[1]夏海龙,金彪,牟家民,等.原位骨瓣骨性重建在神经内镜扩大经鞍结节-蝶骨平台入路中的应用[J].临床神经外科杂志,2020,17(03):278-282.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.008]
 XIA Hai-long,JIN Biao,MOU Jia-min,et al.Clinical application of In Situ Bone Flap for skull base bone reconstruction in extended endoscopic endonasal-transplanum-transtuberculum approach[J].Journal of Clinical Neurosurgery,2020,17(03):278-282.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.008]
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原位骨瓣骨性重建在神经内镜扩大经鞍结节-蝶骨平台入路中的应用()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
17
期数:
2020年03期
页码:
278-282
栏目:
颅底肿瘤专题
出版日期:
2020-06-15

文章信息/Info

Title:
Clinical application of In Situ Bone Flap for skull base bone reconstruction in extended endoscopic endonasal-transplanum-transtuberculum approach
文章编号:
202003008
作者:
夏海龙金彪牟家民王晓澍霍钢娄四龙杨刚
400020 重庆,重庆市红十字会医院(江北区人民医院)神经外科(夏海龙);重庆医科大学附属第一医院神经外科(金彪,牟家民,王晓澍,霍钢,杨刚);重庆大学附属肿瘤医院神经肿瘤科(娄四龙)
Author(s):
XIA Hai-long JIN Biao MOU Jia-min et al.
Department of Neurosurgery, Chongqing Red-cross Hospital(Peoples Hospital of Jiangbei District), Chongqing 400020, China
关键词:
原位骨瓣颅底重建神经内镜扩大经鞍结节-蝶骨平台入路
Keywords:
In Situ Bone Flap skull base reconstruction neuroendoscopy transplanum-transtuberculum approach
分类号:
R651.1
DOI:
DOI:10.3969/j.issn.1672-7770.2020.03.008
文献标志码:
A
摘要:
目的探讨在神经内镜扩大经鞍结节-蝶骨平台入路中应用原位骨瓣(In Situ Bone Flap)进行颅底骨性重建的优势和可行性。方法回顾性分析重庆医科大学附属第一医院神经外科2016年1月—2019年12月,采用神经内镜下扩大经鞍结节-蝶骨平台入路治疗的89例鞍区肿瘤患者的临床资料。所有患者均采用原位骨瓣进行颅底骨性重建;统计术后脑脊液漏及颅内感染的发生率,并结合文献分析使用原位骨瓣进行颅底骨性重建的应用。结果术后出现脑脊液漏的患者4例(4.5%),经给予严格卧床、腰大池持续引流联合抗生素治疗后治愈,均未行手术修补;颅内感染患者3例(3.4%)。术后随访患者2~48个月,随访期间无发生迟发性脑脊液漏及颅内感染者。术后复查颅底CT三维重建示,原位骨瓣经历了“骨质吸收-骨痂形成-鞍底重塑”的愈合过程。结论使用“原位骨瓣”技术对内镜下扩大经鞍结节-蝶骨平台入路进行颅底骨性重建,术后脑脊液漏的发生率较低,且具有一定的优势,值得在临床推广。
Abstract:
Objective To investigate the advantage and feasibility of In Situ Bone Flap for skull base bone reconstruction via an extended endoscopic transplanum-transtuberculum-endonasal approach. Methods The clinical data of 89 patients with sellar tumors underwent surgery via extended endoscopic transplanum-transtuberculum-endonasal approach at Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University from January 2016 to December 2019 were analyzed retrospectively. All patients received bone reconstruction of skull base with In Situ Bone Flap, the incidence of postoperative cerebrospinal fluid leakage and intracranial infection was calculated, and the feasibility and advantages of rigid reconstruction of skull base by using In Situ Bone Flap were analyzed based on the literature. Results Postoperative cerebrospinal fluid leakage occurred in 4 cases(4.5%, 4/89), none of them need operation to repair skull base again. They were cured by strictly bed rest and continuous lumbar cistern drainage combined with antibiotics. Postoperative intracranial infection was found in 3 patients(3.4%, 3/89). There was no delayed cerebrospinal fluid leakage or intracranial infection during the follow-up period lasting for 2-48 months. The In Situ Bone Flap underwent the healing process of “bone resorption-callus formation-sellar reconstruction” showed by the postoperative follow-up CT scan. Conclusion The adoption of In Situ Bone Flap technique for the bone reconstruction of the skull base can achieve a low incidence of postoperative cerebrospinal fluid leakage with certain advantages and deserves clinical promotion.

相似文献/References:

[1]赵富文,支文勇,程序曲.前额颅底开放性颅脑损伤的手术治疗[J].临床神经外科杂志,2017,14(04):313.
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[2]李三中,王凯,孙季冬,等.中颅窝底脑膜瘤的临床特点及手术治疗研究[J].临床神经外科杂志,2020,17(03):273.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.007]
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更新日期/Last Update: 2020-06-17