Clinical outcomes of intraoperative skull base reconstruction in endoscopic endonasal skull base tumor resection

Q4 Medicine

中华神经外科杂志 Pub Date : 2020-01-28 DOI:10.3760/CMA.J.ISSN.1001-2346.2020.01.002

Zhengyuan Chen, Xuefei Shou, Ming Shen, Wenqiang He, Keyi Zhang, Yao Zhao, Shiqi Li, P. Zhong, Yongfei Wang

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引用次数: 0

Abstract

Objective To summarize the reconstruction strategy and efficacy for skull base defect in endoscopic endonasal skull base tumor resection. Methods The clinical outcomes of 202 patients with skull base defect who underwent endoscopic tumor resection at Department of Neurosurgery, Huashan Hospital, Fudan University from April 2011 to February 2016 were retrospectively analyzed. Skull base defects were intraoperatively classified into Ⅰ-Ⅲ grades based on the diameter of dura defect and flow of cerebrospinal fluid (CSF), and corresponding reconstruction strategies were adopted. Results The classification result of 202 skull base defects was 15.8%(32 cases) in Grade Ⅰ, 24.3%(49 cases) in Grade Ⅱ and 59.9%(121 cases) in Grade Ⅲ. Six patients (3.0%) had postoperative CSF rhinorrhea, which resolved following secondary endoscopic repair surgery. Four patients (2.0%) had intracranial infection which was finally cured by antibiotics medication. One elderly patient (0.5%) died of pulmonary infection after prolonged bed rest after surgery. Conclusions Endoscopic surgery seems safe and effective for the reconstruction of skull base defect. The occurrence of postoperative CSF leakage could be effectively avoided when specific reconstruction strategy is adopted according to the classification of skull base defect. Key words: Natural orifice endoscopic surgery; Skull base neoplasms; Reconstructive surgical procedures; Skull base defect

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内镜下鼻内颅底肿瘤切除术术中颅底重建的临床效果

目的总结鼻内窥镜颅底肿瘤切除术中颅底缺损的重建策略及疗效。方法回顾性分析2011年4月至2016年2月在复旦大学华山医院神经外科行颅底缺损内镜肿瘤切除术的202例患者的临床结果。术中根据硬脑膜缺损直径及脑脊液流量将颅底缺损分为Ⅰ~Ⅲ级，并采取相应的重建策略。结果202例颅底缺损的分类结果为:Ⅰ级32例(15.8%)，Ⅱ级49例(24.3%)，Ⅲ级121例(59.9%)。6例(3.0%)患者术后出现脑脊液鼻漏，经二次内镜修复手术解决。颅内感染4例(2.0%)，经抗生素治疗治愈。1例老年患者(0.5%)术后长时间卧床后死于肺部感染。结论内镜手术治疗颅底缺损安全有效。根据颅底缺损的分类，采取针对性的重建策略，可有效避免术后脑脊液漏的发生。关键词:自然孔道内镜手术;颅底肿瘤;重建外科手术;颅底缺损

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.