OBJECTIVE: To explore the feasibility and key technology of microscopic resection of lumbar intraspinal tumor through microchannel keyhole approach. METHODS: The clinical features, imaging characteristics and surgical methods of 54 cases of lumbar intraspinal tumor which were microscopically operated by microchannel from February 2017 to September 2019 were reviewed and analyzed. There were 8 cases of extradural tumor, 3 cases of extra-and intradural tumor and 43 cases of subdural extramedullary tumor (including 3 cases of ventral spinal tumor). The tumors were 0.5-3.0 cm in diameter. The clinical symptoms included 49 cases of pain in the corresponding innervation area, 5 cases of sensory disturbance (numbness) at or below the tumor segment, 7 cases of limb weakness and 2 cases of urination and defecation dysfunction. RESULTS: In the study, 37 tumors were resected through hemilaminectomy, 14 tumors were resected through interlaminar fenestration, 3 tumors were resected through hemilaminectomy or interlaminar fenestration combined with facetectomy of medial 1/4 facet. All of the 54 tumors were totally resected. The operation time was 75-135 min, with an average of 93.3 min. The postoperative hospital stay was 4-7 days, with an average of 5.7 days. Postoperative pathology included 34 cases of schwannoma, 4 cases of meningioma, 9 cases of ependymoma, 1 case of enterogenous cyst, 5 cases of teratoma/epidermoid/dermoid cyst, and 1 case of paraganglioma. No infection or cerebrospinal fluid leakage was found after operation. No neurological dysfunction occurred except 1 case of urination dysfunction and 4 cases of limb numbness. The follow-up period ranged from 3 to 33 months with an average of 14.4 months. Five patients with new onset symptoms returned to normal. The pain symptoms of 49 patients were completely relieved; 4 of 5 patients with hypoesthesia recovered completely, the other 1 patient had residual mild hypoesthesia; 7 patients with limb weakness, and 2 patients with urination and defecation dysfunction recovered to normal. No spinal instability or deformity was found, and no recurrence or residual tumors were found. According to McCormick classification, they were of all grade Ⅰ. CONCLUSION The lumbar intraspinal extramedullary tumors within two segments (including the ventral spinal tumors) can be totally resected at stage Ⅰ through microchannel keyhole approach with appropriate selection of the cases. Microchannel technique is beneficial to preserve the normal structure and muscle attachment of lumbar spine, and to maintain the integrity and stability of lumbar spine.
Humans ; Hypesthesia ; Lumbar Vertebrae/surgery* ; Meningeal Neoplasms ; Pain ; Retrospective Studies ; Spinal Cord Neoplasms/surgery* ; Spinal Neoplasms/surgery* ; Treatment Outcome

Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.
Airway Obstruction ; Dyskinesias ; Glossectomy* ; Hypesthesia ; Macroglossia ; Orthognathic Surgery* ; Prognathism* ; Prognosis ; Tongue

PURPOSE: It is known that the chronic absence of unilateral breast can cause spine curvature. The artificial breast manufactures take up the position of that possibility. This study was designed to evaluate the influence of the mastectomy on the spine and appearance of scoliosis among women who wanted delayed breast reconstruction. ted delayed breast reconstruction. METHODS: The study population consisted of 47 women who underwent delayed breast reconstruction at our Department of Plastic Surgery from April 2001 to May 2007. The whole spine anteroposterior and lateral X-ray was taken to evaluate the Cobb's angle. As a general rule a Cobb angle of 10 is regarded as a minimum angulation to define scoliosis. We evaluated Cobb's angle and drew a correlation between the duration of the mastectomy state and the weight of the mastectomy specimen. RESULTS: There were no family history of scoliosis, and no numbness or weakness in the upper or lower extremities. They had normal reflex and experienced no tenderness of the perispinal area. The Spearman Correlation Coefficient between Cobb's angle and the period that took time from the mastectomy to the X- rays and analysis between Cobb's angle and specimen weight was 0.032 and-0.115. there were no correlation between Cobb's angle and time, or between Cobb's angle and specimen weight. CONCLUSION: lthough the patients attribute their back pain and distorted posture to having received an one- sided mastectomy, it is unlikely that one-sided mastectomy causes spinal deformity and scoliosis.
Back Pain ; Breast ; Breast Neoplasms ; Congenital Abnormalities ; Female ; Humans ; Hypesthesia ; Lower Extremity ; Mammaplasty ; Mastectomy ; Posture ; Reflex ; Scoliosis ; Spine ; Surgery, Plastic

