BACKGROUND Digital subtraction angiography(DSA),the gold standard for the diagnosis of intracranial arteriovenous malformations(AVMs),can show clean nidus resection,leading to a perceived cure.Most cases of intracrani...BACKGROUND Digital subtraction angiography(DSA),the gold standard for the diagnosis of intracranial arteriovenous malformations(AVMs),can show clean nidus resection,leading to a perceived cure.Most cases of intracranial AVM recurrence have been reported in pediatric patients.The conventional understanding indicates that AVMs arise when abnormal blood vessels develop between the fourth and eighth weeks of embryonic development,which coincides with the typical period of blood vessel formation in the brain.As such,recurrent ectopic AVM are rare in adults.CASE SUMMARY Herein,we present the case of a 31-year-old adult with a history of an intracranial AVM originally diagnosed with a symptomatic de novo cerebellar AVM formation.Recurrence was observed five years following angiographically-confirmed excision of the initial AVM.DSA performed prior to initial AVM resection indicated no cerebellar abnormalities.Moreover,the recurrent arteries exhibited differences in arteries and draining veins.In addition to reporting this case,we analyzed six previously-reported adult patients with similar ectopic recurrent AVMs.These cases are summarized to review and explore the potential causes of ectopic AVM recurrence in adults,which increase the likelihood of acquired AVM.CONCLUSION The clinical course of the reported patients demonstrated the possibility of ectopic AVM recurrence in adults.The median time between the diagnosis of the initial AVM and the occurrence of ectopic recurrent AVM in adults was 11 years(range:5–20 years).Magnetic resonance imaging follow-up for more than 10 years may be required in adult AVM-treated patients.展开更多
Background: Lymphatic malformations are developmental defects of the lymphatic system. They are frequently present at birth and are most commonly found in the head and neck regions. The aim of the study was to investi...Background: Lymphatic malformations are developmental defects of the lymphatic system. They are frequently present at birth and are most commonly found in the head and neck regions. The aim of the study was to investigate the clinical presentation of head and neck Lymphatic malformations in relation to, age, gender, color and site of distribution. Methods: This is a retrospective descriptive study, where the record of the patient diagnosed as lymphatic malformation at the Department of Oral and Maxillofacial Surgery at Khartoum Teaching Dental Hospital, during the period of 2005 to 2008 where retrieved and analysed. Result: A cervicofacial lymphatic malformation was found more common in females than in males with a ratio of 11:9. The mean age was 14 ± 10 years, with lip and tongue being the most common sites, followed by the buccal mucosa in the intraoral site and neck in the posterior triangle was the most common site for extraoral site (30%). It was found that the bluish color was the commonest presenting color in oral lymphangioma followed by red pink color. Conclusion: Females are more affected than males, while infants and children were more affected than other age groups. The bulks of the patients were presented with soft swelling, blue to normal colour in the lip, neck and in the tongue. Further prospective studies are needed to evaluate the clinic picture and treatment outcome.展开更多
Objective To investigate therapeutic effect of tri- amcinolone acetonide and pingyangmycin on lymphatic malformations in oral and maxillofacial regions. Methods 29 patients with lymphatic malformations in oral and max...Objective To investigate therapeutic effect of tri- amcinolone acetonide and pingyangmycin on lymphatic malformations in oral and maxillofacial regions. Methods 29 patients with lymphatic malformations in oral and maxillofacial regions were divided into two groups to re-展开更多
