[Feasibility of a novel material for the reconstruction of skull base in a canine].

OBJECTIVE: To explore the therapeutic efficacy of a novel complex material of shape-memory alloy brace and artificial dura (nitinol brace and NormalGEN) for the reconstruction of skull base in a canine model with lateral media skull base defect. METHODS: The complex of nitinol brace and NormalGEN was developed with corresponding apparatus. A common adult dog model with lateral media skull base defect was established and then reconstructed with the complex. At Month 3 post-operation, cranial lateral radiographic projection, three-dimensional reconstruction of computer tomography, 1.5T magnetic resonance imaging and histopathological examination were detected. RESULTS: Five animal models and cranial reconstructions were made. All survived without any complication, such as leakage of cerebrospinal fluid, local tissue eminence and neurological function defect. The imaging detection showed that nitinol brace was distinct and satisfactorily positioned without shift and artifact. And histopathological examination showed that granulation tissue substituted NormalGEN and grew around the brace with numerous fibroblasts. CONCLUSION: The complex of shape-memory alloy brace and artificial is suitable for the reconstruction of skull base on dog model with lateral media skull base defect.

[Onyx embolization for treatment of dural arteriovenous fistula: comparison of long- distance versus routine injection method].

OBJECTIVE: To compare the efficacy, clinical characteristics, safety, injection time and radiation exposure of Onyx embolization using a long-distance injection method and routine injection method for management of dural arteriovenous fistula (DAVF). METHODS: The clinical data were retrospectively analyzed in 59 patients with DAVF treated with Onyx embolization using long-distance injection method (28 patients) and routine injection method (31 patients). The efficacy, safety, injection time and radiation exposure during Onyx embolization were compared between the two injections methods. RESULTS: The average radiation dose exposure to the surgeon per procedure was significantly lower in the long-distance injection group than in the routine group. The injection time (P=0.53), injection volume (P=0.78), number of supply arteries (P=0.80), Cognard types (P=0.67), and effect of embolization (P=0.88) were all similar between the two groups. CONCLUSION: Endovaseular treatment of intracranial DAVF with Onyx embolization using the long-distance injection method is feasible, safe and effective and can reduce the radiation exposure to the surgeon.

[Treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy].

OBJECTIVE: To investigate the effectiveness of treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy. METHODS: In 30 patients with recurrent malignant brain gliomas, the tumor was surgically removed and Vp-16 biodegradable polymers were implanted during operation in the tumor bed at a dose of 100 - 150 mg. The patients were followed up for 3 - 24 months, and the results were compared with 46 cases with the recurrent malignant brain gliomas who received operation only. RESULTS: At 3, 6, 12, 24 months after treatment, the recurrent rate was 16.7%, 30%, 50% and 83.3%, respectively; the mortality rate was 6.67%, 20%, 40% and 70%, respectively. All the patients had no apparent side-effects of chemotherapy. CONCLUSION: Surgical treatment combined with interstitial chemotherapy with biodegradable Vp-16 polymers improves the treatment result of recurrent malignant brain gliomas compared to surgery alone.