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3D Slicer重建联合神经内镜锁孔入路治疗脑脊液鼻漏:2例报告并文献复习

3D Slicer reconstruction combined with neuroendoscopic keyhole approach for the treatment of cerebrospinal fluid rhinorrhea:2 cases report and literature review.

作者信息

Zhou Long, Lv Yuan, Li Zhiyang, Zhang Huikai, Lei Pan, Song Ping, Gao Lun, Chen Qianxue, Ye Hui, Cai Qiang

机构信息

Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Neurosurgery, Zhongxiang People's hospital, Zhongxiang, China.

出版信息

Heliyon. 2024 Aug 9;10(16):e36046. doi: 10.1016/j.heliyon.2024.e36046. eCollection 2024 Aug 30.

Abstract

BACKGROUND AND IMPORTANCE

Explore the techniques, advantages and disadvantages of 3D Slicer reconstruction combined with transcranial neuroendoscopy in cerebrospinal fluid rhinorrhea surgery.

CLINICAL PRESENTATION

We collected complete clinical data of two patients with cerebrospinal fluid rhinorrhea who underwent minimally invasive surgery using 3D Slicer reconstruction combined with transcranial neuroendoscopy through the supraorbital eyebrow arch keyhole approach in our hospital from June 2022 to May 2023. The patients were one male and one female, aged 50 and 63 years old. At the same time, a retrospective summary of relevant literature at home and abroad in recent years was conducted. 1 case had spontaneous cerebrospinal fluid rhinorrhea with secondary cribriform plate lesion, and the other 1 case had traumatic cerebrospinal fluid rhinorrhea. Both 2 patients were ineffective after long-term conservative treatment, and ultimately recovered after detailed preoperative evaluation and preparation and surgical treatment.

CONCLUSION

Cerebrospinal fluid rhinorrhea is a challenging disease in neurosurgery, and improper management can lead to serious complications such as meningitis. Our team used 3D Slicer reconstruction combined with transcranial endoscopic minimally invasive keyhole surgery to treat cerebrospinal fluid rhinorrhea, achieving good results, proving that this combined technology has certain advantages and is a new surgical technique worth promoting. However, the widespread application and promotion of this technology in anterior skull base surgery still require comprehensive and reliable prospective clinical studies to test.

摘要

背景与重要性

探讨三维切片重建联合经颅神经内镜在脑脊液鼻漏手术中的技术、优缺点。

临床表现

收集2022年6月至2023年5月在我院接受三维切片重建联合经颅神经内镜经眶上眉弓锁孔入路微创手术的2例脑脊液鼻漏患者的完整临床资料。患者1例男性,1例女性,年龄分别为50岁和63岁。同时,对近年来国内外相关文献进行回顾总结。1例为自发性脑脊液鼻漏伴筛板继发性病变,另1例为外伤性脑脊液鼻漏。2例患者长期保守治疗均无效,最终经详细的术前评估、准备及手术治疗后康复。

结论

脑脊液鼻漏是神经外科一种具有挑战性的疾病,处理不当可导致脑膜炎等严重并发症。我们团队采用三维切片重建联合经颅内镜微创锁孔手术治疗脑脊液鼻漏,取得了良好效果,证明该联合技术具有一定优势,是一种值得推广的新手术技术。然而,该技术在前颅底手术中的广泛应用和推广仍需要全面可靠的前瞻性临床研究来验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dc2/11369414/f27c3628dfb3/gr1.jpg

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