Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi Hachioji, Tokyo, 193-0998, Japan.
Acta Neurochir (Wien). 2013 Apr;155(4):733-6. doi: 10.1007/s00701-013-1630-3. Epub 2013 Feb 13.
The anterior skull base is a deep and narrow area, which makes dural repair technically challenging. The goal of this study was to demonstrate the efficacy of a new instrument for anterior skull base dural repair.
Ten patients underwent surgery via the transbasal approach, combined with either a transfacial or a transnasal endoscopic resection. The dural repair was performed prior to tumor resection, and the new instrument was used to suture the fascia lata in an underlay fashion. The repaired dural defect was then covered with a pericranial flap.
The follow-up period ranged from 2 to 18 months, with an average follow-up time of 8.7 months. During this period, none of the patients experienced cerebrospinal fluid leakage, meningitis, tension pneumocephalus, abscess formation, or flap necrosis.
Our findings suggest that the use of this instrument combined with the technique of suturing the fascia lata in an underlay fashion and covering it with a pericranial flap, may be an effective alternative approach to anterior skull base reconstruction.
前颅底是一个深而狭窄的区域,使得硬脑膜修复具有技术挑战性。本研究的目的是展示一种新的仪器在前颅底硬脑膜修复中的疗效。
10 名患者通过经颅底入路手术,结合经面或经鼻内镜切除术。在肿瘤切除前进行硬脑膜修复,使用新仪器以覆盖方式缝合阔筋膜。然后用颅骨膜瓣覆盖修复后的硬脑膜缺损。
随访时间为 2 至 18 个月,平均随访时间为 8.7 个月。在此期间,无患者出现脑脊液漏、脑膜炎、张力性气颅、脓肿形成或皮瓣坏死。
我们的研究结果表明,使用这种仪器结合缝合阔筋膜和覆盖颅骨膜瓣的技术,可能是一种有效的前颅底重建替代方法。