枕下-颞下联合入路颞骨良性肿瘤切除术-附3例报告

目的:介绍枕下-颞下联合入路切除颞骨良性肿瘤的方法及体会。方法:对3例颞枕骨化纤维瘤、颞骨纤维异常增殖症、颞骨血管瘤的巨大颞骨良性肿瘤,均采用枕下-颞下联合入路(倒钩形切口)。辅以显微外科技术进行手术摘除肿瘤。结果:3例均基本完整切除肿瘤,无颅内外感染、脑脊液漏、迷路及颅神经损伤等并发症,经术后随访1.5年～2年未发现肿瘤复发。结论:采用枕下-颞下联合入路切除颞枕骨良性肿瘤可获理想的暴露,最大范围切除肿瘤,可避免损伤毗邻的颅神经、血管以及内耳结构,值得推广。     

内镜鼻窦手术后局部应用Merogel对促进术腔黏膜上皮化的临床效果观察

目的　观察使用美国Xomed公司生产的Merogel(透明质酸 )作为内镜鼻窦手术后的术腔填塞物对促进术腔上皮化的作用。方法　对 16例 (32侧 )经鼻内镜全鼻窦开放术患者进行同体对照观察 ,左侧为Merogel观察组 ,右侧为空白对照组 ,连续内镜随访 12周 ,观察双侧术腔上皮化过程。结果　Merogel侧治愈 93 75 % ,好转 6 2 5 % ,平均上皮化时间 3 4周 ;对照侧治愈 87 5 0 % ,好转12 5 0 % ,平均上皮化时间 8 3周。表明使用Merogel侧术腔上皮化时间比对照组明显缩短。结论　内镜鼻窦手术后局部使用Merogel ,可以促进术腔上皮化过程     

Cross-Cultural Understanding of Aesthetic Surgery: The Male Cosmetic Surgery Patient in Japan and the USA

This review describes the historical development of aesthetic surgery in Japan and parallels with the development of the specialty in the United States. The focus is on the consequences of aesthetic surgery in the male patient when collaboration between mental health clinicians and surgeons lags. The cultural, social, and psychological issues raised are relevant to the diverse cultural groups now seeking aesthetic surgery in the United States. Case illustrations are a reminder to aesthetic surgeons of the potential need for more comprehensive evaluation in the group of male patients who may be at added risk for negative outcomes in terms of satisfaction.     

矢状窦旁脑膜瘤的手术治疗(附39例报告)

目的 提高矢状窦旁脑膜瘤的手术疗效。方法 对39例经手术治疗的矢状窦旁脑膜瘤的临床资料进行回顾性分析，探讨该病的诊断、手术方法、受累矢状窦的处理及对无法全切除之残瘤的补充治疗。结果 本组39例无1例死亡。随访34例，其中3例分别于手术后1年、1．5年、2年复发，均为无法全切除而术后又未行补充治疗者；其余31例随访9个月～11年，未发现复发。结论 矢状窦旁脑膜瘤应尽可能行肿瘤全切除手术，术后辅以放疗可提高疗效。     

电阻抗断层成像硬件系统的初步研究

各种原因导致的人体重要器官的缓慢出血等是导致病人死亡或预后较差的重要原因之一,目前的医学成像技术,包括CT、MRI、PET、超声等还无法对出血的过程进行长期、连续的床旁监测和监护。电阻抗断层成像是以目标体内电阻抗的分布或变化为成像对象的一种新型成像技术,作为一种廉价的无损伤检测技术,不使用核素或射线,无毒无害,因而可以成为对病人进行长期、连续图像监护的设备。本文介绍了一个基于物理模型的电阻抗成像硬件系统(FMMU V3),包括具有32个银复合电极的物理模型、采用DDS技术的恒流激励源、高精度信号检测模块、驱动测量模式程控设置模块、数据采集模块、数字I/O模块和高精度多路电源模块。该系统基于物理模型的测量数据经100次迭加后,测量精度在小信号时为1.0%,大信号时为0.1%。采用外触发DMA方式采集一组成像数据(32 X 31个)的时间小于1秒,基本满足了基于物理模型的动态成像要求,并给出了基于物理模型的初步动态成像结果。     

