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侧门颞顶筋膜瓣:一种用于前颅底重建的新型技术的初步经验。

Side-door temporoparietal fascia flap: First experience with a novel technique for anterior skull base reconstruction.

机构信息

Neurosurgery Department, Foch Hospital, Université Paris Saclay, Suresnes, France.

Neurosurgery Department, AP-HP, Henri Mondor Hospital, Créteil, France.

出版信息

Head Neck. 2024 Apr;46(4):772-784. doi: 10.1002/hed.27611. Epub 2024 Jan 8.

Abstract

BACKGROUND

Modern achievements in transnasal endoscopic skull base (SB) surgery have led to complex resections that render reconstruction a challenge. Temporoparietal fascia flap (TPFF) is a suitable option for SB reconstruction. The side-door TPFF technique for anterior SB reconstruction is described here for the first time in a real-life surgical setting.

METHODS

Patients affected by a SB malignancy who underwent cranioendoscopic resection were included. For reconstruction, a multilayer reconstruction technique including side-door TPFF transposition was employed.

RESULTS

TPFF transposition was performed in five patients. The TPFF could be easily transposed via a side-door approach. It adequately covered the edges of the defect and supported optimal healing of the surgical site. During follow-up, vitality and integration of the TPFF were assessed endoscopically and radiologically.

CONCLUSIONS

The TPFF side-door transposition technique is a valuable option in anterior SB reconstruction that can provide fast and effective healing, especially in patients needing adjuvant radiotherapy.

摘要

背景

经鼻内镜颅底 (SB) 手术的现代成就导致了复杂的切除,这使得重建成为一项挑战。颞顶筋膜瓣 (TPFF) 是 SB 重建的合适选择。本文首次在真实手术环境中描述了用于前 SB 重建的侧门 TPFF 技术。

方法

纳入接受颅内镜切除术的 SB 恶性肿瘤患者。采用包括侧门 TPFF 移位的多层重建技术进行重建。

结果

在五名患者中进行了 TPFF 移位。TPFF 可通过侧门入路轻松移位。它充分覆盖了缺损的边缘,并支持手术部位的最佳愈合。在随访期间,通过内窥镜和放射学评估 TPFF 的活力和整合情况。

结论

TPFF 侧门移位技术是前 SB 重建的一种有价值的选择,可提供快速有效的愈合,特别是在需要辅助放疗的患者中。

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