Somasundaram Aravind, Pendleton Courtney, Raza Shaan M, Boahene Kofi, Quinones-Hinojosa Alfredo
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
J Neurol Surg B Skull Base. 2012 Oct;73(5):358-62. doi: 10.1055/s-0032-1322799.
Objectives In this report, we review Dr. Cushing's early surgical cases at the Johns Hopkins Hospital, revealing details of his early operative approaches to infections of the skull base. Design Following institutional review board (IRB) approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912. Setting The Johns Hopkins Hospital, 1896 to 1912. Participants Eleven patients underwent operative treatment for suspected infections of the skull base. Main Outcome Measures The main outcome measure was operative approach, postoperative mortality, and condition recorded at the time of discharge. Results Eleven patients underwent operative intervention for infections of the skull base. The mean age was 30 years (range: 9 to 63). Of these patients, seven (64%) were female. The mean length of stay was 16.5 days (range: 4 to 34). Postoperatively eight patients were discharged in "well" or "good" condition, one patient remained "unimproved," and two patients died during their admission. Conclusion Cushing's careful preoperative observation of patients, meticulous operative technique, and judicious use of postoperative drainage catheters contributed to a remarkably low mortality rate in his series of skull base infections.
目的 在本报告中，我们回顾了库欣医生在约翰霍普金斯医院的早期手术病例，揭示了他早期针对颅底感染的手术方法细节。设计 经机构审查委员会（IRB）批准，并承蒙艾伦·梅森·切斯尼档案馆的帮助，我们查阅了1896年至1912年约翰霍普金斯医院的手术档案。背景 1896年至1912年的约翰霍普金斯医院。参与者 11例疑似颅底感染患者接受了手术治疗。主要观察指标 主要观察指标为手术方式、术后死亡率及出院时记录的状况。结果 11例颅底感染患者接受了手术干预。平均年龄为30岁（范围：9至63岁）。其中7例（64%）为女性。平均住院时间为16.5天（范围：4至34天）。术后，8例患者出院时状况为“良好”或“尚可”，1例患者病情“未改善”，2例患者在住院期间死亡。结论 库欣对患者细致的术前观察、精湛的手术技巧以及对术后引流管的明智使用，使得他治疗的一系列颅底感染患者死亡率显著降低。
