Costa H, Cunha C, Conde A, Cerejo A, Baptista A, Vaz R, Gonçalves M
Serviço de Cirurgia Plástica e Reconstrutiva, Hospital S. João, Porto.
Acta Med Port. 1997 Jan;10(1):19-26.
Craniofacial infection is a major problem for the plastic and neurosurgical team. Previous successful experiences with free muscle and omentum flaps and the galea frontalis myofascial flap have been reported, avoiding disastrous complications after frontofacial advancements and the resection of skull base tumors. The authors report the clinical use of the galea frontalis myofascial flap in the treatment of anterior fossa CSF leaks. This flap provides an adequate sized and vascularized barrier between the cranial and nasal cavities through which the cells of the inflammatory response reach the target area. This technique was used in 11 cases with complete success; in-6 patients, repair of the anterior cranial base bone defect was performed with split calvarium bone grafts, harvested from craniotomy bone. In all the patients, neither the recurrence of the CSF leakage nor post-operative meningitis or its recurrence were observed.
颅面部感染是整形和神经外科团队面临的一个主要问题。此前已有关于游离肌肉和网膜瓣以及额肌筋膜瓣成功应用的报道，这些方法避免了额面部前移和颅底肿瘤切除术后的灾难性并发症。作者报告了额肌筋膜瓣在治疗前颅窝脑脊液漏中的临床应用。该瓣在颅腔和鼻腔之间提供了一个大小合适且血管化的屏障，炎症反应细胞可通过该屏障到达目标区域。该技术应用于11例患者，全部成功；6例患者采用取自开颅术骨的颅骨劈开骨移植修复前颅底骨缺损。所有患者均未观察到脑脊液漏复发、术后脑膜炎或其复发情况。
