Park Jaechan, Guthikonda Murali
Department of Neurosurgery, Kyungpook National University, Daegu, Republic of Korea.
Surg Neurol. 2004 May;61(5):488-92; discussion 493. doi: 10.1016/S0090-3019(03)00581-0.
A technique to use the Medpor (porous high-density polyethylene) sheet as an optimal implant to reconstruct the sellar floor or the sphenoid rostrum in endonasal transsphenoidal surgery is described.
After endonasal transsphenoidal surgery, a 0.4-mm thick Medpor sheet is cut with scissors to a round or elliptical piece, which is placed in the sellar epidural space to reconstruct the sellar floor and buttress the pituitary gland and the sellar packing. In cases of a complete absence of the sellar floor, the sphenoid sinus is packed with autologous fat and fibrin glue, which are buttressed at the defect of the sphenoid rostrum with the Medpor sheet.
Ten patients underwent the reconstruction using the Medpor sheet in endonasal transsphenoidal surgery, and were then evaluated clinically and radiologically with magnetic resonance images (MR) postoperatively. The Medpor sheet was easy to cut with scissors and flexible to introduce through a small nostril. It was also sufficiently stiff to buttress the packing material in the sellar cavity or the sphenoid sinus. On MRI, the low-signal intensity of the implant was so remarkable without artifact helping to understand the postoperative image around the reconstructed area. There was no infection or granulomatous tissue reaction related to the implant.
The Medpor sheet can be an optimal implant to reconstruct the sellar floor or the sphenoid rostrum after endonasal transsphenoidal surgery.
描述了一种在鼻内镜经蝶窦手术中使用Medpor（多孔高密度聚乙烯）片作为重建蝶鞍底或蝶骨嵴的理想植入物的技术。
鼻内镜经蝶窦手术后，用剪刀将0.4毫米厚的Medpor片剪成圆形或椭圆形，置于蝶鞍硬膜外间隙以重建蝶鞍底并支撑垂体和蝶鞍填充物。在蝶鞍底完全缺失的情况下，用自体脂肪和纤维蛋白胶填充蝶窦，并用Medpor片在蝶骨嵴缺损处进行支撑。
10例患者在鼻内镜经蝶窦手术中使用Medpor片进行重建，术后通过磁共振成像（MR）进行临床和影像学评估。Medpor片易于用剪刀裁剪，可通过小鼻孔灵活置入。它也足够坚硬以支撑蝶鞍腔或蝶窦内的填充材料。在MRI上，植入物的低信号强度非常明显，无伪影，有助于了解重建区域周围的术后图像。未出现与植入物相关的感染或肉芽肿组织反应。
Medpor片可作为鼻内镜经蝶窦手术后重建蝶鞍底或蝶骨嵴的理想植入物。
