后颅窝扩大成形术治疗Arnold-Chiari畸形合并脊髓空洞症的临床研究

目的研究Arnold—Chiari畸形合并脊髓空洞症显微外科手术中后颅窝底及寰椎后弓切除对脑组织和寰枕部稳定性的影响及钛网后颅窝扩大成形术对保持后颅窝结构、功能稳定的临床应用。方法对12例Arnold—Chiari畸形钛网后颅窝及寰椎后弓扩大成形患者与156例未成型患者的术后临床症状、枕颈部的稳定性及生活质量进行对照。结果12例扩大成型患者术后临床症状不明显,生活质量高;而未成型者多有头痛、头晕、枕颈交界部不适等症状以及惧怕枕颈部遭受外力的恐惧心理。结论钛网后颅窝及环椎后弓扩大成形术可相对维持后颅窝的生理结构,减少患者的临床症状,提高生活质量。     

阴茎海绵体破裂治疗并文献分析

目的:探讨阴茎海绵体破裂的治疗方法。方法:总结分析某医院收治的8例阴茎海绵体破裂患者的临床资料、诊断及治疗。结果:8例患者中,7例患者立即手术治疗,1例保守治疗。术后患者性生活正常,无阴茎勃起功能障碍。结论:阴茎海绵体破裂有典型的病史及临床表现,急诊手术治疗是推荐的治疗方法。     

Microsurgical anatomy of the abducens nerve

The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. Clin. Anat. 25:1030–1042, 2012. © 2012 Wiley Periodicals, Inc.     

Midcheek mass: 10 year of clinical experience

This is a literature review and retrospective chart review of ten years experience on the treatment of midcheek masses in our department. The purpose of this study is to provide the reader with an overview of the pathology of this complex anatomic area focusing the attention on the differential diagnosis and the recent surgical strategies.From May 2002 to December 2012 we enrolled 22 consecutive patients studied for masses located in the midcheek area. Only four studies were found in the literature describing the experience of individual centres reporting few cases of midcheek masses. Combined with the previously reported 37 cases, we describe 22 lesions for a total of 59 cases. Patients were evaluated with a head and neck clinical and instrumental examination. Apart from 4 cases treated with intramuscular infiltration of botulinum toxin for masseter hypertrophy, surgical approach to the lesions was varied: 10 patients received an external approach (standard parotidectomy approach or face-lift-type approach); 6 patients had the lesion removed through an intraoral approach; in 2 cases a direct skin incision was performed. In our series we found a significant rate (55.5%) of temporary complications in all the procedures performed (external, intraoral, direct skin approach). This study aims to emphasize the role of endoscope assisted surgery as a possible alternative to the traditional approaches for the management of well selected benign midcheek masses.It would be advisable to increase the study of the endoscopic anatomy of the midcheek area in order to standardize the procedure and better define the surgical indications.     

超声诊断女性生殖器畸形的临床价值

二维超声可诊断较典型的子宫畸形。三维超声既能显示子宫外形，又能显示宫腔情况，还能量化畸形的程度，而且无创、费用低、可重复性高，相比二维超声、输卵管子宫造影准确性较高，已经被越来越多的应用于诊断复杂的子宫畸形。     

先天性二尖瓣瓣上隔膜合并复杂心脏畸形一例并文献复习

1病例资料 患儿男性，8岁7个月，因“发现心脏杂音8年”入院。生长发育、活动量稍差，多汗，易感冒。无发作呼吸困难、发绀、晕厥、黑蒙，无咯血，无水肿。既往史：无特殊。查体：血压：右上：100／60mmHg（1mmHg=0．133kPa）：右下：80／50mmHg。     

Case of double-outlet right ventricle after repair with pulmonary arteriovenous malformations using cardiac CT

We present a case where cardiac CT clearly defines the complex anatomy of a 22 year old man with double outlet right ventricle who is status bilateral bidirectional Glenn and Fontan conduit. This case also shows the association of pulmonary arteriovenous malformations with Fontan and Glenn procedures.