[1]徐远志 毕云科 张安可 齐向前 薛亚军 楼美清.蝶窦鞍底黏膜骨瓣翻转术在内镜下经鼻蝶入路手术颅底重建中的应用[J].中国临床神经外科杂志,2017,(11):748-750.[doi:10.13798/j.issn.1009-153X.2017.11.005]
 XU Yuan-zhi,BI Yun-ke,ZHANG An-ke,et al.Transposition of sellar pedicled-mucoperiostal flap for skull base reconstruction after endoscopic endonasal transsphenoidal surgery[J].,2017,(11):748-750.[doi:10.13798/j.issn.1009-153X.2017.11.005]
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蝶窦鞍底黏膜骨瓣翻转术在内镜下经鼻蝶入路手术颅底重建中的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年11期
页码:
748-750
栏目:
论著
出版日期:
2017-11-25

文章信息/Info

Title:
Transposition of sellar pedicled-mucoperiostal flap for skull base reconstruction after endoscopic endonasal transsphenoidal surgery
文章编号:
1009-153X(2017)11-0748-03
作者:
徐远志 毕云科 张安可 齐向前 薛亚军 楼美清
200080 上海,上海交通大学附属第一人民医院神经外科(徐远志、毕云科、张安可、齐向前、薛亚军、楼美清) 通讯作者:楼美清,E-mail:loumq68128@sina.com
Author(s):
XU Yuan-zhi BI Yun-ke ZHANG An-ke QI Xiang-qian XUE Ya-jun LOU Mei-qing.
Department of Neurosurgery, First People’s Hospital, Shanghai Jiaotong University, Shanghai 200080, China
关键词:
鞍区病变经鼻蝶入路内镜手术蝶窦鞍底黏膜骨瓣翻转术颅底重建
Keywords:
Pituitary adenomas Transposition of sellar pedicled-mucoperiosteum flap Skull base reconstruction Endoscopic
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.11.005
文献标志码:
A
摘要:
目的 探讨蝶窦鞍底黏膜骨瓣翻转术在内镜下经鼻蝶入路手术颅底重建中的方法及应用价值。方法 回顾性分析2014年10月至2016年1月在内镜下经鼻蝶入路手术治疗的23例鞍区病变的临床资料,术中均采用蝶窦鞍底黏膜骨瓣翻转术进行颅底重建,即术中在导航引导下确定鞍底粘膜骨瓣的大小,使用磨钻制作骨瓣并向底部翻转,形成半游离的黏膜骨瓣;肿瘤切除后,将半游离的黏膜骨瓣翻转复位,辅以生物蛋白胶固定。结果 23例中,颅咽管瘤1例,鞍上型Rathke囊肿2例,垂体腺瘤20例。术中发生脑脊液漏3例,采用人工材料常规修补后以蝶窦鞍底黏膜骨瓣翻转术。23例术后随访6个月,均未出现脑脊液漏、细菌性脑膜炎和张力性气颅等并发症。结论 在内镜下经鼻蝶入路手术中,采用蝶窦鞍底黏膜骨瓣翻转术进行颅底重建中是一种可靠、安全、有效的方法。
Abstract:
Objective To explore the method of transposition of sellar pedicled-mucoperiosteum flap for skull base reconstruction after endoscopic endonasal transsphenoidal surgery (EETS) and its value to the skull base reconstruction. Methods The clinical data of 23 patients who underwent skull base reconstruction by transposition of sellar pedicled-mucoperiosteum flap after EETS for the tumors or cysts from October, 2014 to January, 2016 were analyzed retrospectively. The size of sellar pedicled-mucoperiosteum flap was determined by neuro-navigator-assisted surgery and then semi-free sellar pedicled-mucoperiosteum flap was made by electrical drill and fractured down. After the resection of the tumors or cysts, the semi-free sellar pedicled-mucoperiosteum flaps were transpositioned, and fixed with fibrin glue. Results Of 23 patients, 1 had craniopharyngioma, 2 suprasellar Rathke cysts and 20 pituitary adenomas. The cerebrospinal fluid leakage happened intraoperatively in 3 patients, in whom the artificial material was used to repair the leakage and then the transposition of sellar pedicled-mucoperiosteum flap was performed. All the patients were followed up for 6 months. There were no cerebrospinal fluid leakage, bacterial meningitis, tension pneumocephalus and other complications in all the patients during the following-up. Conclusion The transposition of sellar pedicled-mucoperiosteum flap is a reliable, safe and effective method to reconstruct the skull base after EETS

参考文献/References:

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[6] Thorp BD, Sreenath SB, Ebert CS, et al. Endoscopic skull base reconstruction: a review and clinicalcase series of 152 vascularized flaps used for surgical skullbase defects in the setting of intraoperative cerebrospinalfluid leak [J]. Neuro- surg Focus, 2014, 37(4): E4.
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备注/Memo

备注/Memo:
基金项目:上海交通大学医工交叉基金(YG2016QN32)
更新日期/Last Update: 2017-09-12