PURPOSE: Surgery for thyroid disease requires skin incisions that can result in postsurgical problems, such as prominent scars, adhesions and hypesthesia, as well as paresthesia of the neck. To overcome these problems we performed a gasless endoscopic thyroidectomy via an axillary approach. METHODS: Between November 2001 and April 2005, 141 patients underwent a gasless endoscopic thyroidectomy via an axillary approach. The surgical outcomes were evaluated in terms of the operating time, length of hospital stay and the incidence of perioperative complications. Patient opinions were assessed using a verbal response scale at two and four months after surgery. RESULTS: The mean operating time and length of hospital stay were 122.7+/-32.8 minutes and 3.4+/-0.9 days, respectively. No cases required either conversion to open surgery or involved significant intraoperative complications. Two months after surgery, 75 patients (53.2%) complained of hypesthesia or paresthesia in the anterior chest wall. The number of patients with such complaints (9.9%) had decreased 4 months after surgery (P<0.001). Four months after surgery, only 4 patients (2.8%) complained of hypesthesia or paresthesia in the neck, and 10 (7.1%) complained of discomfort while swallowing. All patients were satisfied with the cosmetic results. CONCLUSION: A gasless endoscopic thyroidectomy via an axillary approach is feasible and safe, and provides excellent cosmetic results, with a minimal degree of postoperative complaints. This procedure provides another surgical option for the treatment of benign thyroid disease in selected patients.
Cicatrix ; Conversion to Open Surgery ; Deglutition ; Humans ; Hypesthesia ; Incidence ; Intraoperative Complications ; Length of Stay ; Neck ; Paresthesia ; Skin ; Thoracic Wall ; Thyroid Diseases ; Thyroidectomy*

OBJECTIVE: To evaluate clnical effect of minimally invasive osteotomy with absorbable screws in treating hallux valgus deformity. METHODS: Clnical data of 31 patients with hallux valgus deformity were retrospective analyzed from January 2019 to December 2020, and divided into absorbable screws group (17 patients) and titanium cannulated screw group (14 patients). In absorbable screws group, there were 1 male and 16 females aged from 32 to 72 years old with an average of (54.53±12.12) years old;6 patients on the left side, 5 on bilateral and 6 on the right side;1 patient was mild, 11 moderate and 5 severe;treated with minimally invasive osteotomy and fixation of absorbable screws. In titanium cannulated screw group, there were 2 males and 12 females aged from 18 to 71 years old with an average of (47.57±15.68) years old;4 patients on the left side, 4 on bilateral and 6 on the right side;1 patient was mild, 9 moderate and 4severe;treated with minimally invasive osteotomy and fixation of titanium cannulated screw. Complications between two groups were observed, changes of hallux valgus angle (HVA)and intermetatarsal angle (IMA)were detected and compared before and after operation at 12 months, American Orthopedic Foot and Ankle Society(AOFAS) and visual analogue scale(VAS) before and after operation at 12 months were also compared. RESULTS: All 31 patients were followed up from 13 to 20 months with an average of (16.61±2.47) months. Patients in absorbable screws group were followed up from 14 to 20 months with an average of (16.88±2.80) months, while patients in titanium cannulated screw group were followed up from 13 to 19 months with an average of (16.29±2.05) months;there was no difference between two groups(P>0.05). One patient in absorbable screws group occurred numbness around incision, 3 patients in titanium cannulated screw group occurred complications, including numbness around incision in 1 patient, skin irritation due to internal fixation in 1 patient, and recurrence in 1 case;there was no statistic difference between two groups (χ²=1.651, P=0.199). There were no statistic difference in HVA and IMA between two groups before and after operation at 12 months(P>0.05). There were no statistic difference between two groups in AOFAS and VAS before and after operation at 12 months(P>0.05). CONCLUSION Compare with mainstream fixation with titanium hollow screw after minmally invasive osteotomy, fixation with absorbable screw could achieve comparable clinical outcome on the basis of images and function evaluation.
Adolescent ; Adult ; Aged ; Bunion ; Female ; Hallux Valgus/surgery* ; Humans ; Hypesthesia ; Male ; Metatarsal Bones/surgery* ; Middle Aged ; Osteotomy/methods* ; Radiography ; Retrospective Studies ; Titanium ; Young Adult

Melorheostosis is a rare, progressive bone disease accompanied by hyperostosis and soft tissue fibrosis. While affected adults present with contracture and pain, children present with limb length discrepancy and deformity. We report the case of a 20-year-old woman with melorheostosis since childhood who presented with right hand deformity and numbness. Radiographs showed not only a combination of dense sclerosis and opacities, but also the classic 'flowing candle wax' appearance. Radiography can be used to identify melorheostosis, thus preventing unnecessary bone biopsies. Carpal tunnel release revealed the presence of a thickened flexor retinaculum and a degenerated median nerve distal to the retinaculum, but did not show hyperostosis. This case highlights the role of nerve decompression in melorheostosis and the importance of early identification of the disease to prevent unnecessary bone biopsies.
Carpal Tunnel Syndrome ; complications ; diagnostic imaging ; surgery ; Diagnosis, Differential ; Female ; Fibrosis ; pathology ; Hand ; pathology ; Hand Deformities ; diagnostic imaging ; surgery ; Humans ; Hypesthesia ; Median Nerve ; surgery ; Melorheostosis ; complications ; diagnostic imaging ; surgery ; Radiography ; Sclerosis ; diagnostic imaging ; Young Adult