胸锁乳突肌肌骨膜瓣喉气管重建术动物实验与临床应用

为探讨胸锁乳突肌肌骨膜瓣在喉气管重建术中的作用，切除狗环状软骨弓及部分气管前壁造成缺损，取胸锁乳突肌肌骨膜瓣修复，分别于术后２个月～８个月处死动物，观察修复情况，并取材作光镜及扫描电镜检查。结果发现：胸锁乳突肌肌骨膜瓣行喉气管重建具有良好支撑力，修复的呼吸道通畅，无瘢痕及肉芽组织形成，移植骨膜表面为粘膜上皮覆盖，深层有新骨组织形成。临床治疗５例患者，均拔除气管套管，恢复正常呼吸功能。胸锁乳突肌肌骨膜瓣是理想的喉气管重建材料。     

Vascular compression of the airway: Indications for and results of surgical management

Vascular compression of the airway is a significant cause of respiratory compromise in children. While the indications for surgical repair are sometimes life threatening, they can also be subtle. This retrospective study examines 45 surgical cases of tracheobronchial compromise secondary to vascular compression at a large children's hospital between July 1983 and February 1996. A total of 34 were diagnosed with innominate artery compression, ten with a double aortic arch and one with an anomalous right subclavian artery. The 45 patients, 25 male and 20 female, ranged in age from 12 days to 11 years at surgery (average 13 months). A total of 21 (47%) presented with proven or suspected episodes of cyanosis or apnea. All 45 patients had evidence of vascular compression during microlaryngoscopy and bronchoscopy. The diagnosis was confirmed by magnetic resonance imaging (MRI) in 23/45 (51%), barium swallow in 22/45 (49%) and aortogram in 3/45 (7%). There was one death. One patient had a tracheotomy before surgery and continues to require it after surgery. Complete resolution of symptoms was achieved in 39/45 (87%) with five requiring more than one operation before their symptoms resolved completely. A total of four patients experienced a recurrence of symptoms within a variable length of time after surgery. Surgical indications and treatment alternatives will be discussed.     

GLOMUS TUMORS──A REVIEW OF 8 CASES WITH INTRODUCTION OF A MODIFIED COMBINED INTRA-AND EXTRACRANIAL APPROACH

Eight cases of glomus tumors hospitalized in our department from 1982 through 1995 were reviewed. It comprised of five glomus tympanic tumors and three glomus jugular tumors. Discussion was centered on it’s contemporary diagnosis, classification and surgical treatment with introduction of a modified combined intra-and extracranial surgical approach to resect the extensive glomus tumors.     

Clinical experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results

The Danish model for vestibular schwannoma (VS) surgery has been influenced by some historical otological events, taking its origin in the fact that the first attempt to remove CPA tumors was performed by an otologist in 1916. In approximately 50 years VS surgery was performed by neurosurgeons in a decentralized model. Highly specialized neuro- and otosurgeons have been included in our team since the early beginning of the centralized Danish model of VS surgery in 1976. Our surgical practice has always been performed on the basis of known and proven knowledge, but we spared no effort to search for innovative procedures. The present paper reflects the experience we have gained in two decades of VS surgery. Our studies on the incidence, symptomatology, diagnosis, expectancy and surgical results are presented. Received: 26 February 1997 / Accepted: 7 July 1997     

食管腺癌单纯手术与合并术前化疗比较

[目的]比较食管腺癌单纯手术与合并术前化疗的预后。[方法]单纯手术组91例，术前DDP，5FU联合化疗组16例，术前VP16、ADM、DDP联合化疗组22例，比较3组的生存率。[结果]单纯手术组91例手术死亡率2％，2年生存率24％，4年生存率8％。术前DDP、5FU联合化疗组16例，化疗后完全缓解1例（16％），部分缓解5例（31％），无效10例（63％），12例手术切除，1例由于化疗有关死亡，1例手术死亡，2、4年生存率均为42％。术前DDP、ADM、VP16联合化疗组22例，化疗后1例完全缓解（5％），11例部分缓解（50％），10倒无效（45％），18例手术切除，无手术死亡，2年生存率58％。[结论]术前化疗能明显提高食管腺癌病人的生存率，同时治疗应个体化。