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991.
This report concerns one case of a sphenoid sinus mucocele occurring 17 years after transsphenoidal surgery for acromegaly.
In 1979, a 51-year-old man was successfully operated by the transnasal transsphenoidal approach for a growth hormone (GH)
adenoma 1 cm in diameter. In 1996, the patient was hospitalized for headaches and diplopia. He presented a loss of right visual
acuity with paralysis of the right oculomotor nerve. The basal GH level was normal with a satisfactory decrease after oral
glucose ingestion. Pituitary sellar radiography showed a disappearance of the posterior clinoid while magnetic resonance imaging
revealed the existence of a bilocular, circular, homogeneous lesion of the sphenoid sinus 3 cm in diameter with a posterior
and lateral extension. The diagnosis of mucocele was confirmed by surgical treatment, allowing drainage of the mucocele through
a transsphenoidal approach. The drained material was composed of sinus epithelium containing many polynuclear and resorptive
cells. Postoperatively, the symptoms decreased dramatically, leading to full recovery of visual function and disappearance
of the headaches. Apart from the tumor recurrence, the mucocele of the sphenoid sinus can be evoked as a possible long term
complication of transsphenoidal sugery for pituitary adenoma.
Received: 2 June 1998 / Accepted: 23 February 1999 相似文献
992.
Craniofacial surgery concepts developed originally for reconstruction may also be applied to aesthetic surgery. The facial
skeleton is an important component of appearance and may be modified using common craniofacial surgery techniques. Three representative
male patients are presented, who each desired an improvement in his appearance. The techniques used were different and combined
orthognathic and remodeling procedures. Aesthetic male facial skeletal surgery was beneficial in these selected cases. The
results were well received and without complications. Surprisingly, we have found that male skeletal aesthetic patients did
not have unrealistic expectations and were pleasant to manage pre- and postoperatively. 相似文献
993.
窥镜下激光治疗前列腺增生症 总被引:2,自引:0,他引:2
目的 评价经尿道激光前列腺切除术(TULP)的疗效及其与前列腺大小的关系。方法 回顾分析了1988年至1998年10年,采用TULP治疗的469例前列腺增生症患者对手术技术、手术前后的症关改善情况进行比较,并对233例符合条件的患者TULP手术效果与前列腺大小的相关性进行了研究。结果 469例患者前列腺症状评分(IPSS)平均值由术前的26.7降到术后的14.2;最大尿流率平均值由6.2ml/s上 相似文献
994.
目的:通过对拟诊为宫外孕的100例病人行腹腔镜检查,探讨腹腔镜在异位妊娠中的早确诊、早治疗以及对一些不典型病例诊断中的意义。方法:于腹腔镜下对83例有停经史、17例无停经文病人进行观察,同时部分病人实施药物局部注射治疗。结果:输卵管妊娠95例,卵巢妊娠2例,非宫外孕3例;平均出血量51ml,宫外孕未破裂者9例。结论:腹腔镜在异位妊娠的早期确诊中有重要价值,根据腹腔镜下观察的病变作出正确诊断,同时为手术方式提供合理方案。 相似文献
995.
冠脉搭桥术:8例经验体会 总被引:1,自引:0,他引:1
目的 总结冠脉搭桥术( C A B G) 的临床经验和体会、寻找最佳的围术期处理方法。方法 分析8 例 C A B G 患者完整的临床资料。心绞痛7 例,陈旧性心肌梗塞伴左室室壁瘤形成及发作性心绞痛1 例。并发高血压病者6 例,糖尿病3 例。 N Y H A 心功能Ⅱ级1 例,Ⅲ级4 例,Ⅳ级3 例。内乳动脉替代7 例,共用大隐静脉桥15 支。结果 1 例,术后因对角支静脉桥出血,行第2 次开胸修补止血。次2 日又因胸骨裂开,第3 次开胸行胸骨再固定术。全组无手术死亡病例,出院时心绞痛症状完全缓解。结论 C A B G 成功的关键除病变部位的准确诊断外,桥的获取及良好的心肌保护至关重要。 相似文献
996.
The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern 总被引:1,自引:0,他引:1 下载免费PDF全文
AIM: To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern. METHODS: Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual acuity, visual fields, intraocular pressure, satisfaction with current vision, personal health history and habits, and a standardised eye examination and photography of the lens and fundus. Lens photographs were graded twice and adjudicated to document lens opacities. Cataract was defined as nuclear greater than or equal to standard 2, 4/16 or greater cortical opacity, or any posterior subcapsular opacities. RESULTS: 3271 (83% response) people living in their own homes were examined. The participants ranged in age from 40 to 98 years and 1511 (46.2%) were men. Previous cataract surgery had been performed in 107 (3.4%) of the participants. The overall prevalence of any type of cataract that had not been surgically corrected was 18%. If the presence of cataract as defined was considered the sole criterion for cataract surgery with no reference to visual acuity, there would be 309 cataract operations per 1000 people aged 40 and over (96 eyes of people who were not satisfied with their vision, 210 eyes of people who were satisfied with their vision, and three previous cataract operations). At a visual acuity criterion of less than 6/12 (the vision required to legally drive a car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision. CONCLUSIONS: Estimates of the need for cataract surgery vary dramatically by level of lens opacity, visual acuity, and patient concern. These data should be useful for the planning of health services. 相似文献
997.
