Background:Classical pterional appoach for temporal surgeries may cause atrophy and dysfunction of temporalis,injury to the facial nerve,and unnecessary cortical exposure.As an alternative to the classical pterional a...Background:Classical pterional appoach for temporal surgeries may cause atrophy and dysfunction of temporalis,injury to the facial nerve,and unnecessary cortical exposure.As an alternative to the classical pterional approach for such surgeries,we hereby describe an mini-temporal approach which reduces these risks and proven to be practical in neurological surgeries.Material and methods:In the mini-temporal incision design,the frontal end of the incision never surpassed the hairline at the level of temporal line,and a one-layer skin-galea-muscle flap was detached from the cranium,effectively avoiding the injuries of facial nerve.The surgical bone window was completely located underneath the temporalis muscle,allowing it to be completely repositioned postoperatively.Results:We demonstrated the application of mini-temporal approach in a variety of temporal region tumors,which can be applied to complete successful resective surgeries while effectively reducing injuries to extra-temporal cortex,temporalis,and facial nerve.There were no postoperative complications related to extra-temporal cortical damage,atrophy of temporalis,or injury to the facial nerve.Conclusion:The mini-temporal approach can effectively shorten the time of craniotomy and closure,decrease the size of bony removal,increase the restoration of temporalis during closure,and lower the chance of facial nerve injury.Therefore,it improves cosmetic outcomes and reduces the risk of unintentional extra-temporal cortical injury,which fully embodies the minimally invasive principle in neurosurgery.展开更多
Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral ...Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral Supraorbital (LSO) approach, but there are shortcomings. Methods:This study retrospectively analyzed clinical and imaging data from 181 patients with MCA aneurysm clipping in the Department of Neurosurgery, First Affiliated Hospital of Soochow University between 2011 and 2017. Statistical analysis using parametric and nonparametric tests showed that P values below 0.05 were considered statistically significant. Results: The preoperative GCS score (P=0.003), Hunt-Hess scale (P < 0.001) and the operating habits of the surgeon (P < 0.001) affected the surgeon to choose a surgical approach. The choice of two surgical methods on the operation time (P < 0.001), skin incision (P < 0.001), complications (P=0.026), tracheotomy (P=0.014), prognosis (P=0.002) were significantly different. Different surgical approaches (P=0.002), Hunt-Hess scale (P <0.001), GCS scale (P < 0.001), GCS sorse (P < 0.001), skin incision (P=0.031) and complications (P < 0.001) are closely related to the prognosis of patients. Conclusions: Modified LSO approach provides another surgical approach for MCA aneurysm clipping, while avoiding the drawbacks of the LSO approach in the clipping of MCA distal aneurysm.展开更多
Background: Craniopharyngioma is a kind of intracranial benign tumor that is primarily treated with surgery. At present, a variety of surgical approaches are used for tumor resection. We have conducted a comparative a...Background: Craniopharyngioma is a kind of intracranial benign tumor that is primarily treated with surgery. At present, a variety of surgical approaches are used for tumor resection. We have conducted a comparative analysis of the two approaches most used in our department. Methods: The study retrospectively analyzed the clinical data from 65 patients with craniopharyngioma surgically treated by the two approaches mentioned above. Among these patients, 24 were treated by lateral supraorbital (LSO) approach and 41 by standard pterional approach. Indicators including, but not limited to, length of incision, operation time, postoperative pituitary function, urine volume, visual function improvement, and hospitalization were used to compare these two groups of patients. Results: The data shows that there was no significant difference in total tumor resection rate (P=0.54), postoperative visual field improvement (P=0.68) and postoperative function of endocrine. However, the LSO approach significantly reduced the operative incision (P=0.001), shortened the operation time (P=0.001) and operative complexity, while reducing the incidence of postoperative complications (P=0.04). Conclusions: In surgical treatment of craniopharyngioma, LSO approach has similar surgical effect with standard pterional approach, but it can significantly shorten the operation time, reduce surgical trauma and the incidence of complications. Therefore, LSO provides another alternative to surgical approach for microsurgical removal of craniopharyngioma.展开更多
基金Matthias Mäurer and Marcel Kamp were funded by the Stifterverband in cooperation with the Thuringian Ministry of Economics,Science and Digital Society within the framework of the"Fellowship for Innovations in Digital University Teaching"(GZ:5508/78-15-25)Matthias Mäurer was funded by the Deutsche Forschungsgemsinschaft(DFG,German Research Foundation)Clinician Scientist Program OrganAge(funding number 413668513)by the Interdisciplinary Center of Clinical Research of the Medical Faculty Jena.Irina Mäurer was supported by funding from the Foundation"Else-Kröner-Fresenius-Stiftung"within the Else Kröner Research School for Physicians"AntiAge".
