Objective To investigate the clinical effects of communicating tumors on anterior skull base with neuroendoscope-assisted surgery. Methods Nineteen eases of crani-nosel and crani-orbital nosel communicating tumors underwent the combined craniofacial approach. The defect of anterior skull base was repaired with the compound flap with pedicel frontal galea muscle and temporalis myofascial flap.Results All 19 patients were successfully treated without CSF leak and cranial infection. The tumor total re-section rate was 78.9%, subtotal resection rate was 15.8% ,partial resection rate was 5.3%. Four patients of benign tumor were survival,15 patients of malignant tumor 2- year survival was 11, 3-year survival was 8,above 5- year survival was 6. Conclusion The neuroendoscope-assisted combined craniofacial approach can provide a relatively safe and effective resection for communicating tumors on anterior skull base,and has better clinicall value.

Objective To study the expression and significance of survivin,an apoptotic suppressor gene,in craniopharyngioma. Methods Fifty specimens were collected from patients with craniopharyngioma admitted in West China Hospital of Sichuan University from 2000 to 2005. By using immunohistocbemistry (S-P) method, the expression of survivin in craniopharyngioma was detected. The results were analyzed quantitatively by using digital image analysis. Results Survivin positive expression was observed in craniopharyngioma but not in normal brain tis-sue. There was more expression of survivin in adamantinomatous craniopharyngiomas than in squamous papillary types( P = 0.036 ) , in male than in female (P = 0.002 ), in children ≤ 16 years than in adults > 16 years, and in re-current group than in non-recurrent group( P = 0.011 ). There was no significant difference among different properties of craniopharyngioma ( P = 0. 057 ), and different courses of disease ( P = 0. 083 ). Conclusions Survivin may be considered as a significant index for assessment of tumor recurrence.

Objective To analyze the patients with convexity meningioma with respect to pathological factors leading to recurrence, surgical technique, and complication. Methods The data of 120 surgical cases of convexity meningioma were retrospectively reviewed. Statistical analysis were performed by SPSS 17.0 with method of Kaplan-Meier survival analysis. Results The 30-day mortality was 0. The pathology of the tumors was benign in 105 cases (87.5%), atypical meningioma in 12 cases (10.0%), and anaplastic/malignant meningioma in 3 cases (2.5%). In 8 cases designated benign, there were borderline atypical features. Two cases of benign tumor recurred whose pathology involved tumors with borderline atypia.Conclusions Patients with convexity meningioma should be actively operated, and Simpson Ⅰ resection must be performed to the best of ability whether the tumors are benign or malignant. Further postoperative adjuvant treatment will be implemented or not according to the histopathological types of the tumors. Although there are many factors of recurrence for convexity meningioma. The range of surgical resection and pathological types are still the important causes for recrudescence.

Objective To evaluate the effectiveness of absolute alcohol in hemostasis in surgical resection of giant meningiomas with rich blood supply. Methods Twelve patients with giant meningiomas with rich blood supply were injected with absolute alcohol (8.5-27 mL, mean 11.2 mL) in the operations, and the tumors were resected under microscope. Results The tissues in the injection areas turned white and the tumors became hardened after the injection. The bleeding of the tumor surface and section was obviously decreased or even stopped. The quantities of bleeding were 48-154 mL in the operations, with an average of 67 mL. Total tumor resection was achieved in 11 patients (91.6%) and partial resection in 1 patient. No complications associated with the surgery were found in these cases. Conclusion Injection of absolute alcohol for hemostasis in surgical removal of giant meningiomas with rich blood supply is convenient and effective and can be widely applied in clinical practice.