目的评价加速康复外科(Enhanced recovery after surgery,ERAS)在牙颌面畸形患者围手术期营养管理中的效果。方法回顾性分析2023年7—12月在我院行正颌手术患者的个人基本信息、一般临床资料、营养指标等信息,采用倾向性评分匹配(Propen...目的评价加速康复外科(Enhanced recovery after surgery,ERAS)在牙颌面畸形患者围手术期营养管理中的效果。方法回顾性分析2023年7—12月在我院行正颌手术患者的个人基本信息、一般临床资料、营养指标等信息,采用倾向性评分匹配(Propensity score matching,PSM)后,入组应用ERAS干预措施的患者79例(观察组),以及同数量的作为对照组的非ERAS患者79例。采用倾向评分匹配控制混杂因素,通过t检验、χ^(2)检验、多元线性回归分析等,评估ERAS措施对正颌患者术后营养相关指标的影响。结果倾向性评分匹配后,两组一般资料差异均无统计学意义(P>0.05)。患者年龄中位数为23(21,28)岁。女性患者较多(63.3%)。就诊原因中,仅因功能原因就诊与仅因面型原因就诊的患者比例为1∶7.7。95.6%患者具有大学专科及以上学历,有基础疾病及用药史的患者均少于10%。围手术期营养风险筛查结果显示,术前存在营养风险的患者占19%,术后存在营养风险的患者达27.8%。术后患者体质量下降(1.40±2.02)kg。两组术后营养相关指标分析结果显示,术后实验室指标(血红蛋白数值)、手术当日进食量、术后第1日进食量、术后第2日进食量及术后进食总量等的差异均具有统计学意义(P<0.05)。多元回归分析显示,性别及就诊原因是患者术后第1日血红蛋白数值的影响因素。结论正颌患者术后营养风险增加,ERAS措施能够改善患者部分术后营养相关指标。展开更多
A growing number of children and adolescents are being diagnosed as Chiari malformation type I （CM- I ） for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this stu...A growing number of children and adolescents are being diagnosed as Chiari malformation type I （CM- I ） for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this study was to compare the clinical characteristics, imaging findings and surgical outcomes of CM- I in pediatric and adult patients. Between January 2014 and June 2017, 84 patients with CM- I underwent surgical treatment in our department. We divided the patients into two groups： pediatric group （n=l 1, age 〈18 years） and adult group （n=73, age 〉18 years）. Data on clinical characteristics, imaging findings, surgical outcomes, and prognosis were retrospectively reviewed and compared between these two groups. For clinical presentation, scoliosis （36.4%） and developmental delay （36.4%） were more common in pediatric patients, whereas, sensory disturbance （58.9%） and motor weakness （41. 1%） were more common in adult patients. Imaging findings showed that the incidence of hydrocephalus and craniovertebral junctional abnormalities was significantly higher in pediatric group than in adult group （P〈0.05）. Compared to adult group, pediatric group showed a better improvement or resolution of syrinx and tonsillar herniation after surgical treatments （P〈0.05）. The total Chicago Chiari Outcome Scale （CCOS） score in pediatric patients at the last follow- up was significantly higher than that in adult patients （P=0.002）. In conclusion, the clinical characteristics and imaging findings appeared to be different in pediatric and adult patients with CM- I. The surgical outcomes of pediatric patients were shown to be significantly better than those of adult patients.展开更多
Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladde...Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. Our objective was to show the importance of the morbidity linked to the late diagnosis of this anomaly, the incidence of the infection and the complications that this pathology poses as a problem. It was a clinical case of fortuitous discovery taken care of by a general surgeon in the general surgery department of the hospital “Mother Child” Le Luxembourg Bamako Mali. We report a case of complete ureteral duplication complicated by ureterohydronephrosis on a lithiasis wedged in the uretero-vesical junction of one of the left ureters in its lower portion which required a uretero-lithotomy with bladder reimplantation of the left ureters and secondly to a uretero-lithotomy with bladder reimplantation after two months. The postoperative course was simple.展开更多
Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder ...Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.展开更多
目的：探讨成人Chiari畸形Ⅰ型（Chiari malformation type Ⅰ，CMⅠ）患者后颅窝线性容积特征及其与脊髓空洞和小脑扁桃体下疝程度之间的相关性。方法：收集2010年6月~2014年6月在我院接受治疗的CMⅠ患者，入选标准为：（1）年龄＞30...目的：探讨成人Chiari畸形Ⅰ型（Chiari malformation type Ⅰ，CMⅠ）患者后颅窝线性容积特征及其与脊髓空洞和小脑扁桃体下疝程度之间的相关性。方法：收集2010年6月~2014年6月在我院接受治疗的CMⅠ患者，入选标准为：（1）年龄＞30岁；（2）经头颈部MRI确诊为CMⅠ伴或不伴脊髓空洞；所有入选患者均排除颅内占位性病变、颅骨破坏、后颅窝手术史或获得性Chiari畸形。选取年龄匹配的正常成人作为对照组，测量两组头颅正中矢状位MRI中斜坡长度、枕骨大孔横径、枕上长度、后颅窝矢状径、后颅窝高径和后颅窝斜坡倾斜角α等指标，并将两组按性别分组后比较后颅窝线性容积差异。同时根据小脑扁桃体下疝程度及是否伴发脊髓空洞进行分组，分析后颅窝线性容积特征与小脑扁桃体下疝程度及脊髓空洞的关系。结果：共纳入CMⅠ患者37例，男18例，女19例；年龄38.5±5.5岁（31～56岁）。正常对照组41例，男19例，女22例；年龄36.4±6.3岁（33～58岁），成人CMⅠ患者后颅窝斜坡长度、枕上长度、后颅窝矢状径、后颅窝高径及斜坡倾斜角分别为35.9±4.2mm、38.2±5.8mm、77.4±6.1mm、28.2±3.9mm和47.4°±6.4°，均明显小于正常对照组（43.3±2.9mm、43.5±5.6mm、82.5±4.5mm、35.4±3.4mm、58.6°±5.7°，P＜0.05）；伴脊髓空洞的成人CMⅠ组患者斜坡倾斜角（45.8°±7.6°）较单纯CMⅠ组（49.7°±5.1°）显著减小；Ⅱ度扁桃体下疝CMⅠ患者的后颅窝斜坡长度（31.4±3.6mm）及倾斜角（42.3°±5.4°）明显小于Ⅰ度扁桃体下疝CMⅠ患者（36.2±3.8mm、48.1°±5.2°；P＜0.05），余指标未见明显差异。结论：成人CMⅠ患者的后颅窝容积明显减少，但与脊髓空洞和扁桃体下疝程度之间无显著相关性；CMⅠ患者斜坡发育不良与脊髓空洞的形成以及小脑扁桃体下疝程度存在一定相关性。展开更多
