves, but significantly facilitates nerve disclosure as well as functional integrity. Intraoperative neuromonitoring permits to reduce the unintended injury or motor nerves during the operation. This is extremely actual in cases of atypical nerve dispositions, reoperations and when surgery is executed by inexperienced surgeon. 

The paper presents a review of literature on the most unstudied problem in head and neck oncology — the diagnosis and treatment of patients with cervical lymph node metastases without a primary focus being detected.

The paper analyzes a rise in the incidence of oral cancer in the Rostov Region since the 1990s. The study has indicated that this rise is associated with regional population growth due to the forced migrants after the collapse of the USSR. Financial problems, unbalanced nutrition, poor oral hygiene, and depression in this group of patients have contributed to the higher incidence of precancers and cancers.

Reports of metastatic meningiomas are rare. The previous existence of a cranial neoplasm, the non-contiguous site of metastasis and the close histological resemblance point towards the metastatic nature of extracranial lesion

The paper describes the rare malignancy alveolar soft tissue sarcoma. The tumor was located in the parapharyngeal space; it was detected during pregnancy. The authors give the data available in the literature on the clinical manifestations of this disease, the specific features of morphological diagnosis, and treatment policy. The described case focuses on the complexities of diagnosis and preoperative preparation and surgical techniques.