Tanrikulu Levent, Buchfelder Michael, Naraghi Ramin
Hannover Nordstadt Hospital, Department of Neurosurgery, Hannover, Germany.
Turk Neurosurg. 2017;27(5):763-767. doi: 10.5137/1019-5149.JTN.17462-16.2.
Cerebrospinal fluid (CSF) leakage is a feared complication after microvascular decompression (MVD). In this study, we present our experience of fleece-bound tissue sealing in MVD with an aim to minimize the rate of postoperative CSF leakage.
We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia) by MVD from 2003 to 2006. All patients underwent retromastoid craniectomy and duraplasty by fleece-bound tissue sealing using the so-called "sandwich technique" by a three-layer reconstruction and cranioplasty.
In 49 (98%) of 50 patients, we did not observe postoperative CSF leakage. One patient (2%) suffered postoperative CSF leakage and required surgical revision.
Fleece-bound tissue sealing by a three-layer reconstruction is effective and safe in the prevention of cerebrospinal fluid leakage in microvascular decompression.
脑脊液漏是微血管减压术(MVD)后令人担忧的并发症。在本研究中,我们介绍了我们在MVD中使用羊毛毡包裹组织密封的经验,旨在将术后脑脊液漏的发生率降至最低。
2003年至2006年,我们对50例患有神经血管压迫(NVC)综合征(三叉神经痛、面肌痉挛和舌咽神经痛)的患者(女性/男性:26/24)进行了MVD治疗。所有患者均接受了乳突后颅骨切除术,并采用所谓的“三明治技术”通过三层重建和颅骨成形术进行羊毛毡包裹组织密封的硬脑膜成形术。
50例患者中有49例(98%)未观察到术后脑脊液漏。1例患者(2%)出现术后脑脊液漏,需要进行手术修复。
通过三层重建进行羊毛毡包裹组织密封在预防微血管减压术中的脑脊液漏方面是有效且安全的。