G. Melles F. Lander F. Rietveld L. Remeijer W Beekhuis P. Binder 《The British journal of ophthalmology》1999,83(3):327-333
AIMS: To describe a new surgical technique for deep stromal anterior lamellar keratoplasty. METHODS: In eye bank eyes and sighted human eyes, aqueous was exchanged by air, to visualise the posterior corneal surface--that is, the "air to endothelium" interface. Through a 5.0 mm scleral incision, a deep stromal pocket was created across the cornea, using the air to endothelium interface as a reference plane for dissection depth. The pocket was filled with viscoelastic, and an anterior corneal lamella was excised. A full thickness donor button was sutured into the recipient bed after stripping its Descemet's membrane. RESULTS: In 25 consecutive human eye bank eyes, a 12% microperforation rate was found. Corneal dissection depth averaged 95.4% (SD 2.7%). Six patient eyes had uneventful surgeries; in a seventh eye, perforation of the lamellar bed occurred. All transplants cleared. Central pachymetry ranged from 0.62 to 0.73 mm. CONCLUSION: With this technique a deep stromal anterior lamellar keratoplasty can be performed with the donor to recipient interface just anterior to the posterior corneal surface. The technique has the advantage that the dissection can be completed in the event of inadvertent microperforation, or that the procedure can be aborted to perform a planned penetrating keratoplasty. 相似文献
998.
OCT imaging of choroidal neovascularisation and its role in the determination of patients'' eligibility for surgery 总被引:2,自引:1,他引:1 下载免费PDF全文
A Giovannini G Amato C Mariotti B Scassellati-Sforz... 《The British journal of ophthalmology》1999,83(4):438-442
AIM: To evaluate the optical coherence tomographic characteristics of choroidal neovascularisation (CNV) in age related macular degeneration (AMD) and in idiopathic and inflammatory CNV. The use of this technique in the selection of patients for surgery is discussed. METHODS: Ocular coherence tomography (OCT), fluorescein, and indocyanine green angiography were performed in 23 patients affected by AMD complicated by well defined CNV and in 10 patients affected by inflammatory or idiopathic CNV. The neovascular membrane was surgically removed in five age related CNVs, two inflammatory choroidopathies, and two idiopathic CNVs. RESULTS: In inflammatory and idiopathic CNV, the OCT displayed a neovascularisation on the retinal pigment epithelium (RPE). In three cases the CNV was excised with an improvement of visual acuity equal to or greater than two Snellen lines; in a fourth case, the visual acuity after surgery was unchanged. In the cases of AMD the OCT fell into three different patterns: (A) CNV above the RPE (five cases); (B) focal, irregular thickening of the retinal pigment epithelial band (12 cases); (C) CNV above and below the RPE (six cases). The five pattern A CNV patients underwent the surgical excision of the neovascularisation. In four cases the visual acuity improved by two or more Snellen lines; in the fifth case the visual acuity remained unchanged. CONCLUSIONS: The authors suggest that the surgical removal of early age related CNV could be performed in those cases where the OCT shows a neovascular membrane on the RPE, as in idiopathic and inflammatory CNVs. 相似文献
999.
准分子激光原位角膜磨削术后继发圆锥角膜病因分析 总被引:1,自引:0,他引:1
目的 对4眼准分子激光原位角膜磨削术(LASIK)后继发圆锥角膜进行病因分析。方法 为4眼重度近视患者行常规LASIK治疗,术后角膜地形图分析确诊圆锥角膜,对手术前皇检查的各项数值行回顾性分析。结果 4眼LASIK术后患者激光切削后剩余角膜基质厚度均大于200um,眼压正常,术后7个月~1年半发生圆锥角膜,其中1眼行穿透性角膜移植术获得满意疗效。结论 虽然LASIK术后保留角膜常规厚度,眼压正常, 相似文献
1000.
脱位晶状体摘出联合后房型人工晶状体缝线固定术 总被引:3,自引:1,他引:2
目的 探讨晶状体脱位手术摘出联合Ⅰ期后房型人工晶状体缝线固定的临床疗效。方法 对15眼脱位晶状体,其中Marfan 综合征2 眼、钝挫性晶状体脱位7 眼、确诊为单纯性晶状体脱位3 眼、白内障囊外摘出术中晶状体脱入玻璃体内3 眼进行晶状体摘出联合后房型人工晶状体缝线固定术。结果 术后视力在0.1 以上者13 眼(86.7% ),0.5 以上者9眼(60% );主要手术并发症:前房少量出血、高眼压、虹膜炎性反应、玻璃体腔内出血,术后1~2w k 均得到控制。结论 此术式是一种安全有效、视力恢复满意的治疗方法,可获得好的临床效果。 相似文献