Pendleton Courtney, Raza Shaan M, Boahene Kofi D, Quiñones-Hinojosa Alfredo
The Johns Hopkins University School of Medicine, Departments of Neurosurgery and Otolaryngology, Baltimore, Maryland.
Skull Base. 2011 Jul;21(4):207-14. doi: 10.1055/s-0031-1275631.
In this report, we review Dr. Cushing's early surgical cases at the Johns Hopkins Hospital, revealing details of his early use of craniofacial approaches for malignant pathology of the skull base. Following Institutional Review Board approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912, which included three patients who underwent surgical treatment of lesions involving the skull base through craniofacial approaches: two adults and one child (range 3 to 43 years). The main outcome measures were length of stay and condition recorded at the time of discharge. The indications for surgery included osteochondroma of the sphenoid sinus, sarcoma of the maxillary sinus and middle fossa, and osteoma of the frontal sinus. The mean length of stay was 24.5 days (range 7 to 45 days). Cushing employed craniofacial approaches for malignant pathology nearly 40 years before such techniques became widely used. He practiced the fundamentals of skull base surgery, including preferential removal of bone to achieving adequate exposure for resection. In addition, Cushing clearly understood the importance of proximal vascular control in approaching lesions with complex vascular involvement.
在本报告中，我们回顾了库欣医生在约翰霍普金斯医院早期的外科手术病例，揭示了他早期对头面部入路用于颅底恶性病变的详细情况。经机构审查委员会批准，并承蒙艾伦·梅森·切斯尼档案馆的协助，我们查阅了约翰霍普金斯医院1896年至1912年的外科手术档案，其中包括3例通过头面部入路接受颅底病变手术治疗的患者：2名成人和1名儿童（年龄范围为3至43岁）。主要观察指标为住院时间和出院时记录的病情。手术适应证包括蝶窦骨软骨瘤、上颌窦和中颅窝肉瘤以及额窦骨瘤。平均住院时间为24.5天（范围为7至45天）。在这些技术广泛应用近40年前，库欣就采用头面部入路治疗恶性病变。他践行了颅底外科手术的基本原则，包括优先去除骨质以获得足够的暴露进行切除。此外，库欣清楚地认识到在处理伴有复杂血管受累的病变时近端血管控制的重要性。
