大型听神经瘤显微外科治疗24例分析

目的: 总结大型听神经瘤的手术体会,探讨如何全切肿瘤并避免对周围重要结构的损害。方法: 采用枕下乙状窦后经内听道入路及显微外科技术切除肿瘤。结果: 肿瘤全切21例(87.5%),次全切2例,大部切除1例;面神经解剖保留率为75.0%(18/24)。依据House-brackmann大型听神经瘤评定法评定面神经术后功能,其中Ⅰ~Ⅲ级10例(41.6%);术前患侧尚有听力9例,术后3例听力保留。结论: 熟悉大型听神经瘤的病理特点、局部解剖,通过枕下乙状窦后经内听道入路可以达到全切肿瘤并减少损伤的目的。

Microsurgical treatment of large acoustic neuromas

Objective: This study was designed to characterize the ultrastructure of the coccoid Helicobacter pylori(H. pylori) forms in the tissues of carcinoma.Methods: Transmission electron microscopy(TEM) technique was used to examine the structure of coccoid H. pylori in 4 cases of gastric carcinoma and 2 cases of esophageal carcinoma.Results: It was found that the coccoid H. pylori were scattered in cancer nest and cancer interspace,some of which enterded cancer cells,macrophages and other cells.The coccoid H. pylori appeared to be similar to the L-forms of other bacteria with varying cell shape and size,different cytoplasmic electron densities and defects in cell wall.Two types of coccoid H. pylori could be distinguished in the tissues of carcinoma by TEM.Type A was smaller with higher electron density in the cytoplasma,and flagellation on the cell membrane,suggesting that it could be viable.However,the type B was larger with lower electron density in the cytoplasma,and no flagellation on the cell membrane,suggesting that it could be a degenerative form.Conclusions: The coccoid forms of H.pulori still have certain degree of viability,thus they may play an important role in the transmission of H. pylori,the relapse of H. pylori related disease after treatment and the development of the related carcinoma.