PURPOSE: Surgery for thyroid disease requires a skin incision that can result in postsurgical problems such as prominent scars, adhesions, hypesthesia, and paresthesia in the neck. To overcome these problems, we performed a gasless endoscopic thyroidectomy via an axillary approach. METHODS: Between May 2004 and April 2005, 30 female patients underwent gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of operating time, length of hospital stay, and the incidence of perioperative complications. Patient opinion was assessed using a verbal response scale at two and four months after surgery. RESULTS: The mean operating time was 126.8±32.4 minutes, and the mean length of hospital stay was 4.3±1.1 days. No cases required conversion to open surgery and none involved significant intraoperative complications. Three patients (10.0%) complained slight hypesthesia or paresthesia in the anterior chest wall, and only 2 patients (6.7%) complained the discomfort while they were swallowing for 4 months after surgery. All patients were satisfied with the cosmetic results. CONCLUSION: Gasless endoscopic thyroidectomy via an axillary approach is feasible and safe and provides excellent cosmetic results with a minimal degree of postoperative complaints. This procedure provides another surgical option for the treatment of benign thyroid disease in selected patients.
Cicatrix ; Conversion to Open Surgery ; Deglutition ; Female ; Humans ; Hypesthesia ; Incidence ; Intraoperative Complications ; Length of Stay ; Neck ; Paresthesia ; Skin ; Thoracic Wall ; Thyroid Diseases ; Thyroidectomy*

BACKGROUND: The authors report the results of preserving the infrapatellar branch of the saphenous nerve during unicompartmental knee arthroplasty to prevent lateral skin numbness. METHODS: All 100 cases had medial compartmental osteoarthritis and a minimally invasive technique had been used. The mean follow-up duration was two years and eight months (range, 24 to 42 months). RESULTS: The classification according to the location of this nerve was observed as either Mochida Type I with 76 cases (76%), Type II with 16 cases (16%), and unclassified type with 8 cases (8%). In Type I, the nerve was saved in 62 cases (82%), but could not be preserved in Type II because of the surgical procedure. These results showed that the mean distance from the joint line to the nerve of Type I was 9.13 mm (range, 4 to 15 mm) and the nerve passed inferiorly. CONCLUSIONS: This study showed the location of this nerve can be predicted ahead of the procedure, which will help preserve it during the surgery.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects/*methods ; Female ; Humans ; Hypesthesia/etiology/*prevention & control ; *Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Skin/*innervation

OBJECTIVE: The purpose of this study is to review the surgical results of 19 patients with idiopathic trigeminal neuralgia treated by percutaneous ballooning compression(PBC) of trigeminal gasserian ganglion under brief general anesthesia. METHODS: The mean patient age was 63.5 years(range, 27-78). The mean follow-up period was 24 months(range, 1-46). Three patients had already undergone radiofreqnency trigeminal rhizotomy and two patients had previously microvascular decompression. The balloon was inflated by injecting radio-contrast media 0.7-1cc in amount. The mean inflating time is 81 seconds(range, 60-90). RESULTS: During the procedure, brief intraoperative bradycardia and hypotension were noted in seven cases(36.7%). All patients had immediate relief of pain except 1 case. 18 cases(94.5%) of patients were satisfied or very satisfied with their pain relief. There were immediate, mild to moderate sensory complication of hypesthesia, dysesthesia or paraesthesia in all cases and the immediate motor complication-difficulty of mastication in 3 cases, transient 6th nerve palsy in 2 cases. The immediate motor and sensory complications disappeared or much improved after 3-4 months. CONCLUSION: It is the simple technique that can be performed effectively in a brief period of general anesthesia. This procedure might be one of attractive methods in the treatment of idiopathic trigeminal neuralgia.
Abducens Nerve Diseases ; Anesthesia, General ; Bradycardia ; Follow-Up Studies ; Humans ; Hypesthesia ; Hypotension ; Mastication ; Microvascular Decompression Surgery ; Paresthesia ; Rhizotomy ; Trigeminal Ganglion* ; Trigeminal Neuralgia*

Trigeminal neuralgia is a disease of intermittent short lasting facial pain but most severe pain from which mankind suffers. It's treatment usually depends on medication, microvascular decompression surgery, and nerve block such as trigeminal nerve block, retrogasserrian ganglion block and radiofrequency destruction of gasserian ganglion. Here we report two cases performed radiofrequency(RF) thermocoagulation with TEW-TC cannular in a recurred trigeminal neuralgia patient after microvascular decompression and an inoperable patient due to hypertensive cerebral infarction. After the paresthesia and masseter muscle contracture test at 50 Hz - 0.2 volt and 2 Hz - 0.6 volt respectively, RF lesionings were performed for 60 sec at 60oC and 60 sec at 65oC. One patient got relief of pain completely and has been achieved over 8 months with mild hypoesthesia on face and the other patient got incomplete pain relief without hypoesthesia even though has satisfied over 7 months. Radiofrequency thermocogulation is a safe procedure that can be well controlled and less invasive even though inoperable or recurred trigeminal neuralgia patient.
Cerebral Infarction ; Contracture ; Electrocoagulation* ; Facial Pain ; Ganglion Cysts ; Humans ; Hypesthesia ; Masseter Muscle ; Microvascular Decompression Surgery ; Nerve Block ; Paresthesia ; Trigeminal Ganglion ; Trigeminal Nerve ; Trigeminal Neuralgia*