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内镜下经鼻硬脑膜重建术治疗戈谢病合并颅底缺损患者中颅窝脑脊液漏

Endoscopic Endonasal Dural Reconstruction for a Cerebrospinal Fluid Leak in the Middle Cranial Fossa of a Patient with Gorham-stout Disease with Skull Base Defect.

作者信息

Morinaga Yusuke, Akutsu Hiroyoshi, Kino Hiroyoshi, Tanaka Shuho, Miyamoto Hidetaka, Matsuda Masahide, Ishikawa Eiichi

机构信息

Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

Department of Neurosurgery, Dokkyo Medical University School of Medicine, Tochigi, Japan.

出版信息

NMC Case Rep J. 2022 Apr 1;9:55-61. doi: 10.2176/jns-nmc.2021-0319. eCollection 2022.

Abstract

We report the use of endoscopic endonasal surgery for dural reconstruction following a cerebrospinal fluid leak in a 33-year-old patient with recurrent meningitis since at age of 2 years. Magnetic resonance imaging showed osteolytic changes in the left temporal and sphenoid bones, including the left pterygoid plate, a few left temporal encephaloceles, and cerebrospinal fluid-like fluid in the expanded Meckel's cave and the parapharyngeal space. After endoscopic endonasal surgery, Gorham-Stout disease was diagnosed. No recurrence of cerebrospinal fluid leakage or meningitis has been observed. Thus, endoscopic endonasal surgery might improve clinical outcomes in patients with Gorham-Stout disease and skull base defects.

摘要

我们报告了一名自2岁起反复发生脑膜炎的33岁患者,采用鼻内镜下鼻内手术进行脑脊液漏后的硬脑膜重建。磁共振成像显示左侧颞骨和蝶骨有骨质溶解改变,包括左侧翼突,少量左侧颞叶脑膨出,以及扩大的 Meckel腔和咽旁间隙内的脑脊液样液体。鼻内镜下鼻内手术后,诊断为戈谢病。未观察到脑脊液漏或脑膜炎复发。因此,鼻内镜下鼻内手术可能改善戈谢病和颅底缺损患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cabe/9020871/baf6338322fd/2188-4226-9-0055-g001.jpg

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