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筛动脉带蒂鼻中隔底黏膜瓣在经蝶垂体手术后脑脊液漏修补中的应用

[Application of ethmoid artery pedicled septal floor mucosa flap in repair of postoperative cerebrospinal fluid leak after transsphenoidal pituitary surgery].

作者信息

Sun Xiwen, Mao Song, Tang Ru, Li Zhipeng, Luo Chunyu, Tan Shaolin, Zhang Weitian

机构信息

Department of Otolaryngology Head and Neck Surgery,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200233,China.

JinzhouMedical University Postgraduate Training Base(Shanghai Sixth People's Hospital).

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Feb;37(2):136-140. doi: 10.13201/j.issn.2096-7993.2023.02.012.

Abstract

To investigate the safety and effectiveness of the ethmoid artery pedicled septal floor mucosal flap in repair of postoperative cerebrospinal fluid leakage after transsphenoidal pituitary tumor surgery.Methods: The clinical data of 6 patients with cerebrospinal fluid leak in Department of Otolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2011 to June 2022. In 6 patients with postoperative cerebrospinal fluid leakage after transsphenoidal pituitary surgery, the bilateral posterior septal arteries were sacrificed due to the endoscopic transsphenoidal expanded approach, so the ethmoid artery pedicled septal floor mucosal flaps were adopted.Results:All patients had good growth of the mucosal flaps during postoperative follow-up without recurrent cerebrospinal fluid leakage. Cerebrospinal fluid leakage is still one of the postoperative complications of pituitary surgery. For patients with bilateral posterior septal arteries sacrificed through the transsphenoidal approach, when the classic posterior septal artery pedicled mucosal flap is not available, the ethmoid artery pedicled septal floor mucosal flap is one of the alternative methods.

摘要

探讨筛动脉蒂鼻中隔底黏膜瓣修复经蝶垂体瘤切除术后脑脊液漏的安全性及有效性。方法:回顾上海交通大学医学院附属第六人民医院耳鼻咽喉头颈外科2011年6月至2022年6月收治的6例脑脊液漏患者的临床资料。6例经蝶垂体瘤切除术后脑脊液漏患者,因采用内镜经蝶扩大入路,双侧鼻中隔后动脉被牺牲,故采用筛动脉蒂鼻中隔底黏膜瓣。结果:所有患者术后随访黏膜瓣生长良好,无脑脊液漏复发。脑脊液漏仍是垂体手术的术后并发症之一。对于经蝶入路牺牲双侧鼻中隔后动脉的患者,当无法采用经典的鼻中隔后动脉蒂黏膜瓣时,筛动脉蒂鼻中隔底黏膜瓣是可供选择的方法之一。

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[Ectopic pituitary tumor of sphenoid sinus: a case report].[蝶窦异位垂体瘤:一例报告]
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本文引用的文献

1
Cerebrospinal Fluid Leak after Transsphenoidal Surgery: A Systematic Review and Meta-analysis.经蝶窦手术后脑脊液漏:一项系统评价和荟萃分析
J Neurol Surg B Skull Base. 2021 Aug 20;83(Suppl 2):e501-e513. doi: 10.1055/s-0041-1733918. eCollection 2022 Jun.
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Reconstruction of Skull Base Defects in Pituitary Surgery.垂体手术中的颅底重建。
Otolaryngol Clin North Am. 2022 Apr;55(2):449-458. doi: 10.1016/j.otc.2022.01.004.
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[Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea].[医源性脑脊液耳鼻漏延迟发生的危险因素分析]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec;35(12):1111-1114. doi: 10.13201/j.issn.2096-7993.2021.12.011.

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