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前颅底手术后化脓性脑室炎的内镜下脑室冲洗及带血管蒂皮瓣重建治疗

Pyogenic Ventriculitis After Anterior Skull Base Surgery Treated With Endoscopic Ventricular Irrigation And Reconstruction Using a Vascularized Flap.

作者信息

Tomita Yusuke, Shimazu Yosuke, Kawakami Masato, Matsumoto Hiroshi, Fujii Kentaro, Kameda Masahiro, Yasuhara Takao, Suruga Yasuki, Ota Tomoyuki, Kimata Yoshihiro, Kurozumi Kazuhiko, Date Isao

机构信息

Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.

Department of Pediatrics, Northwestern University.

出版信息

Acta Med Okayama. 2021 Apr;75(2):243-248. doi: 10.18926/AMO/61908.

Abstract

Ventriculitis is a rare, serious complication of neurosurgery. A 59-year-old man who had undergone a craniotomy for a paranasal adenocarcinoma, developed a right frontal cystic lesion. We performed a bifrontal craniotomy to remove the lesion. The dura was repaired with non-vascularized free fascia lata in watertight fashion. Ventriculitis occurred 3 days postoperatively. Ventricular drainage, craniectomy, and endoscopic irrigation were undertaken to remove an abscess. The dura and the resection cavity were reconstructed using a vascularized anterolateral thigh adipofascial flap. His symptoms disappeared, indicating that endoscopic irrigation and reconstruction can effectively address ventriculitis even in patients in critical clinical condition.

摘要

脑室炎是神经外科一种罕见的严重并发症。一名59岁男性因鼻旁腺癌接受了开颅手术,术后出现右侧额叶囊性病变。我们实施了双额开颅手术以切除该病变。用无血管的游离阔筋膜以防水方式修补硬脑膜。术后3天发生了脑室炎。进行了脑室引流、颅骨切除术和内镜冲洗以清除脓肿。使用带血管蒂的股前外侧脂肪筋膜瓣重建硬脑膜和切除腔。他的症状消失,这表明即使对于临床情况危急的患者,内镜冲洗和重建也能有效治疗脑室炎。

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