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用于颅底缺损的纳米纤维合成硬脑膜补片:经鼻扩大入路术后重建的初步经验

Nanofibrous Synthetic Dural Patch for Skull Base Defects: Preliminary Experience for Reconstruction after Extended Endonasal Approaches.

作者信息

Zenga Francesco, Tardivo Valentina, Pacca Paolo, Garzaro Massimiliano, Garbossa Diego, Ducati Alessandro

机构信息

Division of Neurosurgery, Department of Neuroscience, University of Torino, Turin, Italy.

1st Division of ENT, Department of Surgical Sciences, University of Torino, Turin, Italy.

出版信息

J Neurol Surg Rep. 2016 Mar;77(1):e50-5. doi: 10.1055/s-0035-1570388.

Abstract

Setting One of the consequences of the widespread use of endoscopic endonasal approaches (EEA) to skull base pathologies is the management of complex skull base defects. Nowadays, the gold standard is a multilayer closure that reproduces the physiological tissue barriers. Several techniques have been described in the literature; however, skull base reconstruction after EEA still represents a matter of debate, especially after extended EEA. A watertight closure is paramount to prevent cerebrospinal fluid leak and meningitis. Design Regarding this issue, we present our experience with a new synthetic dural patch, ReDura (Medprin Biotech, La Mirada, California, United States), as a subdural inlay in three patients who underwent endoscopic endonasal removal of sellar and suprasellar lesions. Conclusions ReDura patch showed the same versatility of autologous iliotibial tract. A dural patch that easily adapts to all defects, revealed to be a useful tool for performing watertight closure, possibly in a short operative time, after endoscopic approaches.

摘要

背景

鼻内镜鼻内入路(EEA)广泛应用于颅底病变的后果之一是复杂颅底缺损的处理。如今,金标准是进行多层缝合以重建生理性组织屏障。文献中已描述了多种技术;然而,EEA术后的颅底重建仍是一个有争议的问题,尤其是在扩大的EEA术后。严密缝合对于预防脑脊液漏和脑膜炎至关重要。设计:针对这一问题,我们介绍了我们使用一种新型合成硬脑膜补片ReDura(美国加利福尼亚州拉米拉达市Medprin生物技术公司)作为硬膜下植入物,用于3例接受鼻内镜经鼻切除鞍区和鞍上病变患者的经验。结论:ReDura补片显示出与自体髂胫束相同的多功能性。一种易于适应所有缺损的硬脑膜补片,被证明是在内镜手术后进行严密缝合的有用工具,可能在较短的手术时间内完成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e657/4773823/4b5da6e4e204/10-1055-s-0035-1570388-i150029-1.jpg

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