Guity A, Young P H
Microsurgery and Brain Research Institute, St. Louis, Missouri.
J Neurosurg. 1990 May;72(5):824-8. doi: 10.3171/jns.1990.72.5.0824.
Watertight closure of the dura following transsphenoidal operations for pituitary adenoma or hypophysectomy and following transclival operations for paraclival tumors has been technically very difficult. This is true both immediately after the initial approach and later for the treatment of delayed cerebrospinal fluid leakage. An innovative practical technique and special suture-tying instruments and needle designed by the principal author for this purpose have greatly facilitated this procedure. This technique has been applied to both direct dural closure and dural patching with watertight dural closure. The technique is also widely applicable for closing (or suturing) the dura following any procedure through a small opening, such as the dural tears occasionally encountered during lumbar or cervical discectomy, or tacking the tentorium during a craniotomy. The technique and suture-tying instruments are described in detail.
对于垂体腺瘤经蝶窦手术或垂体切除术以及岩斜区肿瘤经斜坡手术之后，硬膜的水密性闭合在技术上一直非常困难。无论是在初次手术刚结束时，还是在后续治疗迟发性脑脊液漏时都是如此。主要作者为此设计的一种创新实用技术以及特殊的缝线打结器械和针极大地便利了这一操作过程。该技术已应用于直接硬膜闭合以及采用水密性硬膜闭合的硬膜修补。此技术还广泛适用于通过小切口进行的任何手术后硬膜的闭合（或缝合），比如在腰椎或颈椎椎间盘切除术中偶尔遇到的硬膜撕裂，或者在开颅手术中固定小脑幕。现将该技术及缝线打结器械详细描述如下。
