A case-control study of endoscopic endonasal approach and transcranial approach in the treatment of skull base chordomas / 中国神经精神疾病杂志

Objective To investigate the surgical outcomes and strategies selection of endoscopic endonasal approach and craniotomy in the treatment of cranial base chordomas.Methods Thirty-one patients diagnosed pathologically with cranial base chordoma in Tianjin huanhu hospital from Jan.2010 to Sep.2020 were analyzed retrospectively.The patients were divided into the endoscopic endonasal group and the craniotomy microscope group according to the different surgical approaches.The surgical results and follow-up between the two groups were compared.Results In the endoscopic endonasal group,there were 7 cases of gross total resection,9 cases of subtotal resection and 2 cases of partial resection.The main complications included death in 2 cases,cerebrospinal fluid leakage in 8 cases,cranial nerve injury in 2 cases and hypopituitarism in 1 case.In the craniotomy microscope group,there were 2 cases of gross total resection,10 cases of subtotal resection,and 1 case of partial resection.The main complications included cerebrospinal fluid leakage in 1 case,cranial nerve injury in 3 cases,epilepsy in 1 case and epidural hematoma in 1 case.There was no statistical significance in the resection rate between the two groups(P＞0.05).The rate of cerebrospinal fluid leakage in the endoscopic group was significantly higher than that in the craniotomy microscope group,and the comparison was statistically significant(P＜0.05).There was no statistically significant between the two groups for tumor recurrence or progression.Conclusions The endoscopic endonasal approaches for resection of cranial base chordomas have improved the gross total resection rate,but craniotomy is still an important surgical method for tumor resection.It is necessary to select an appropriate surgical approach according to the lesion location and pattern of tumor growth.

Compound nerve conduits in peripheral nerve repair / 中华整形外科杂志

Peripheral nerve injury is a relatively common sequela of trauma. Nerve regeneration and target re-innervation are complex processes, and remain clinical challenges. For a long period of time, the placement of an autologous nerve graft is the gold standard. However, autologous nerve grafts are limited in supply due to its potentially associated with donor site morbidities. Therefore, researchers keep seeking the ideal alternatives for neural repair. The clinical application of artificial nerve regeneration conduit has made incremental advancement. Specifically, compound conduits are gaining more and more attention, which are reported to have comparable effect to autologous nerve graft. The purpose of this paper is to review the progress of construction and application of compound nerve conduits in peripheral nerve repair.