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101.
102.
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. 相似文献
103.
咽旁间隙肿瘤及手术入路 总被引:8,自引:2,他引:8
为探讨咽旁间隙肿瘤的手术方法及入路的选择。报告66例经各种手术入路治疗的良、恶性肿瘤。结果表明,经颈或经颈合并下颌及正中裂开外旋入路较之其他几种手术入路具有手术适应证广、安全、术后并发症少等优点。认为经颈或经颈合并下颌正中裂开外旋入路是一种安全、彻底切除咽旁间隙原发肿瘤效果最好的入路。 相似文献
104.
F. Doz S. Urien E. Chatelut J. Michon H. Rubie J. M. Zucker P. Canal G. Bastian 《Cancer chemotherapy and pharmacology》1998,42(3):250-254
Carboplatin is a widely used cytotoxic agent in numerous solid tumors of children. Since there is a large degree of interpatient
variability in the area under the curve of free carboplatin for a given dose of the drug, the current tendency is to adjust
the carboplatin dose so as to reach a target area under the curve rather than to determine a carboplatin dose on the basis
of the body surface area. A limited-sampling method was developed for estimation of the ultrafilterable carboplatin area under
the curve and for adjustment of the carboplatin dose on subsequent treatments. Population parameters were obtained from 16
children (reference group). We used the maximum a posteriori (MAP) Bayesian approach on 15 children with complete carboplatin
pharmacokinetic data (test group). Two blood samples were sufficient to obtain reliable prediction of the area under the curve.
The best sampling times were: (a) 30 min after the end of the infusion and (b) 5 h after the end of the infusion. On the basis
of these data it is possible to prescribe prospectively a target area under the curve for free carboplatin given in a fractionated
daily infusion and to adapt the carboplatin dose directly to ultrafilterable carboplatin measurements.
Received: 8 June 1997 / Accepted: 9 January 1998 相似文献
105.
目的总结一期前路病灶清除植骨内固定治疗脊柱结核的临床效果。方法对13例平均年龄42·3岁,平均病程5·6个月的脊柱结核患者,采用一期病灶清除结合植骨内固定,手术前后配合正规化疗,根据X线片观察脊柱融合时间,手术前后后凸角度变化以及按照Frankel分级的神经功能变化。结果全部病例伤口均一期愈合,未出现严重并发症。平均随访时间17·3个月,植骨界面骨性融合时间平均5·6个月。后凸平均矫正度数为11·7°,7例术前伴有神经损害症状者Frankel分级平均提高1·1级。结论一期病灶清除植骨内固定治疗脊柱结核,骨结构重建可靠,治疗过程相对简化,住院周期缩短,效果肯定。 相似文献
106.
目的探讨视神经鞘脑膜瘤的显微神经外科手术方法。方法收治13例视神经鞘脑膜瘤,根据肿瘤位置采用3种不同经颅入路:单侧额部入路、经额经眶上缘入路及经额颧经眶上缘入路,利用显微外科技术安全显露眶上裂外侧部、眶上裂中央部切除肿瘤。结果肿瘤全切11例,部分切除2例。术后13例患者的眼球突出均恢复正常,11例其它症状和体征也恢复或改善。术后动眼神经麻痹1例,患侧眼失明2例。结论熟悉显微神经外科解剖学,利用显微外科技术选择合适的经颅入路,可以提高视神经鞘脑膜瘤的全切除率,并使颅眶区的正常结构得到最大程度的保护。 相似文献
107.
