95% cases of otitis mastoid were sucessfully treated by the reservation and surgery and the rest 5% cases with this were treated by many different methods aiming to management of the hollows of the radical surgery of mastoid bone according to the cause or individuals. The recovering of the partly poor epithelization in the surgical hollow reported effectively. 13 patients received a surgery in the Central Military Hospital 108 during 1987-1996 were studied. The indicators of age, gender, symptoms before receiving operation and status of the surgical hollow were used to classify the result
Mastoid ; Petrous Bone ; surgery

Cholesteatoma ; diagnosis ; surgery ; Humans ; Petrous Bone ; pathology

Humans ; Nose ; anatomy & histology ; surgery ; Petrous Bone ; anatomy & histology ; surgery

OBJECTIVESubtemporal transpetrosal ridge approach (STA) was introduced to remove the petroclival meningiomas with the simple, safe and minimal invasive character. It is suggested to replace the combined approach to reduce the morbidity and mortality.

METHODSSurgical anatomic study was done on 10 adult cadaver heads fixed in 10% formalin and 10 dry skulls. Ten cadaver heads were examined by bone-window CT scan pre and post-operation. The relationships of important anatomic structures and positions were measured and photographed.

RESULTSFor the STA, the important structures include Vein of Labbe, petrous bone and brain stem ventral space. The important data include the drilling space of the petrous ridge.

CONCLUSIONSSTA is an original approach to remove petroclival meningiomas. By drilling the petrous ridge, it allows the resecion of the tumor simple, safe and minimal invasive. It is suggested to replace the combined approach with STA to diminish the morbidity and mortality.

Adult ; Humans ; Meningeal Neoplasms ; surgery ; Meningioma ; surgery ; Microsurgery ; Neurosurgical Procedures ; methods ; Petrous Bone ; anatomy & histology ; surgery

BACKGROUNDDespite the presigmoid transpetrosal approach has been used by different researchers in various ways, the surgical injury rate remains high. Applying a minimally invasive keyhole idea, we devised a presigmoid transpetrosal keyhole approach (PTKA), classified and quantitatively assessed their approach to the petroclival area on a cadaver model by using a neuronavigation system.

METHODSThe presigmoid transpetrosal keyhole approach was divided into four increasingly morbidity-producing steps: retrolabyrinthine, partial labyrinthectomy with petrous apicectomy, translabyrinthine and transcochlear keyhole approaches. Six latex-injected cadaveric heads (twelve sides) underwent dissection in which a neuronavigation system was used. An area of exposure 10 cm superficial to a central target (working area) was calculated. The area of clival exposure with each subsequent dissection was also calculated.

RESULTSThe retrolabyrinthine keyhole approach (RLK) spares hearing and facial function in theory but provides for only a small window of upper clival exposure. The view afforded by partial labyrinthectomy with petrous apicectomy keyhole approach (PLPAK) provides for up to four times this exposure. The translabyrinthine keyhole approach (TLK) and transcochlear keyhole approach (TCK), although producing more morbidity, add little in terms of a larger petroclival window. However, with each step, the surgical freedom for manipulation of instruments increases.

CONCLUSIONSThe presigmoid transpetrosal keyhole approach to the petroclival area is feasible and useful. The RLK has relatively limited utility. For lesions without bone invasion, the PLPAK provides a much more versatile exposure with an excellent chance of hearing and facial nerve preservation. The TLK provides for greater versatility in treating lesions but clival exposure is not greatly enhanced. The TCK adds little in terms of intradural exposure but should be reserved for cases in which access to the petrous carotid artery is necessary.

Cadaver ; Cranial Fossa, Posterior ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Neuronavigation ; Petrous Bone ; surgery

OBJECTIVETo evaluate a facial rhytidectomy technique to reduce the complications of temporal alopecia and incisional scar hyperplasia.

METHODSThe 82 aged patients were divided into 2 groups in random way: group A in 46 with the use of the three-point relief-tension suspension technique and group B in 36 as control. In group A, the two point of every relief-tension suture was located respectively in the subcutis of the hairline and fascia under the incision. The parallel three sutures formed a mechanical plane to make the relief suture more strong and permanent. The temporal alopecia and incisional scar was observed with the follow-ups after the operation.

RESULTSWith the 82 cases of facial rhytidoplasty, the complications of the temporal alopecia and incisional scars in group A were much less than in group B.

CONCLUSIONSThis technique could decrease the complications such as temporal alopecia and incisional scars, and get a good and long term effect of temporal lifting simultaneously.

Adult ; Fasciotomy ; Female ; Humans ; Male ; Middle Aged ; Petrous Bone ; surgery ; Rhytidoplasty ; methods

OBJECTIVETo explore the reliability of humping the forehead and temple by en block frontal temporal silicone .

METHODSMake wax mold by piling up wax slices layer by layer according to the rang of depressing of the forehead and temple, the section being humped and the hight need to be projected. Order the silicone block according to the dimension of the wax mold. Make the implant from the silicon block. Under local anaesthesia dissection under the superficial temporal fascia and galea through forehead and two temporal incisions. Implant the silicon through the middle incision.

