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鼻内镜下自体材料重建鼻颅底缺损

Autologous tissue used to reconstruct nasal -cranial base defects undergoing endoscopic management
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摘要 目的:鼻内镜手术较传统的手术方式有良好的可视效果和微创性,已经广泛应用于鼻颅底的重建和脑脊液鼻漏的修复。在众多的修复材料中,自体材料由于取材方便、兼容性好在颅底修复中应用最为广泛。该文通过回顾性分析,旨在阐明如何根据颅底缺损的位置和大小,选择合适的修复材料和手术方式。方法:回顾性分析近10年来应用自体材料修补脑脊液鼻漏27例,颅底病变手术后所致颅底缺损重建24例。其中利用颞肌和颞肌筋膜作为修复材料28例,中鼻甲18例,利用筛骨垂直板修复6例。结果:5l例患者术后随访4~72个月,49例一次性手术成功,手术成功率达96%。结论:根据患者鼻颅底缺损的位置和范围的大小,选择适当的自体修复材料和修复方法,就可以减少并发症,提高手术的成功率。 Objective: The advantage of the endoscopic microsurgery with respect to the traditional techniques is a better visualization and minimally invasion. The new minimally invasive techniques for the repair of Cerebrospinal tluid (CSF) leak and reconstructon of nasal--cranial base defects have been generally applied in clinic. In multiple repairing materials, autologous tissue is most popular for conveniently drawing the materials and good compatibility. The purpose of this paper is to clarify the decision process for selectng the suitable autologous tissue and the procedure of operation according to the location and the size of defects. Methods: 27 patients with CSF leak and 24 patients with nasal-cranial base defects after operation undergoing endoscopic operation were retrospectively analyzed in 10 years. Of those 28 patients utilize temporal muscle and fascia museulares, 18 patients with niddle turbinate and 6 patients with lamina mediana. Results: At follow-up examinations at 4 months to six years, 49 patients have succeeded with once operation, and the achievement ratio is up to 96%. Conclusions: Selecting the suitable autologous tissue and the procedure of repairing according to the location and the size of derects could decrease complication and elevate achievement ratio.
出处 《中国内镜杂志》 CSCD 北大核心 2005年第B11期122-123,共2页 China Journal of Endoscopy
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