文摘Background:Classical pterional appoach for temporal surgeries may cause atrophy and dysfunction of temporalis,injury to the facial nerve,and unnecessary cortical exposure.As an alternative to the classical pterional approach for such surgeries,we hereby describe an mini-temporal approach which reduces these risks and proven to be practical in neurological surgeries.Material and methods:In the mini-temporal incision design,the frontal end of the incision never surpassed the hairline at the level of temporal line,and a one-layer skin-galea-muscle flap was detached from the cranium,effectively avoiding the injuries of facial nerve.The surgical bone window was completely located underneath the temporalis muscle,allowing it to be completely repositioned postoperatively.Results:We demonstrated the application of mini-temporal approach in a variety of temporal region tumors,which can be applied to complete successful resective surgeries while effectively reducing injuries to extra-temporal cortex,temporalis,and facial nerve.There were no postoperative complications related to extra-temporal cortical damage,atrophy of temporalis,or injury to the facial nerve.Conclusion:The mini-temporal approach can effectively shorten the time of craniotomy and closure,decrease the size of bony removal,increase the restoration of temporalis during closure,and lower the chance of facial nerve injury.Therefore,it improves cosmetic outcomes and reduces the risk of unintentional extra-temporal cortical injury,which fully embodies the minimally invasive principle in neurosurgery.
文摘Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral Supraorbital (LSO) approach, but there are shortcomings. Methods:This study retrospectively analyzed clinical and imaging data from 181 patients with MCA aneurysm clipping in the Department of Neurosurgery, First Affiliated Hospital of Soochow University between 2011 and 2017. Statistical analysis using parametric and nonparametric tests showed that P values below 0.05 were considered statistically significant. Results: The preoperative GCS score (P=0.003), Hunt-Hess scale (P < 0.001) and the operating habits of the surgeon (P < 0.001) affected the surgeon to choose a surgical approach. The choice of two surgical methods on the operation time (P < 0.001), skin incision (P < 0.001), complications (P=0.026), tracheotomy (P=0.014), prognosis (P=0.002) were significantly different. Different surgical approaches (P=0.002), Hunt-Hess scale (P <0.001), GCS scale (P < 0.001), GCS sorse (P < 0.001), skin incision (P=0.031) and complications (P < 0.001) are closely related to the prognosis of patients. Conclusions: Modified LSO approach provides another surgical approach for MCA aneurysm clipping, while avoiding the drawbacks of the LSO approach in the clipping of MCA distal aneurysm.
文摘Background: Craniopharyngioma is a kind of intracranial benign tumor that is primarily treated with surgery. At present, a variety of surgical approaches are used for tumor resection. We have conducted a comparative analysis of the two approaches most used in our department. Methods: The study retrospectively analyzed the clinical data from 65 patients with craniopharyngioma surgically treated by the two approaches mentioned above. Among these patients, 24 were treated by lateral supraorbital (LSO) approach and 41 by standard pterional approach. Indicators including, but not limited to, length of incision, operation time, postoperative pituitary function, urine volume, visual function improvement, and hospitalization were used to compare these two groups of patients. Results: The data shows that there was no significant difference in total tumor resection rate (P=0.54), postoperative visual field improvement (P=0.68) and postoperative function of endocrine. However, the LSO approach significantly reduced the operative incision (P=0.001), shortened the operation time (P=0.001) and operative complexity, while reducing the incidence of postoperative complications (P=0.04). Conclusions: In surgical treatment of craniopharyngioma, LSO approach has similar surgical effect with standard pterional approach, but it can significantly shorten the operation time, reduce surgical trauma and the incidence of complications. Therefore, LSO provides another alternative to surgical approach for microsurgical removal of craniopharyngioma.
