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鼻内脑膨出:内镜下切除及麻醉考量

Nasal encephalocele: endoscopic excision with anesthetic consideration.

作者信息

Abdel-Aziz Mosaad, El-Bosraty Hussam, Qotb Mohamed, El-Hamamsy Mostafa, El-Sonbaty Mohamed, Abdel-Badie Hazem, Zynabdeen Mustapha

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.

出版信息

Int J Pediatr Otorhinolaryngol. 2010 Aug;74(8):869-73. doi: 10.1016/j.ijporl.2010.04.015.

Abstract

OBJECTIVE

Nasal encephalocele may presents as a nasal mass, its treatment is surgical and it should be done early in life. When removal is indicated, there are multiple surgical approaches; including lateral rhinotomy, a transnasal approach and a coronal flap approach. However, the treatment of a basal intranasal encephalocele using transnasal endoscopic approach could obviates the possible morbidity associated with other approaches. The aim of this study was to evaluate the efficacy of endoscopic removal of intranasal encephalocele, also to document the role of anesthetist in the operative and postoperative periods.

METHODS

Nine cases with nasal encephalocele were included in this study; CT and/or MRI were used in their examination. The lesions were removed via transnasal endoscopic approach. Preoperative evaluation, intervention and postoperative follow-up were presented with discussion of anesthesia used for those children.

RESULTS

The lesions of all patients were removed successfully with no recurrence through the follow-up period of at least 21 months. No cases showed morbidity or mortality intra- or post-operatively.

CONCLUSIONS

Endoscopic excision of intranasal encephalocele is an effective method with high success rate. Anesthetist plays an important role in the operative and postoperative period, even during the endoscopic follow up; sedation of the children is usually needed.

摘要

目的

鼻内脑膨出可能表现为鼻腔肿物,其治疗方法为手术治疗,且应在患儿早期进行。当需要切除时,有多种手术入路,包括鼻侧切开术、经鼻入路和冠状皮瓣入路。然而,采用经鼻内镜入路治疗鼻底部鼻内脑膨出可避免与其他入路相关的可能并发症。本研究的目的是评估内镜下切除鼻内脑膨出的疗效,并记录麻醉医生在手术期和术后的作用。

方法

本研究纳入9例鼻内脑膨出患者,采用CT和/或MRI进行检查。通过经鼻内镜入路切除病变。介绍了术前评估、干预措施及术后随访情况,并讨论了这些患儿所采用的麻醉方法。

结果

所有患者的病变均成功切除,在至少21个月的随访期内无复发。所有病例在手术中及术后均未出现并发症或死亡。

结论

内镜下切除鼻内脑膨出是一种成功率高的有效方法。麻醉医生在手术期和术后,甚至在内镜随访期间都起着重要作用,通常需要对患儿进行镇静。

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