Quantitative analysis of the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region / 中华外科杂志

<p><b>OBJECTIVE</b>To study the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region based on quantitative measurements, and provide reliable anatomic data for selecting surgical approach individually and protecting the function of important structures.</p><p><b>METHODS</b>The complete approach of the suboccipital far-lateral approach and the postauricular transtemporal approach were reproduced in twelve (twenty-four sides) head-neck specimens of adults be fixed in 10% formalin. The exposure area to the jugular foramen region was obtained using a stereotactic device, and the length of exposure of the clivus and the trigeminal nerve were measured using a vernier caliper.</p><p><b>RESULTS</b>In the suboccipital far-lateral approach, the significant increase in exposure was noted after removal of the jugular process and partial resection of occipital condyle. In the postauricular transtemporal approach, the exposure increased significantly after complete retrolabyrinthine approach, partial labyrinthectomy and transcochlear approach.</p><p><b>CONCLUSIONS</b>Resection of jugular process is the key to expose the jugular foramen through the far-lateral approach. The infralabyrinthine approach and the partial labyrinthectomy approach are ideal approaches to expose the jugular foramen region laterally.</p>

Bromocriptine treatment of invasive giant prolactinomas prior to comprehensive treatments: results of a long-term follow up / 中华外科杂志

<p><b>OBJECTIVE</b>To observe long-term outcomes of patients with invasive giant prolactinomas (IGPs) treated with bromocriptine followed by comprehensive treatments.</p><p><b>METHODS</b>Thirty-four patients met the criteria of IGPs were treated with bromocriptine initially. Among of them, 11 had radiotherapy at the same time. During the treatments, transsphenoidal surgery or/and Gamma Knife were considered to apply to the patients according to the location, shrinkage of residual tumors and resistance of bromocriptine. Small dosage of bromocriptine was kept after operation.</p><p><b>RESULTS</b>The average follow-up duration is 33.6 months. Thirty-three patients obtained significant improvement, but one failed recovery of vision due to side-injury by radiotherapy. Tumor volume on magnetic resonance imaging (MRI) was decreased on average by 91.4%, PRL by 97.1%. The number of patients with low testosterone level restored from 17 to 6 and hypoadrenalism from 10 to 6 after combined treatment with priority of medical therapy. Rhinorrhea occurred in 2 cases, 1 restored in two weeks, 1 had transsphenoidal combined with transcranial surgery to remove the tumor and repair the fistula.4 had resistance to bromocriptine to some extend.</p><p><b>CONCLUSIONS</b>Dopamine agonist medications are effective as a first-line therapy for IGPs. In some patients treated by bromocriptine only, the tumor may disappear on MRI. Combined with surgery and Gamma Knife, the duration of treatment could be shortened and the dosage may be minimized, but using radiotherapy should be cautions.</p>

Co-culture of Schwann cell with fascia / 中国康复理论与实践

@#ObjectiveTo explore the method of co-culture of Schwann cell(SCs) with fascia and provide experimental basis for repairing transected nerve.MethodsSCs were co-cultured with fascia.Double staining by anti-BrdU and anti-S-100,S-100 fluorescent staining and anti-BrdU staining were used.ResultsThere were a plenty of SCs around fascia proliferated rapidly and disposed in parallel. SCs could be distinguished from fibroblastic cells by S-100 fluorescent staining and also be staining positive by anti-BrdU antibody,implying their high proliferous ability. Anti-BrdU and anti-S-100 staining showed numerous double staining positive SCs on the fascia: nucleus was stained deep blue while cytoplasm was stained red.ConclusionMany SCs with high proliferous ability were seen on the fascia, which can be used to repair transected nerve.

Research on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia / 中国康复理论与实践

@#ObjectiveTo observe the effect on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia. Methods22 rabbits with transected facial nerve were divided into 2 groups randomly, control group (8 rabbits,15 sides totally), which transected facial nerve were wrapped by autologous fasia, and treament group (14 rabbits, 20 sides totally), which were wrapped by neural stem cells and autologous fasia. Six weeks after transplantation, neuro-electrophysiological test, immunohistochemical examination were done. The number and thickness of myelin in the re-connected area of transected facial nerve were observed. ResultsThe transplanted animals recovered much better than that in control group (P<0.05). Immunohistochemical examination showed a great deal of BrdU positive cells around the re-connected area of transected facial nerve. Immunohistochemical staining also found plenty of regenerative myelins in this area in the treatment group. While in control group, there were no BrdU positive cells and only a few of regenerative myelins in the same area. ConclusionTransplantation of neural stem cells combined with autologous fasia might become the new method to treat facial nerve injury.