基金Supported by Beijing Municipal Science and Technology Project,No.Z201100005520095.
文摘BACKGROUND Digital subtraction angiography(DSA),the gold standard for the diagnosis of intracranial arteriovenous malformations(AVMs),can show clean nidus resection,leading to a perceived cure.Most cases of intracranial AVM recurrence have been reported in pediatric patients.The conventional understanding indicates that AVMs arise when abnormal blood vessels develop between the fourth and eighth weeks of embryonic development,which coincides with the typical period of blood vessel formation in the brain.As such,recurrent ectopic AVM are rare in adults.CASE SUMMARY Herein,we present the case of a 31-year-old adult with a history of an intracranial AVM originally diagnosed with a symptomatic de novo cerebellar AVM formation.Recurrence was observed five years following angiographically-confirmed excision of the initial AVM.DSA performed prior to initial AVM resection indicated no cerebellar abnormalities.Moreover,the recurrent arteries exhibited differences in arteries and draining veins.In addition to reporting this case,we analyzed six previously-reported adult patients with similar ectopic recurrent AVMs.These cases are summarized to review and explore the potential causes of ectopic AVM recurrence in adults,which increase the likelihood of acquired AVM.CONCLUSION The clinical course of the reported patients demonstrated the possibility of ectopic AVM recurrence in adults.The median time between the diagnosis of the initial AVM and the occurrence of ectopic recurrent AVM in adults was 11 years(range:5–20 years).Magnetic resonance imaging follow-up for more than 10 years may be required in adult AVM-treated patients.
文摘Background: Lymphatic malformations are developmental defects of the lymphatic system. They are frequently present at birth and are most commonly found in the head and neck regions. The aim of the study was to investigate the clinical presentation of head and neck Lymphatic malformations in relation to, age, gender, color and site of distribution. Methods: This is a retrospective descriptive study, where the record of the patient diagnosed as lymphatic malformation at the Department of Oral and Maxillofacial Surgery at Khartoum Teaching Dental Hospital, during the period of 2005 to 2008 where retrieved and analysed. Result: A cervicofacial lymphatic malformation was found more common in females than in males with a ratio of 11:9. The mean age was 14 ± 10 years, with lip and tongue being the most common sites, followed by the buccal mucosa in the intraoral site and neck in the posterior triangle was the most common site for extraoral site (30%). It was found that the bluish color was the commonest presenting color in oral lymphangioma followed by red pink color. Conclusion: Females are more affected than males, while infants and children were more affected than other age groups. The bulks of the patients were presented with soft swelling, blue to normal colour in the lip, neck and in the tongue. Further prospective studies are needed to evaluate the clinic picture and treatment outcome.
文摘Objective To investigate therapeutic effect of tri- amcinolone acetonide and pingyangmycin on lymphatic malformations in oral and maxillofacial regions. Methods 29 patients with lymphatic malformations in oral and maxillofacial regions were divided into two groups to re-
基金This project was supported by grants from the National Natural Science Foundation of China （No. 81702478 and No. 81270865） and China Postdoctoral Science Foundation （No. 2016M600596）.
