CAJ | 학술논문

目的总结鼻内镜手术治疗颅底脑膜脑膨出的方法和临床经验.方法运用内镜经鼻外科手术治疗鼻部脑膜脑膨出9例,采用自体阔肌筋膜片修补颅底缺损.结果 9例患者中,8例1次手术治愈,随访1～4年无复发.中位随访时间2年.1例复发,于术后1个月出现脑脊液鼻漏,再次手术以阔肌筋膜+人工脑膜修复,术后随访1年半未复发.术后并发症包括发热1例、脑脊液鼻漏1例,全部病例无颅内感染、颅内出血、脑水肿及脑积水等其他并发症.结论内镜经鼻治疗颅底脑膜脑膨出不仅微创、安全,而且视野清晰,可更好地辨认漏口及其周围结构,是治疗鼻部脑膜脑膨出的首选手术方法 .准确定位漏孔,选用合适的修复材料及技术是手术成功的关键.
목적 총결비내경수술치료로저뇌막뇌팽출적방법 화림상경험.방법 운용내경경비외과수술치료비부뇌막뇌팽출9례,채용자체활기근막편수보로저결손.결과 9례환자중,8례1차수술치유,수방1～4년무복발.중위수방시간2년.1례복발,우술후1개월출현뇌척액비루,재차수술이활기근막+인공뇌막수복,술후수방1년반미복발.술후병발증포괄발열1례、뇌척액비루1례,전부병례무로내감염、로내출혈、뇌수종급뇌적수등기타병발증.결론 내경경비치료로저뇌막뇌팽출불부미창、안전,이차시야청석,가경호지변인루구급기주위결구,시치료비부뇌막뇌팽출적수선수술방법 .준학정위루공,선용합괄적수복재료급기술시수술성공적관건.
Objective To investigate the management experience with transnasal endoscopic technique for meningoencephalocele.Methods Nine patients with endonasal encephalomeningocele were managed by transnasal endoscopic surgery,and the skull base defect was repaired by fascia. Results Eight cases were successfully managed at the time of the first operation,and no relapse case was found during 1 to 4 years follow-up.Only one case of a two years old child relapsed with cerebrospinal fluid rhinorrhea one month after operation.During the second operation,titanium mesh uncovering was found,and replacement of titanium mesh by fascia via skull base defect was done.without relapse one and half years after the seaond operation.Another case of a one year old child got a fever one day after operation,but no white blood cell Was found in the cerebrospinal fluid,and the temperature recovered to normal after release cerebrospinal fluid management.There were no complications of cranial infection,hemorrhage,edema and water retention in brain to be found in all cases.Conclusions It is not only minimally invasive.safety and efficiencv of transnasal endoscopic technique for meningoencephalocele, but also had a clear operating view for better recognization of the position of leak and the structure of operating field,therefore,transnasal endoscopic technique is the first choice for the management of endonasal encephalomeningocele.The accurate localization of leak and selection of the appropriate repairing materials are the key point for the successful operation.