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Zöller JE Mischkowski RA Behr R Ernestus RI Speder B 《Journal of maxillofacial surgery》2001,29(3):159-164
Introduction: A combined extra-intracranial access for the operative exploration of tumours of the anterior and middle skull base is indicated when the tumour extends intracranially and simultaneously into the nasal cavity, the paranasal sinuses or the orbit. Methods: Two standardized modifications of the fronto-orbital osteotomy, the fronto-orbito-nasal and the fronto-orbito-zygomatic osteotomy, allow safe removal of skull base tumours in these locations. In extensive skull base tumours, a modified bilateral fronto-orbital-zygomatic osteotomy can be used. Results: Between February 1993 and July 2000 skull base tumours in 111 patients were resected using the presented methods. The most frequent tumour type was meningioma in 29 cases. Complications were encountered in 13 cases (11.7%). Conclusion: The advantages over other approaches are good extra- and intracranial overview and minimal cerebral trauma. Additional transfacial incisions are not usually necessary. Exact repositioning of the fronto-orbital segments leads to optimal aesthetic results. Copyright 2001 European Association for Cranio-Maxillofacial Surgery. 相似文献
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Cara J. Kiff Stephanie Ernestus Araceli Gonzalez Philip C. Kendall Anne Marie Albano Scott N. Compton 《Journal of clinical child and adolescent psychology》2018,47(6):S542-S554
Bioecological models of developmental psychopathology underscore the role of familial experiences of adversity and children’s individual-level characteristics in heightening risk for pediatric anxiety through direct, combined, and interactive effects. To date, much of the existing research dedicated to pediatric anxiety disorders has largely been examined in bioecological models of diathesis-stress using community samples. This study extends our understanding of children’s differential responsiveness to familial adversity by examining the diathesis-stress interaction of cumulative risk and children’s individual-level vulnerabilities (negative affectivity and coping efficacy) within a clinic-referred treatment study for pediatric anxiety disorders. A cumulative risk index assessing exposure to familial adversity (e.g., socioeconomic status [SES], parent psychiatric illness) and self-reported measures of children’s negative affectivity and coping efficacy were each measured at the intake of a randomized controlled clinical trial for the treatment of pediatric anxiety disorders (N = 488; 7–17 years of age). Trajectories of interviewer-rated anxiety symptoms were assessed across 12 weeks of treatment at baseline, 4 weeks, 8 weeks, and 12 weeks. Consistent with models of temperamental risk for mental health problems, negative affectivity predicted higher anxiety symptoms at intake. A significant diathesis-stress interaction between cumulative risk and coping efficacy emerged, as high risk and perceptions of lower coping efficacy attenuated declines in anxiety across 12 weeks. These patterns did not differ across treatment conditions. The results indicate that for youth experiencing high levels of stress, additional treatment efforts targeting familial stressors and coping efficacy may be important in maximizing treatment outcomes. 相似文献
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The spinal nerve can be pinched between the transverse process of the fifth lumbar vertebra and the sacral ala. The patients
are divided into two types: elderly persons with degenerative scoliosis and somewhat younger adults with isthmic spondylolisthesis.
For the first time, we describe extraforaminal impingement of the spinal nerve in transitional lumbosacral segment with unilateral
transverse process anomaly. Selective nerve root blocks were performed in two clinical cases. One patient underwent nerve
root decompression via a posterior approach. One year after operation, this patient reported no radicular or lumbar pain.
The pathoanatomical study demonstrated pseudoarthrosis between the transverse process and the ala of the sacrum and showed
dysplastic facet joints at the level below the transitional vertebra in all specimens. Furthermore, we present the oldest
illustration of this pathological condition, published in a book by Carl Wenzel in 1824. Extraforaminal entrapment of the
spinal nerve in transitional lumbosacral segment with unilateral transverse process anomaly can cause radiculopathy, and osteophytes
are the cause of the entrapment. Dysplastic facet joints on the level below the transitional vertebra could be one reason
for “micromotion” resulting in pseudoarthrosis with osteophytes. Sciatica relief was obtained by means of selective nerve
root blocks or posterior decompression via a dorsomedial approach. 相似文献
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