AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate ...AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate of associated complications of this operation. METHODS: We performed a retrospective analysis of a series of 37 cases involving patients who underwent transcranial surgery through pterional approach for treatment of cranio-orbital tumors in our department in the past 8 years. Pterion approach craniotomy was performed to all patients. After removing tumors in the skull by the neurosurgeon, ophthalmologist removed tumors in orbit. We took measures below to decrease complications, including grounding optic canal through an abrasive drilling when necessary, hanging various extraocular muscles to be exposed for protection, refrigerating by refrigeration heads to remove tumors, at last sewing up orbit septum after surgery. RESULTS: Tumors were removed completely in 32 cases, and incomplete in 5 cases due to extensive invasion into the cavernous sinus or sphenoid sinus. Of all the cases, benign tumors were demonstrated in 28 cases (75.6%, 28/37) and malignant in 9 (24.3%, 9/37). The most common lesion type was meningioma in 11 cases (29.7%, 11/37). Extraocular muscles (EOM) impairment, occurring in 21 cases (56.7%, 21/37), was the most frequent postoperative complication. The most serious consequence was vision loss occurred in 4 cases (10.8%, 4/37). Other complications, such as 11 cases of transient blepharoptosis 29.7% (11/37), 5 cases of mydriasis in 13.5% (5/7); 2 cases of cerebrospinal rhinorrhea in 5.4% (2/37). CONCLUSION: Cranio-orbital tumors can be removed completely using transcranial approach, and the pterional approach offers excellent exposure. Cooperation of interdisciplinary team of neurosurgeons and ophthalmologists conduces to full use of respective professional advantages. The experience of ophthalmic operation technology can decrease occurrence of ocular complications after surgery.展开更多
AIM:To determine the frequency and types of retinal diseases and the extend of the related visual loss in adult patients attending two public eye clinics of Kinshasa,Democratic Republic of Congo.METHODS:Review of medi...AIM:To determine the frequency and types of retinal diseases and the extend of the related visual loss in adult patients attending two public eye clinics of Kinshasa,Democratic Republic of Congo.METHODS:Review of medical records of patients with retinal diseases seen in the major eye clinics in Kinshasa,the University Hospital of Kinshasa(UHK)and Saint Joseph Hospital(SJH),from January 2012 to December 2014.Demographics and diagnoses were retrieved and analyzed.Outcome measures were frequency and prevalence of retinal diseases,blindness and low vision.RESULTS:A total of 40965 patients aged 40 y or older were examined during this period in both clinics.Of these,1208 had retinal disease,giving a 3-year and an annual prevalence of 3%and 1%,respectively.Mean age was 61.7±10.7 y,and 55.8%of the patients were males.Arterial hypertension(68.1%)and diabetes(43.3%)were the most common systemic comorbidities.Hypertensive retinopathy(41.8%),diabetic retinopathy(37.9%),age-related macular degeneration(AMD;14.6%),and chorioretinitis and retinal vein occlusion(7.3%each)were the most common retinal diseases,with 3-year prevalence rates of 1.3%,1.0%,0.43%,and 0.21%respectively.Bilateral low vision and blindness were present in 26.8%and 8.4%of the patients at presentation.Major causes of low vision and blindness were diabetic retinopathy(14.8%),AMD(4.9%),retinal detachment(2.8%),and retinal vein occlusion(2.5%).The prevalence was significantly higher among males than females,and at the UHK than SJH.CONCLUSION:Retinal diseases are common among Congolese adult patients attending eye clinics in Kinshasa.They cause a significant proportion of low vision and blindness.展开更多
文摘AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate of associated complications of this operation. METHODS: We performed a retrospective analysis of a series of 37 cases involving patients who underwent transcranial surgery through pterional approach for treatment of cranio-orbital tumors in our department in the past 8 years. Pterion approach craniotomy was performed to all patients. After removing tumors in the skull by the neurosurgeon, ophthalmologist removed tumors in orbit. We took measures below to decrease complications, including grounding optic canal through an abrasive drilling when necessary, hanging various extraocular muscles to be exposed for protection, refrigerating by refrigeration heads to remove tumors, at last sewing up orbit septum after surgery. RESULTS: Tumors were removed completely in 32 cases, and incomplete in 5 cases due to extensive invasion into the cavernous sinus or sphenoid sinus. Of all the cases, benign tumors were demonstrated in 28 cases (75.6%, 28/37) and malignant in 9 (24.3%, 9/37). The most common lesion type was meningioma in 11 cases (29.7%, 11/37). Extraocular muscles (EOM) impairment, occurring in 21 cases (56.7%, 21/37), was the most frequent postoperative complication. The most serious consequence was vision loss occurred in 4 cases (10.8%, 4/37). Other complications, such as 11 cases of transient blepharoptosis 29.7% (11/37), 5 cases of mydriasis in 13.5% (5/7); 2 cases of cerebrospinal rhinorrhea in 5.4% (2/37). CONCLUSION: Cranio-orbital tumors can be removed completely using transcranial approach, and the pterional approach offers excellent exposure. Cooperation of interdisciplinary team of neurosurgeons and ophthalmologists conduces to full use of respective professional advantages. The experience of ophthalmic operation technology can decrease occurrence of ocular complications after surgery.
文摘AIM:To determine the frequency and types of retinal diseases and the extend of the related visual loss in adult patients attending two public eye clinics of Kinshasa,Democratic Republic of Congo.METHODS:Review of medical records of patients with retinal diseases seen in the major eye clinics in Kinshasa,the University Hospital of Kinshasa(UHK)and Saint Joseph Hospital(SJH),from January 2012 to December 2014.Demographics and diagnoses were retrieved and analyzed.Outcome measures were frequency and prevalence of retinal diseases,blindness and low vision.RESULTS:A total of 40965 patients aged 40 y or older were examined during this period in both clinics.Of these,1208 had retinal disease,giving a 3-year and an annual prevalence of 3%and 1%,respectively.Mean age was 61.7±10.7 y,and 55.8%of the patients were males.Arterial hypertension(68.1%)and diabetes(43.3%)were the most common systemic comorbidities.Hypertensive retinopathy(41.8%),diabetic retinopathy(37.9%),age-related macular degeneration(AMD;14.6%),and chorioretinitis and retinal vein occlusion(7.3%each)were the most common retinal diseases,with 3-year prevalence rates of 1.3%,1.0%,0.43%,and 0.21%respectively.Bilateral low vision and blindness were present in 26.8%and 8.4%of the patients at presentation.Major causes of low vision and blindness were diabetic retinopathy(14.8%),AMD(4.9%),retinal detachment(2.8%),and retinal vein occlusion(2.5%).The prevalence was significantly higher among males than females,and at the UHK than SJH.CONCLUSION:Retinal diseases are common among Congolese adult patients attending eye clinics in Kinshasa.They cause a significant proportion of low vision and blindness.