RESULTSTotal 18 cases in this group were followed up for 3-12 months. Wound healed primarily without infection. I case with early blood effusion cured after aspiration. l case with later clear effusion cured after aspiration ad injection of prednisone in to the capsular. The frontal temporal contours were satisfactory . No outline of the implant was seen.

CONCLUSIONIt is safety and satisfied to hump the forehead and temple by en block frontal temporal silicone.

Adult ; Female ; Forehead ; surgery ; Head ; surgery ; Humans ; Middle Aged ; Petrous Bone ; surgery ; Prosthesis Implantation ; Rhytidoplasty ; methods ; Silicones

OBJECTIVE: To investigate the clinical features, operative approach and method of petrous apex cholesteatoma, to improve the effect of operation and to reduce surgical complications. METHOD: Two cases of patients with giant petrous apex cholesteatoma were treated by trans labyrinth approach, one of which was successfully operated with oto-endoscope-assisted surgery. RESULT: No cerebrospinal fluid leakage, infection, vertigo or disequilibrium was found in the two cases after operation. CONCLUSION Temporal CT and MRI are of great importance in clinical diagnosis and choice of surgical approach. Surgery by trans-labyrinth approach paves way for removing cholesteatoma thoroughly, dealing with facial nerve and repairing cerebrospinal fluid leakage. Surgery is considered to be the only way to cure petrous apex cholesteatoma, while the key procedure to prevent recurrence lies in complete removal of lesion, long-time strict follow up and regular clearance of the surgical field.
Cholesteatoma ; diagnosis ; diagnostic imaging ; surgery ; Endoscopy ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Petrous Bone ; pathology ; Tomography, X-Ray Computed

OBJECTIVENasal endoscope has been used increasingly during skull base surgery. However, most of endoscopic surgery limited to the repair of cerebrospinal rhinorrhea, decompression of traumatic optic nerve, hypophysectomy, etc. This study was undertaken to determine whether endoscopic endonasal approach was safe and effective for the resection of tumors located in petroclival region and infratemporal fossa.

METHODSSeventeen patients with tumors of petroclival region and infratemporal fossa treated by endoscopic endonasal surgery between January 2002 and February 2005 were studied prospectively. The operative technique was described in detail. There were 5 chordoma, 1 esthesioneuroblastoma, 1 chondrosarcoma, 1 lymphoma, 1 craniopharyngioma, 1 hemangioblastoma, 4 meningioma, 1 schwannoma, and 2 metastatic carcinoma. 3 patients were selected for neuronavigation-aided endoscopic endonasal surgery.

RESULTSTotal tumor removal was obtained in 15 cases, subtotal removal in 2 case. With follow-up of 5 to 43 months, 1 case with chordoma was recurrent 5 months later postoperatively and underwent reoperation subsequently. The other cases with benign tumors were no recurrence. All of 5 cases with malignant tumors followed up for longer than 2 years were no recurrence and death. The complications included subarachnoid hemorrhage in 1 patient, transient cerebrospinal leakage in 2 cases.

CONCLUSIONSThe endoscopic endonasal surgery provides satisfied treatment for selected tumors of petroclival region and infratemporal fossa. This approach promises a simple and rapid access to petroclival region and infratemporal fossa. It is a safe, minimally invasive and efficient procedure. Using neuronavigation system, it is helpful to determining anatomical landmark and removing the tumor completely and securely.

Adult ; Aged ; Chordoma ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Meningioma ; surgery ; Middle Aged ; Nose ; surgery ; Petrous Bone ; surgery ; Skull Base Neoplasms ; surgery

Objective: By summarizing the technical points and therapeutic outcomes of combing infratemporal fossa approach (IFA) and internal carotid artery (ICA) reconstruction for the colossal skull base tumor invading ICA in petrous bone, the clinical application value was discussed. Methods: Five patients (2 males, 3 females,aging from 27 to 55 years old) who received surgeries between July 2015 and May 2017 for lateral skull base pathology involved petrous ICA using technique combined IFA and pre-reconstruction, were reviewed. Results: Among the five patients, three were paraganglioma of head and neck, one was carotid aneurysms, and one was recurrent adenoid cystic carcinoma (ACC). The median tumor size in the largest cross-section was 60 mm × 51 mm (range, 28 mm × 22 mm-72 mm × 58 mm). Complete excision was achieved with IFA and ICA reconstruction. The median blood loss volume was 1 000 ml (range, 600-2 500 ml). Four cases showed no new long-term neurologic sequelae, while one showed hemiplegia due to graft vessel occlusion. Except for the one with ACC having facial nerve cut, others achieved good facial nerve function of HB grade Ⅰ to Ⅱ during 3 to 12 months, follow-up. No tumor recurrence was observed over the median duration of follow-up for above 36 months (range, 36-58 months). Conclusion: For lesions involved superior part of ICA, which is unable to separate from ICA, IFA and ICA reconstruction can achieve complete excision.
Adult ; Carotid Artery, Internal/surgery* ; Female ; Humans ; Infratemporal Fossa ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Petrous Bone/surgery* ; Skull Base/surgery* ; Skull Base Neoplasms/surgery*