Objective: To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma. Methods: Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch. Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control. The resection rate, operative time, intraoperative blood loss, and postoperative complications were compared between the groups. Results: Two groups of patients underwent craniotomy under microscope. The Simpon grade I resection and grade Ⅱ resection rate was 93.9％ in the cutting of the zygomatic arch approach group and 60.0％ in the control group (P<0.01). The operative time was (325.2±121.3) min in the cutting of the zygomatic arch approach group, which was significantly shorter than that in the control group with (406.4±182.9) min (P<0.05). The intraoperative blood loss was (502.5±101.8) mL and (697.7±115.4) mL in the two groups (P<0.05). In addition, postoperative complication rate was 15.2％ and 45.0％ in the cutting the zygomatic arch approach group and the control group, respectively (P<0.05). No death was reported in both groups. Conclusion: Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area. The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue, which might be helpful for the complete resection of large sphenoid ridge meningioma, and is more conducive to neurovascular anatomy and relevant functional protection.

Objective:To investigate the clinical effacies of endoscopic midline and paramedian supracerebellar infratentorial (SCIT) approaches during resection of pineal tumors.Methods:The clinical data of 4 patients with pineal tumors resected via SCIT approach under neuroendoscope in our hospital from December 2017 to March 2019 were analyzed retrospectively. All patients underwent MR imaging plain and enhanced scans before operation. The tumors were resected via SCIT approach under general anesthesia in lateral subduction position (three were via paramedian SCIT approach and one was via midline SCIT approach). The patients were followed up for 3-12 months and the brain MR imaging was reexamined.Results:The tumors were completely resected in 4 patients. Two patients were confirmed to have mixed germ cell tumors, one was confirmed to have seminoma, and the other one was confirmed to have mature teratoma by postoperative pathology. One achieved good recovery after surgery. Two were treated with whole brain and spinal cord radiotherapy, the original lesion in one patient recurred 4 months after resection and systemic chemotherapy was given, and so far, no recurrence was noted; and the other one achieved good recovery. One did not receive chemoradiotherapy due to economic reasons and relapsed 4 months after surgery.Conclusion:It is safe and effective to resect the tumors in pineal region via midline and paramedian SCIT approaches with neuroendoscopy; the best approach should be selected according to the blood supply, size and location of the lesions.

Objective:To explore the application value of neuroendoscopic Endoport technique in resection of intracranial lesions involving the interventricular foramen.Methods:A retrospective analysis was performed; 21 patients with intracranial lesions involving the interventricular foramina accepted treatment by neuroendoscopic Endoport technique in our hospital from January 2018 to August 2020 were chosen. The surgical results and prognoses at follow-up were discussed.Results:In these 21 patients, total removal of the lesions was achieved in 19 patients, and subtotal removal in 2 patients; perioperative complications included 1 patient with postoperative hemorrhage and 1 patient with intracranial infection. During the follow-up of 3-30 months, except for 1 patient lost of follow-up, Karnofsky performance scale scores at the last follow-up were 85.5±3.5, and no signs of tumor recurrence were found during the imaging follow-up.Conclusion:Neuroendoscopic Endoport technique can help to safely and effectively remove intracranial lesions involving the interventricular foramen, and the patients enjoy good prognosis.

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.