内镜下经蝶鞍底重建预制模块

Pre-bulit module reconstruction by endoscopic transsphenoidal approach

目的:研制内镜下经蝶鞍底重建预制模块。方法:在尸头上建立鞍底缺损模型并模拟神经内镜下经蝶入路修补脑脊液鼻漏手术。分别采用多层重建修补法(A组)和填充高吸水生物树脂的预制模块(B组)进行修补。记录两组修补重建的操作时间,修补次数和修补成功次数。在修补成功后,在不同压力条件下,连续观察8 d,记录其有效时间。结果:A组手术操作时间为(40.7±11.8)min,B组为(30.4±7.0)min;B组用时明显少于A组(P=0.000)。两组修补成功率分别为82.5%和93.8%,差异无统计学意义(P=0.151)。在不同压力下,两组的有效时间差异均无统计学意义(P<0.05)。结论:模拟手术时填充高吸水生物树脂的预制模块能有效、可靠地修补重建鞍底,并可节约操作时间。

Objective To reconstruct a pre-built module by endoscopic transsphenoidal approach. Methods Sellar defect model was built in cadaver heads to imitate cerebrospinal fluid rhinorrhea by neuroendoscopic transsphenoidal approach. Two operations were used to reconstruct the defect, the multilevel reconstruction （Group A） and the pre-built module padding highly absorbent biological resin （Group B）. The operation time, repair frequency and repair successful rate were compared between these two groups. The valid time of these two groups under different pressure was assessed for 8 days consecutively after successful repair. Result The operation time of group A was （40.7± 11.8） rain and that of group B was （30.4±7.0） min, with significant difference （P=0.000）. The repair successful rate of these two groups were 82.5% and 93.8% respectively, without significantly statistical difference （P=0.151）. And no statistical differences in valid time under different pressure was found between these two groups （P〈0.05）. Conclusion In vitro, the pre-built module harboring biomedical super absorbent resin is suitable for sellar reconstruction by neuroendoscopic transsphenoidal approach,