Tokutomi T, Shigemori M, Hirano M, Sakaguchi S, Kiyokawa K, Hayakawa K, Tai Y
Department of Neurosurgery, Kurume University School of Medicine.
No Shinkei Geka. 1997 Jan;25(1):29-34.
The authors present the postoperative complications of skull base surgery based on a 10-year experience with 26 patients operated on via the supraorbital trans-basal or orbitozygomatic approach. The lesions included 19 malignant tumors and seven benign tumors. Postoperative cerebrospinal (CSF) leak occurred in one of the two patients in whom the dural defects were repaired with a fascia lata graft. None of the remaining 24 patients who were repaired with a musculopericranial flap suffered postoperative CSF leak. Three patients developed epidural abscess, but no infection was seen in the patients who had been reconstructed with a vascularized musculo-cutaneous flap to occlude the dead space. Preoperative radiation therapy correlated with a high incidence of postoperative infection. Cranial nerve deterioration or palsy occurred in four patients. Intraoperative injury of the internal carotid artery occurred in one patient who developed severe neurological deterioration. After an average follow-up period of 40 months (range 12 to 109 months), 68% of patients with malignant tumors and 100% of patients with benign tumors were alive with no evidence of recurrence.
作者基于对26例经眶上经基底或眶颧入路手术患者的10年经验，介绍了颅底手术的术后并发症。病变包括19例恶性肿瘤和7例良性肿瘤。在2例用阔筋膜移植修复硬脑膜缺损的患者中，有1例发生术后脑脊液漏。其余24例用肌骨膜瓣修复的患者均未发生术后脑脊液漏。3例发生硬膜外脓肿，但在用带血管的肌皮瓣重建以封闭死腔的患者中未发现感染。术前放疗与术后感染的高发生率相关。4例患者出现颅神经恶化或麻痹。1例患者术中发生颈内动脉损伤，出现严重神经功能恶化。平均随访40个月（范围12至109个月）后，68%的恶性肿瘤患者和100%的良性肿瘤患者存活，无复发迹象。
