Kamoshima Yuuta, Terasaka Shunsuke, Hamauchi Shuji, Kaneko Sadahiro, Murakami Hiroki, Houkin Kiyohiro
Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo-city, Hokkaido, Japan.
No Shinkei Geka. 2011 Aug;39(8):783-8.
We report a case of cerebrospinal fluid (CSF) leak repair using loose areolar connective tissue insertion into the frontal sinus and pericranial flap covering. A 61-years-old man suffered from skull fracture including frontal sinus fracture in violence inflicted by others. Fifty days later, he presented rhinorrhea and pneumocephalus caused by a bone defect site of the frontal sinus and anterior skull base. We performed CSF leak repair with insertion of pedunculated loose areolar connective tissue into his frontal sinus, covering the leak point using pericranial flap. In general, frontal sinus obliteration has been accomplished with autologous grafts such as fat, muscle, or bone. These avascular grafts carry an increased risk of resorption and infection. The use of loose areolar tissue insertion into the frontal sinus was able to increase stability of the construct and caused no cosmetic troubles in our short follow up period. The combined use of these two autologous materials may be useful for repair of CSF leak from an anterior skull base fracture.
我们报告了一例脑脊液（CSF）漏修补术，采用疏松结缔组织植入额窦并覆盖颅骨膜瓣。一名61岁男性因他人暴力导致颅骨骨折，包括额窦骨折。50天后，他因额窦和前颅底骨缺损部位出现鼻漏和气颅。我们通过将带蒂疏松结缔组织植入其额窦进行脑脊液漏修补，并用颅骨膜瓣覆盖漏点。一般来说，额窦闭塞术已通过自体移植物如脂肪、肌肉或骨来完成。这些无血管移植物吸收和感染的风险增加。在额窦中植入疏松结缔组织能够增加结构的稳定性，并且在我们的短期随访期间未引起美容问题。这两种自体材料的联合使用可能有助于修复前颅底骨折导致的脑脊液漏。
