经鼻内镜治疗儿童脑膜脑膨出

Resection of child meningoencephaloceles by transnasal endoscopy

目的:探讨鼻内型儿童脑膜脑膨出的诊断和鼻内镜微创外科治疗的方法.方法:2例均经CT和MRI确诊.在鼻内镜或耳内镜下，经鼻吸出膨出于鼻腔的脑膜组织，判断缺损位置和范围，取同侧大腿外肌肉和筋膜封堵颅底.结果:2例均经1次手术治愈，术后随访1～2年未见复发，无其他并发症.结论:CT和MRI在诊断鼻内型脑膜脑膨出具有重要价值.鼻内型脑膜脑膨出可选择经鼻内镜的鼻内进路手术方式，鼻内镜下经鼻进路手术修补鼻内型脑膜脑膨出具有安全、简便、损伤小、并发症少等优点.

Objective：To discuss the diagnosis of child meningoencephaloceles in nasal cavity and its methods of transnasal endoscopic surgery. Method： Two cases of congenital mengingoencephaloceles which have manifested mass in nasal cavity or nasopharynx received total resection by transnasal endoscopic surgery. Their medical records, radiographic imagings, and surgical procedures were reviewed. Result： We identified 2 patients with endonasal meningoencephaloceles whose main symptoms were watery rhinorrhea, nasal obstruction and mass in nasal cavity. A high index of suspcion for this diagnosis must be maintained, especially in patients with reiterative high fever or meningitis. Imaging examination should be done in those patients. Endonasal meningoencephaloceles, wherever the bone defects were located on the ethmoid roof or skull base,can be remove by endoscopy. Conclusion： CT and MRI are significant in diagnosis of endonasal meningoencephaloceles, nasal endoscopic surgery could be considered to be the best surgical approach without any severe complications.