Objective:To assess the efficacy of "three-step" strategy for preparing autologous pedicled nasal mucosal flaps in repairing cerebrospinal fluid（CSF） leaks following transsphenoidal pituitary adenoma surgery. Methods:A retrospective study was conducted on the clinical data of 25 patients who developed CSF leaks after transsphenoidal pituitary adenoma surgery at the First Affiliated Hospital of Kunming Medical University between July 2012 and June 2022. Surgical repair was selected step by step using nasal septal mucosal flap with either the posterior septal artery or septal branch of the sphenopalatine artery as the pedicle, or a pedicled middle turbinate mucosal flap. All patients underwent ≥2-year endoscopic follow-up to assess flap viability and CSF leak recurrence. Results:The median postoperative hospital stay was 4 days. Five patients developed intracranial infections postoperatively. The follow-up period ranged from 2 to 12 years. Nasal endoscopic examinations showed good mucosal flap growth, with no recurrence of CSF leakage in any of the patients. Conclusion:High-flow cerebrospinal fluid（CSF） leaks following pituitary tumor surgery pose significant challenges for clinical repair. Based on intraoperative nasal septal mucosal preservation and the condition of sellar base CSF leakage, the "three-step" strategy for preparing autologous pedicled nasal mucosal flaps-utilizing posterior septal artery, ethmoidal artery-based, or pedicled middle turbinate mucosal flaps sequentially-is a safe and effective repair method.
Humans ; Retrospective Studies ; Pituitary Neoplasms/surgery* ; Surgical Flaps ; Nasal Mucosa/surgery* ; Cerebrospinal Fluid Leak/surgery* ; Adenoma/surgery* ; Postoperative Complications/surgery* ; Male ; Female ; Middle Aged ; Adult ; Aged

Objective To investigate the features of peripheral nerve injuries in workers exposed to vibration.Methods A total of 197 male workers [median age:34 years (21-50 years);median working years of vibration exposure:7.3 years (1-20 years)] engaged in grinding in an enterprise were enrolled.Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment.Results Of all workers,96 (48.73％) had abnormal electromyography results.Of all workers,88 (44.7％) had simple mild median nerve injury in the wrist,who accounted for 91.7％(88/96) of all workers with abnormal electromyography results.Six workers had ulnar nerve injury,superficial radial nerve injury,or/and superficial peroneal nerve injury and accounted for 6.3％ of all workers with abnormal electromyography results.Of all workers,88 had a reduced amplitude of median nerve sensory transduction,and 28 had slowed median nerve sensory transduction.A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment.They were followed up for more than 4 months after leaving their jobs,and most of them showed improvements in neural electromyography results and returned to a normal state.Conclusion Workers exposed to vibration have a high incidence rate of nerve injury in the hand,mainly sensory function impairment at the distal end of the median nerve,and all injuries are mild peripheral nerve injuries.After leaving the vibration job and being treated,most workers can achieve improvements and return to a normal state.

Objective To investigate the features of peripheral nerve injuries in workers exposed to vibration.Methods A total of 197 male workers [median age:34 years (21-50 years);median working years of vibration exposure:7.3 years (1-20 years)] engaged in grinding in an enterprise were enrolled.Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment.Results Of all workers,96 (48.73％) had abnormal electromyography results.Of all workers,88 (44.7％) had simple mild median nerve injury in the wrist,who accounted for 91.7％(88/96) of all workers with abnormal electromyography results.Six workers had ulnar nerve injury,superficial radial nerve injury,or/and superficial peroneal nerve injury and accounted for 6.3％ of all workers with abnormal electromyography results.Of all workers,88 had a reduced amplitude of median nerve sensory transduction,and 28 had slowed median nerve sensory transduction.A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment.They were followed up for more than 4 months after leaving their jobs,and most of them showed improvements in neural electromyography results and returned to a normal state.Conclusion Workers exposed to vibration have a high incidence rate of nerve injury in the hand,mainly sensory function impairment at the distal end of the median nerve,and all injuries are mild peripheral nerve injuries.After leaving the vibration job and being treated,most workers can achieve improvements and return to a normal state.