OBJECTIVE: To explore the application of the"five-line division method "in selecting the surgical approach for occupying lesions in the saddle area and its adjacent areas. METHODS: Based on the natural anatomic structures, 5 lines (alpha, beta, theta line and lambda, epsilon line) were drawn on the images of the craniocerebral axial plane crossing the middle of the saddle area and the craniocerebral median sagittal plane, thus dividing the saddle area and its adjacent areas into 6 regions in the axial plane (1, 2, 3, 1', 2', and 3' regions) and into 4 regions in the sagittal plane (I, II, III, and IV regions). Based on these divisions, the large space-occupying lesions in the saddle area and adjacent areas were classified and their respective surgical approaches were determined after reviewing the commonly used approaches in the saddle area and clinical experiences. We collected the data of 116 patients undergoing surgeries for space-occupying lesions involving the saddle and the adjacent areas in our hospital between September, 2014 and August, 2017, and analyzed their classifications and the corresponding surgical approaches based on the "five- line division method " to compare the consistency between the hypothetic approaches and the approaches adopted in the actual surgeries. RESULTS: The actual surgical approaches adopted in the 116 cases were all selected under the guidance of experts in our hospital. The hypothetic surgical approaches selected based on the"five- line division method "showed a good consistency with the actually adopted approaches. CONCLUSIONS The"five-line division method "can spatially classify the commonly seen space-occupying lesions involving the saddle area and its adjacent area to provide assistance in the selection of surgical approaches for such lesions.
General Surgery/methods* ; Humans

Endoscopy ; instrumentation ; methods ; trends ; General Surgery ; methods ; Humans

A foreign body was found in left bronchi of a 8-month infant. A fish bone of 26 mm long was pulled out with bronchoscopy under general anesthesia. This kind of surgery done in infant is more challenging than that done in child.
Anesthesia, General ; Bronchi ; Bronchoscopy ; methods ; Foreign Bodies ; surgery ; Humans ; Infant

Acute Disease ; Appendectomy ; methods ; Appendicitis ; surgery ; General Surgery ; standards ; Humans ; Pathology ; methods

Anesthesia, General ; Humans ; Otorhinolaryngologic Surgical Procedures ; methods ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery

Virtual reality is the multi-dimensional sensorial environment produced by the computer, Users can play a part in this virtual environment by particular tools. This technology, possessing the characteristics of being lifelike, interactive and imaginative, plays more and more important part in the medical field. For example, in medical training, in physical and psychological treatments, this technology is of great value.
Computer Simulation ; Computer-Assisted Instruction ; General Surgery ; education ; methods ; Humans ; Surgery, Computer-Assisted ; User-Computer Interface

OBJECTIVE: To compare the efficacy and safety of applications of GlideScope video laryngoscope (GSVL) and Macintosh direct laryngoscope (MDLS) during endotracheal intubation under general anesthesia of abdominal snoring surgeries. METHOD: Forty patients ranged from American Society of Anesthesiologists I to II scheduled for snoring surgery under general anesthesia with endotracheal intubation were randomly divided into GSVL group and MDLS group (20 cases in each group), After traditional induction, endotracheal intubation (ETT) performed by GSVL or MDLS. Glottic exposure, the time of endotracheal intubation(from mask ventilation ending to successful intubation), the times of tracheal intubation operation were recorded in both groups. The mean artery pressure(MAP), heart rate(HR) were monitored before induction (basic value T0), before tracheal intubation (T1), after tracheal intubation (T2), 1 min after tracheal intubation (T3), 3 mins after tracheal intubation (T4). RESULT: The glottic exposure of GSVL group is superior to that of MDLS group. There was no significant difference in the time of tracheal intubation between MDLS group (27 +/- 11)s and GSVL group (26 +/- 11)s (P < 0.05). Compared with T0, MAP of T1 was lower in two groups (P < 0.05), while HR were similar both in two groups (P > 0.05). MAP of T2 and T3 increased and HR became faster (P < 0.05). MAP of T4 declined, but HR still increased (P < 0.05). Between the two groups, there was no significant difference of MAP or HR (P > 0.05). CONCLUSION Compared with MDLS,the GSVL is of benefit to improve the glottic exposure in endotracheal intubation to the snoring patients,so as to improve the success rate of tracheal intubation. But there is no obvious advantages via GSVL in preventing hemodynamic reaction during tracheal intubation.
Adult ; Aged ; Anesthesia, General ; Female ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopy ; methods ; Male ; Middle Aged ; Snoring ; surgery

Oral and maxillofacial surgery (OMFS) trauma cases are commonly treated under general anesthesia. The purpose of this case report is to introduce an alternative method of anesthesia in patients who refuse general anesthesia. A combination of dexmedetomidine and ketamine for sedation anesthesia in 3 frequent fracture types in the field of OMFS—Le Fort I fracture, mandibular fracture, and alveolar bone fracture—was used. Dexmedetomidine as the single agent has not shown stable success rates for invasive procedures. To overcome some of the pitfalls with dexmedetomidine, combination sedation using ketamine was performed. Visual analogue scale scores were recorded postoperatively. Dexmedetomidine combined with ketamine administration provided safe and effective sedation and anxiolysis for surgical reduction and internal fixation of OMFS fractures. It showed advantages of decreased admission time, reduced expenses, minimal pain, and reduced anesthetic burden for the patient thus ultimately increasing overall satisfaction.
Anesthesia ; Anesthesia, General ; Dexmedetomidine ; Humans ; Ketamine ; Mandibular Fractures ; Methods ; Surgery, Oral

OBJECTIVE: To explore whether laryngopharyngeal simulator teaching can improve the quality of clinical operation compared with traditional preclinical teaching program. METHOD: Sixty-five surgical interns were randomly divided into two groups. Experimental group was given traditional clinical practice together with simulator for laryngopharyngeal training, while control group received traditional clinical practice only. The teaching effect were compared through the operation assessment. RESULT: After simulation training, the performance of experimental group was superior to that of the control group, and the difference was statistically significant (P < 0.05). CONCLUSION Simulator can improve the quality of teaching. It is recommended for teaching hospital and doctor's training base and deserves further promotion.
Educational Technology ; instrumentation ; methods ; General Surgery ; education ; Humans ; Pharynx ; anatomy & histology

Clinical Competence ; Communication ; General Surgery ; education ; methods ; trends ; Humans ; Philosophy, Medical ; Practice Patterns, Physicians' ; Singapore