文摘A growing number of children and adolescents are being diagnosed as Chiari malformation type I （CM- I ） for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this study was to compare the clinical characteristics, imaging findings and surgical outcomes of CM- I in pediatric and adult patients. Between January 2014 and June 2017, 84 patients with CM- I underwent surgical treatment in our department. We divided the patients into two groups： pediatric group （n=l 1, age 〈18 years） and adult group （n=73, age 〉18 years）. Data on clinical characteristics, imaging findings, surgical outcomes, and prognosis were retrospectively reviewed and compared between these two groups. For clinical presentation, scoliosis （36.4%） and developmental delay （36.4%） were more common in pediatric patients, whereas, sensory disturbance （58.9%） and motor weakness （41. 1%） were more common in adult patients. Imaging findings showed that the incidence of hydrocephalus and craniovertebral junctional abnormalities was significantly higher in pediatric group than in adult group （P〈0.05）. Compared to adult group, pediatric group showed a better improvement or resolution of syrinx and tonsillar herniation after surgical treatments （P〈0.05）. The total Chicago Chiari Outcome Scale （CCOS） score in pediatric patients at the last follow- up was significantly higher than that in adult patients （P=0.002）. In conclusion, the clinical characteristics and imaging findings appeared to be different in pediatric and adult patients with CM- I. The surgical outcomes of pediatric patients were shown to be significantly better than those of adult patients.
文摘Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. Our objective was to show the importance of the morbidity linked to the late diagnosis of this anomaly, the incidence of the infection and the complications that this pathology poses as a problem. It was a clinical case of fortuitous discovery taken care of by a general surgeon in the general surgery department of the hospital “Mother Child” Le Luxembourg Bamako Mali. We report a case of complete ureteral duplication complicated by ureterohydronephrosis on a lithiasis wedged in the uretero-vesical junction of one of the left ureters in its lower portion which required a uretero-lithotomy with bladder reimplantation of the left ureters and secondly to a uretero-lithotomy with bladder reimplantation after two months. The postoperative course was simple.
文摘Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.
文摘目的：探讨成人Chiari畸形Ⅰ型（Chiari malformation type Ⅰ，CMⅠ）患者后颅窝线性容积特征及其与脊髓空洞和小脑扁桃体下疝程度之间的相关性。方法：收集2010年6月~2014年6月在我院接受治疗的CMⅠ患者，入选标准为：（1）年龄＞30岁；（2）经头颈部MRI确诊为CMⅠ伴或不伴脊髓空洞；所有入选患者均排除颅内占位性病变、颅骨破坏、后颅窝手术史或获得性Chiari畸形。选取年龄匹配的正常成人作为对照组，测量两组头颅正中矢状位MRI中斜坡长度、枕骨大孔横径、枕上长度、后颅窝矢状径、后颅窝高径和后颅窝斜坡倾斜角α等指标，并将两组按性别分组后比较后颅窝线性容积差异。同时根据小脑扁桃体下疝程度及是否伴发脊髓空洞进行分组，分析后颅窝线性容积特征与小脑扁桃体下疝程度及脊髓空洞的关系。结果：共纳入CMⅠ患者37例，男18例，女19例；年龄38.5±5.5岁（31～56岁）。正常对照组41例，男19例，女22例；年龄36.4±6.3岁（33～58岁），成人CMⅠ患者后颅窝斜坡长度、枕上长度、后颅窝矢状径、后颅窝高径及斜坡倾斜角分别为35.9±4.2mm、38.2±5.8mm、77.4±6.1mm、28.2±3.9mm和47.4°±6.4°，均明显小于正常对照组（43.3±2.9mm、43.5±5.6mm、82.5±4.5mm、35.4±3.4mm、58.6°±5.7°，P＜0.05）；伴脊髓空洞的成人CMⅠ组患者斜坡倾斜角（45.8°±7.6°）较单纯CMⅠ组（49.7°±5.1°）显著减小；Ⅱ度扁桃体下疝CMⅠ患者的后颅窝斜坡长度（31.4±3.6mm）及倾斜角（42.3°±5.4°）明显小于Ⅰ度扁桃体下疝CMⅠ患者（36.2±3.8mm、48.1°±5.2°；P＜0.05），余指标未见明显差异。结论：成人CMⅠ患者的后颅窝容积明显减少，但与脊髓空洞和扁桃体下疝程度之间无显著相关性；CMⅠ患者斜坡发育不良与脊髓空洞的形成以及小脑扁桃体下疝程度存在一定相关性。
