Krishnan Shyam Sundar, Nigam Pulak, Manuel Adarsh, Vasudevan Madabushi Chakravarthy
Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India.
J Neurol Surg B Skull Base. 2020 Feb;81(1):8-14. doi: 10.1055/s-0039-1678602. Epub 2019 Feb 4.
Surgery of posterior fossa including cerebellopontine (CP) angle involves either craniectomy or craniotomy. While there has been precedence of craniotomy in recent practice, the preferred access in resource-strapped centers still remains been craniectomy. Although the latter offers an excellent exposure, it is believed to carry increased risk of postoperative pseudomeningocoele and cerebrospinal fluid (CSF) leak compared with craniotomy. We have suggested a technique by which after standard craniectomy for the posterior fossa surgeries the bony defect is covered by Gelfoam bone sandwich (GBS) technique. We studied this technique over a period of 25.6 years in 1,028 patients. We analyze the risk of pseudomeningocoele and CSF leak in our patients using GBS technique and reviewed literature to compare our outcomes with standard craniotomy and craniectomy procedures.
包括小脑脑桥角（CP角）在内的后颅窝手术涉及颅骨切除术或开颅手术。虽然近期实践中开颅手术更为常见，但在资源匮乏的中心，首选的入路仍然是颅骨切除术。尽管后者能提供极佳的暴露视野，但与开颅手术相比，人们认为其术后发生假性脑膜膨出和脑脊液（CSF）漏的风险更高。我们提出了一种技术，即在进行后颅窝手术的标准颅骨切除术后，用明胶海绵骨三明治（GBS）技术覆盖骨缺损。我们在25.6年的时间里对1028例患者研究了该技术。我们分析了采用GBS技术的患者发生假性脑膜膨出和脑脊液漏的风险，并查阅文献以将我们的结果与标准开颅手术和颅骨切除术的结果进行比较。
