摘要
目的随访观察50例前颅底缺损重建病例的长期疗效。方法手术中前颅底缺损只重建硬脑膜不行骨移植,术后定期临床随访及行CT、MRI检查。结果50例病人的前颅底骨缺损范围为:前后径2~6cm(平均35cm),左右径2~5cm(平均28cm),随访时间为3个月至5年(平均2年),均未发生脑脊液漏和脑膜脑膨出现象,其中32例病人得到CT或MRI证实。结论手术中只要将颅底正常硬脑膜修补完整,或选用力学性能接近甚至超过正常硬脑膜的材料进行修补,再辅以带蒂颅骨膜瓣等方法加强颅底重建后,术后颅内压不高,在通常的颅底缺损范围内(缺损直径不超过4cm),一般不会发生脑膜脑疝出,不必行颅底骨移植。
Objective To conduct a long-term follow-up
of 50 patients with the anterior skull-base defects in whom the dural were reconstructed without
bone grafts. Methods At anterior skull-base defect,the dural reconstruction was reinforced by a
pedicled pericranial flap without a free bone graft.CT and MRI examinations were taken
regularly after operation. Results Among 50 cases of anterior skull-base defects with the
longitudinal size from 2cm to 6cm (average 3 5cm )and the transversal size from 2cm to 5cm
(average 2 8cm ),the long-term follow-up study which duration ranged from 3 months to 5 years
(average 2 years)showed no evidence of CSF leakage and encephalomeningocele. It was
comfirmed by CT or MRI among 32 cases.Conclusions Under normal intracranial pressure, if
the dura mater is repaired properly at the skull-base defect and reinforced by a pedicled
pericranial flap,an encephalomeningocele can be prevented.It is not necessary to take free
bone graft when the size of cranial base bone defect is smaller than or equal to 4cm .
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
1999年第2期74-75,共2页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金
关键词
前颅底缺损
前颅底重建
修复术
脑外科手术
Anterior cranial base Reconstruction Encephalomeningocele Follow-up