宫内及出生后修复的脊髓脊膜膨出患儿颅底解剖结构的改变。

Alterations in skull base anatomy in intrauterine and postnatal repaired myelomeningoceles.

作者信息

da Costa Marcos Devanir Silva, Nicacio Jardel Mendonça, Dastoli Patricia Alessandra, Suriano Italo Capraro, Sarmento Stéphanno Gomes Pereira, Barbosa Mauricio Mendes, Moron Antonio Fernandes, Cavalheiro Sergio

机构信息

Department of Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil.

Department of Fetal Neurosurgery, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil.

出版信息

Childs Nerv Syst. 2020 Nov;36(11):2757-2763. doi: 10.1007/s00381-020-04587-6. Epub 2020 Apr 1.

DOI:10.1007/s00381-020-04587-6

PMID:32239293

Abstract

PURPOSE

The aim of this study was to analyze the skull base anatomy of patients who underwent intrauterine or postnatal myelomeningocele repair and to determine its relationship with hydrocephalus.

METHODS

This was a retrospective cross-sectional study that analyzed three groups: the postnatal group, 57 patients who underwent myelomeningocele repair up to 48 h after birth; the fetal group, 70 patients who underwent myelomeningocele repair between 19 and 27 weeks of gestation; and a control group (65). We compared the rate of hydrocephalus treatment, the clivus-supraocciput angle (CSA), and the Welcher angle.

RESULTS

The mean CSA in the fetal group was 87.6°, and the postnatal group was significantly different at 78.3° (p < 0.0001). The control group (89.1°) was significantly different from the postnatal group but not from the fetal group. The mean Welcher angle was not significantly different between the groups. There was an 8.5% rate of surgical treatment for hydrocephalus in the fetal group, compared with 73.6% in the postnatal group.

CONCLUSIONS

The CSA in the fetal group was larger than that in the postnatal group, which may explain the decrease in the prevalence of hydrocephalus in the fetal group.

摘要