To report the efficacy and safety of transsphenidal approach in a series of patients with pituitary adenoma, ninety-one consecutive patients undergoing transsphenoidal surgery of a pituitary adenoma at neurosurgical department, Cho Ray Hospital from January 2001 to June 2003 were included in this study. Postoperative results were analyzed. Total removal rate was 24.2% and partial removal rate was 7.7%. There were 4 patients had rhenorrhea and meningitis. Two patients died because of surgery. Normalization of visual defect was good. Transsphenoidal surgery is an effective and safe treatment for most patients with pituitary adenoma and could be considered the first choice therapy in most of the cases. Sublabial transseptal approach is suitable for our conditions.
Pituitary Neoplasms ; Surgery ; Therapeutics

The author reported 37 cases of pituitary adenoma operated in Department of Neurosurgery, Cho Ray hospital during the period of 30 months. Pitutary adenomas occupated 5.4% of all intracranial tumors. They occurred equally in both male and female and dominated at 30-40 of the age. The most common symptoms was visual disturbance with 57.1% had atrophy of optic nerve and endocrinological disturbance with amenorrhea (7 cases), acromegaly (4 cases), diabetes and galatorrhea. Endocrinological investigation indicated that the hyperprolactinaemia is a main disturbance (14 cases). Treatment results were not so good with 13.5% of bad results and dead. The author also discussed about the classification of pituitary function and the role of modern diagnostic equipments allowing earlier diagnosis. The surgical treatment was simple with the mainly applying of transcranial approach.
Pituitary Neoplasms ; Surgery ; therapeutics

The clinical manifestations, the endocrine examinations and imaging features (MRI) of 91 patients with pituitary adenomas who had undergone transsphenoidal microsurgery from 1/2001 to 6/2003 were analyzed. The patient population was 49.5% female and 50.5% male. Mean age was 40.4 years.71 patients (78%) experienced decreased visual acuity, 67 patients (73.6) experienced headache. The most frequent tumor type was clinically nonfunctioning adenoma (50%), followed by prolactin-secreting adenoma (34.1%), growth hormone-secreting adenoma (13.2%) and last adrenocorticotropin-secreting adenoma (7.7%). there were 86 macro adenomas (94.5%) and in 13 patients (14.3%) the tumor invaded cavernous sinus. mean height was 33.05 mm, length was 26.58mm and width was 29.71mm. Conclusions: Clinical manifestations of pituitary adenomas are the result of excess hormone secretion (acromegaly, hyperprolactinemia, hypercortisolism...) and to compression of the surrounding structures (headache, visual disturbance and ocular movement palsy). The endocrine examinations are very important for diagnosis and treatment. MRI is the first choice.
Pituitary Neoplasms ; Diagnosis

A study on 32 retraction pocked patients at various stages showed that: each stage of the retraction pocked should be done by one kind of technique. Four cases were treated by ventilation tube alone and 21 cases treated by ventilation tube combining with a cartilage placed in the tympanic cavity gave best result, 7 cases treated by ventilation tube combining with open the above ear . Ventilation tube alone did not improve hearing as well as the recovery of eardrum at surgery position. Ventilation tube combining with a cartilage placed in the tympanic cavity to prevent eardrum attack gave best results
retraction pocked

Several theories have been advanced to explain the formation of primary acquired or attic refraction Cholesteatomas including invagination of the pars flaccida, basal cell hyperplasia, otitis media with effusion, and perforation of the pars flaccida membrane with epithelial ingrowth. The study suggests it is the VA to be the cause of the otitis media with effusion and the attic Cholesteatomas.
cholesteatoma ; otitis media

Between 1978 and 1995, 63 patients with facial nervous palsy were treated. From them, 60 cases have petrosal origin and 3 cases - extra petrosal origin, including otitis, especially otitis with cholesteatoma, Bell paralysis, trauma (temporal bone fracture, frequently involving facial nerve). Among them 40 cases required surgical exploration of the facial nerve. 20 cases were treated by medicines.
Therapeutics ; Facial Paralysis

An investigation aimed to identify the risk factors of malaria in the custom of shifting cultivation and sleep in the terrace field. The results have shown that the custom of sleeping in the terrace field increased the malaria morbidity and influenced the malaria control. The risk of malaria morbidity in the people sleeping in the terrace field was higher 3,8 times than this in the people without sleeping in the terrace field and there was an increase of 4,3 times if sleeping in the terrace without mosquito net
Malaria ; epidemiology

It is a radical technique. With delicate modified instruments, this technique can improve considerably the function because of the advances in technology that emphasize mucosal preservation
Vocal Cords ; Immunity, Mucosal ; surgery ; Laryngeal Diseases

For the obliteration of the mastoid cavity, we used 3 kinds of flaps: an dermo-musculo-aponeurotic flap, the musculo- aponeurotic component with a superior or inferior pedicle, and the Hong Kong flap. Rebuilding the posterior wall of external canal: the posterior wall is rebuilt by skin or by cartilage of the auricle. Reconstruction of the middle ear transformer: ossiculoplasty, myringoplasty. The obliteration of the mastoid cavity by aponeuro-muscular flaps is a simple technique. It can be carried out widely at all local hospitals but it is very important to have dry mastoid cavity after operation. The obliteration is done not only at the 1st stage of mastoidectomy but also at the 2nd stage
Rehabilitation ; Recovery of Function ; surgery

The use of electro-acoustic impedance instrument to obtain a tympanogram is an excellent way for determining the status of tube function. The presence of a middle-ear effusion of high negative middle-ear press can be determined by this method. Unfortunately, assessment of the tympanograms is not simple. They always change.
diagnosis ; Middle Ear Ventilation ; physiology ; ear