Pascasio Dax Carlo G, Denadai Rafael, Legaspi Gerardo D, Liban Servando Andres, Tansipek Bernard U
Division of Plastic and Reconstructive Surgery, Philippine General Hospital, 1730 Taft Avenue, Malate, 1000, Manila, Philippines.
Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Brazil.
Childs Nerv Syst. 2019 Aug;35(8):1385-1392. doi: 10.1007/s00381-019-04149-5. Epub 2019 May 26.
It was described that nasoethmoidal encephalocele repair in the Philippines has been limited by insufficient resources, financial constraints, and a lack of surgical expertise. The purpose of this study was to report initial results and complications of Philippine patients with nasoethmoidal encephalocele surgically managed with an approach adapted to an environment with limited financial resources.
All patients (n = 21) with nasoethmoidal encephalocele who underwent intracranial and extracranial repairs (frontal wedge osteotomy to access the encephalocele cyst and cranial base defect, dural defect repair, split frontal grafts fixed with polydioxanone sutures to reconstruct the cranial defect and nasal dorsum, and medial canthopexy) from January 2015 to May 2017 were included. The correlations between sizes of masses and cranial defects with the occurrence of complications were tested. The surgical results were classified based on a previously published outcome grading scales I-IV on the need for additional surgery.
Nineteen patients (90.5%) had unremarkable post-operative course. Two patients (9.5%) presented with complications (cerebrospinal fluid leak and surgical site infection) which were successfully managed with no additional surgery. The sizes of masses and cranial defects were not correlated (p > 0.05) with complications. The overall rate of surgical results ranked according to the need for additional surgery was 2.4 ± 0.5 (between categories II and III).
We reported successful surgical repair of nasoethmoidal encephaloceles in Philippine patients by a local multidisciplinary craniofacial team.
据描述，菲律宾的鼻筛窦脑膨出修复手术受到资源不足、资金限制和缺乏手术专业知识的制约。本研究的目的是报告采用适应资金有限环境的方法对菲律宾鼻筛窦脑膨出患者进行手术治疗的初步结果和并发症情况。
纳入2015年1月至2017年5月期间所有接受颅内和颅外修复手术（额部楔形截骨以暴露脑膨出囊肿和颅底缺损、硬脑膜缺损修复、用聚二氧六环酮缝线固定劈开的额部移植物以重建颅骨缺损和鼻背、以及内眦固定术）的鼻筛窦脑膨出患者（n = 21）。测试肿块大小和颅骨缺损与并发症发生之间的相关性。根据先前发表的结果分级量表I-IV，依据是否需要额外手术对手术结果进行分类。
19例患者（90.5%）术后病程平稳。2例患者（9.5%）出现并发症（脑脊液漏和手术部位感染），经成功处理，无需额外手术。肿块大小和颅骨缺损与并发症无相关性（p > 0.05）。根据是否需要额外手术，手术结果的总体评分率为2.4± 0.5（介于II级和III级之间）。
我们报告了菲律宾当地多学科颅面团队成功手术修复鼻筛窦脑膨出患者的情况。