This work is a continuation of the anatomical study in which safe approach zones through the floor of the fourth ventricle--infrafacial and suprafacial--were morphologically and morphometrically defined (Acta Neurochir (1997) 139: 1014-1019). The purpose of cytoarchitectonic study was to analyze correlation between morphometry of the facial colliculus and hypoglossal triangle and localization of the corresponding cranial nerves nuclei in the brainstem tegmentum in order to verify morphometrical borders of the previously defined zones. Morphometrical evaluation of the fourth ventricle floor of 10 examined brainstems was initially performed. Distances from obex to the rostral portion of hypoglossal triangle and facial colliculus were determined. Then a series of axial sections of each specimen, stained for Nissl substance, were analyzed to define the distance from obex to the rostral portion of the hypoglossal and abducens nuclei. Distances of motor trigeminal and facial nuclei from the midline sagittal plane were also measured. The obtained results allowed morphometrical determination of the infra-abducental and supra-abducental region of safe entry into the brainstem tegmentum. Infra-abducental region corresponds to infrafacial safe approach zone and supra-abducental to suprafacial zone. The distance of the rostral portion of facial colliculus from obex was longer than the distance of the rostral pole of abducens nucleus from obex in every examined specimen (by 0.7 mm on average). A very similar correlation between the distance of the rostral margin of hypoglossal triangle and localization of the rostral pole of hypoglossal nucleus was found. The rostral portion of hypoglossal triangle was longer by 1.5 mm on average. The obtained results show that previously defined infrafacial and suprafacial safe approach zones via the fourth ventricle floor correspond morphometrically to tegmental regions of safe entry--infra-abducental and supra-abducental respectively. It suggests that morphometrical evaluation of the fourth ventricle floor proposed by the authors could be useful in the intra-operative determination of safe entry via the rhomboid fossa into the brainstem tegmentum. 相似文献
108.
Tentorial Meningiomas. Report on Twenty-Seven Cases 总被引:14,自引:0,他引:14
Summary ? Objective. Report our experience with 27 tentorial meningiomas (TM) surgically treated between 1985 and 1998.
Methods. The records of 27 patients with TMs were retrospectively reviewed for clinical presentation, neuroradiological evaluation,
surgical treatment and long-term outcome. The extent of tumor resection was scored according to the Simpson's grading for
tumor removal. Long-term results were evaluated according to the Glasgow Outcome Score (GOS).
Results. The average age was 53 years. Female predominance was 74%. The most common complaints at presentation were headaches (51%),
gait ataxia (33%), memory disturbances (30%) and hypo-acousia (30%). A classification of TMs into 5 subgroups according to
tumor site is proposed on the basis of imaging studies. A cerebrospinal fluid shunt was established prior to direct approach
in 7 patients and as the sole procedure in one inoperable patient. Twenty-seven direct approaches were undertaken in 26 patients,
including 17 infratentorial and 10 supratentorial approaches. Total tumor removal was achieved in 20 patients (77%) and subtotal
removal in 6 (23%). Fifteen patients (55%) experienced 22 postoperative complications. One patient died three months after
a subtotal resection (mortality=3,7%). With a mean follow-up of 54 months, all 26 survivors are currently alive with 23 having
resumed their normal activities and 3 needing assistance. Five of 6 patients with subtotal resection survived and were followed
for a period ranging from 72 to 132 months: none showed residual tumor progression and no re-operation was considered. An
additional patient experienced a ?true? recurrence 6 years after total removal, with no tumor progression 2 years after his
recurrence was recognized.
Discussion. The best surgical approach to TMs is still a controversial matter. The advantages and drawbacks of conventional versus transbasal
approaches are reviewed. Our experience suggests that subtotal removal can be associated with long recurrence-free intervals
and preserved quality of life. TMs located at the tentorial edge carried a definitely worse prognosis than peripheral forms. 相似文献
109.
110.
枕下经颈-颈静脉突入路达颈静脉孔区的显微解剖研究 总被引:1,自引:1,他引:1
目的 研究一期切除颈静脉孔区复杂性肿瘤的微创手术人路。方法 选择经10%福尔马林固定成人头颈标本10具,显微镜下模拟枕下经颈一颈静脉突人路的手术操作,逐层显露颈静脉孔区,研究该区显微解剖特征及显露范围。结果 该人路直接沿乙状窦、颈内静脉的移行方向显露颈静脉孔区结构,其中后颅窝可经枕下显露,颞下窝藉寰椎与下颌升支间的自然间隙显露。通过切除颈静脉突和迷路下骨质分别自后、外、下和上方显露颈静脉孔。头侧直肌是界定颞下窝结构和枕下三角内结构的确切标志。后组颅神经,交感千和颈内动、静脉行于其前方,椎动脉寰椎上段及其周围的静脉丛行于其后方。结论 枕下经颈一颈静脉突人路可自多个方向充分显露颈静脉孔区结构,且可保护面神经、迷路、耳蜗和椎动脉等结构免受不必要的损伤。 相似文献