Simmons N E, Lanzino G, Phillips C D, Jane J A, Lin K Y
Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Neurosurgery. 1998 Oct;43(4):970-2; discussion 972-3. doi: 10.1097/00006123-199810000-00154.
OBJECTIVE/IMPORTANCE: One of the most severe complications of craniosynostosis repair is dural sinus laceration. Massive hemorrhage and air embolism are potentially life-threatening sequelae that can result from such an event. The aberrant anatomy of patients with craniosynostosis only accentuates this risk, because separation of the calvaria from the underlying dura is often performed without direct visualization of the sinuses.
Three-dimensional computed tomography was combined with computed tomographic angiography in the preoperative assessment of patients with craniofacial abnormalities.
A clear understanding of the dural sinus anatomy in relation to the overlying bony landmarks became available to the operating surgeon. Six patients underwent this procedure, with excellent visualization of the bony and sinus anatomy achieved in all cases.
It is thought, that the benefit of combining these procedures has been significant by allowing the visualization of the dural sinus anatomy and overlying bony landmarks. This procedure conveys minimal concomitant morbidity or expense to the patient, yet offers valuable insight toward operative planning and complication avoidance.
目的/重要性：颅骨缝早闭修复术中最严重的并发症之一是硬脑膜窦撕裂。大量出血和空气栓塞是可能由此引发的危及生命的后遗症。颅骨缝早闭患者的异常解剖结构只会加剧这种风险，因为在分离颅骨与下方硬脑膜时，往往无法直接看到窦。
在对颅面畸形患者进行术前评估时，将三维计算机断层扫描与计算机断层血管造影相结合。
主刀医生能够清楚了解硬脑膜窦解剖结构与上方骨性标志的关系。6例患者接受了该手术，所有病例均实现了对骨性和窦解剖结构的良好可视化。
据认为，将这些检查相结合的益处显著，因为它能实现硬脑膜窦解剖结构和上方骨性标志的可视化。该检查给患者带来的伴随发病率和费用极低，但对手术规划和避免并发症具有宝贵的指导意义。
