经鼻内镜治疗创伤性或医源性筛窦损伤所致张力性气颅
Transnasal Endoscopic Treatment of Tension Pneumocephalus Caused by Posttraumatic or Iatrogenic Ethmoidal Damage.
作者信息
Latif Omer Goran, Maurizi Riccardo, Francavilla Beatrice, Rekawt Hama Rashid Kareem, Velletrani Gianluca, Salah Hasan Mustafa, Marzocchella Giulia, Gubari Mohammed Ibrahim Mohialdeen, Di Girolamo Stefano
机构信息
Department of Surgery, University of Sulaimani, College of Medicine, Sulaymaniyah, Iraq.
Department of Otorhinolaryngology, University of Rome Tor Vergata, Rome 00133, Italy.
出版信息
Case Rep Otolaryngol. 2023 Aug 22;2023:2679788. doi: 10.1155/2023/2679788. eCollection 2023.
BACKGROUND
Tension pneumocephalus is a neurosurgical emergency caused by progressive accumulation of air in the intracranial spaces mediated by a valve mechanism. Tension pneumocephalus usually presents with headaches, reduced consciousness, and even death. One of the most common causes is an ethmoidal defect resulted by nasal surgery or facial traumas.
METHODS
A literature review about tension pneumocephalus resulting from ethmoidal damages was performed. Surgery strategies included decompression by frontal burr holes and multilayer repair of the ethmoidal defect. In this paper, an endoscopic technique that exploits the ethmoidal defect to decompress the intracranial spaces and to resolve tension pneumocephalus with fewer complications and shorter hospitalization in comparison to frontal craniotomy is proposed.
CONCLUSION
The proposed endonasal endoscopic technique could be effectively used as a first-line treatment for symptomatic tension pneumocephalus caused by posttraumatic or iatrogenic ethmoidal defect.
背景
张力性气颅是一种神经外科急症，由瓣膜机制介导的颅内间隙空气进行性积聚引起。张力性气颅通常表现为头痛、意识减退，甚至死亡。最常见的原因之一是鼻手术或面部创伤导致的筛骨缺损。
方法
对因筛骨损伤导致的张力性气颅进行文献综述。手术策略包括额部钻孔减压和筛骨缺损的多层修复。本文提出一种内镜技术，该技术利用筛骨缺损来减压颅内间隙，并与额骨开颅术相比，以更少的并发症和更短的住院时间解决张力性气颅问题。
结论
所提出的鼻内镜技术可有效地用作创伤后或医源性筛骨缺损引起的有症状张力性气颅的一线治疗方法。
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