Gonçalves da Silva J A, Gonçalves da Silva C E
Neurochirurgia (Stuttg). 1981 Sep;24(5):153-7.
Within a period of ten years we operated on 126 cases of basilar impression and/or Arnold-Chiari malformation. Two surgical techniques were employed for decompression of the posterior fossa. In the group I (64 cases) the operation consisted of craniectomy and the dura mater was left open and was fixed to the lateral musculature. The technique of the group II (62 cases) consisted in endotracheal intubation without flexion of the head, position of the head without anterior flexion during the operation and plastic closure of the dura. The dural graft was employed to create more space at the craniocervical joint, to avoid cerebrospinal fluid fistula and to restore the integrity of the dura as a protection for the nervous structures of the posterior fossa. The frequency of postoperative complications and mortality observed in group II was definitely less than in the group I.
在十年时间里，我们对126例基底凹陷症和/或阿诺德-奇亚里畸形患者进行了手术。采用了两种手术技术对后颅窝进行减压。在第一组（64例）中，手术包括颅骨切除术，硬脑膜保持开放并固定于外侧肌肉组织。第二组（62例）的技术包括气管内插管且头部不弯曲，手术过程中头部不向前屈曲以及硬脑膜的整形缝合。使用硬脑膜移植物在颅颈关节处创造更多空间，避免脑脊液漏，并恢复硬脑膜的完整性以保护后颅窝的神经结构。第二组观察到的术后并发症和死亡率明显低于第一组。
