小儿脑膜脑膨出鼻内窥镜修复:我们的经验。

IF 2.3 Q1 OTORHINOLARYNGOLOGY
Allergy & Rhinology Pub Date : 2018-10-01 eCollection Date: 2018-01-01 DOI:10.1177/2152656718802408
Hetal K Marfatia, Kartik A Parelkar, Adhara Chakraborty, Shampa Mishra
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引用次数: 4

摘要

背景:以鼻肿块为表现的儿科患者并不常见,对其是否为脑膜膨出的高度怀疑是必要的。其中大多数是先天性的,由于有脑膜炎的危险,需要早期干预。由于麻醉的风险和有限的空间,手术在这些情况下是非常具有挑战性的。目的:本研究旨在描述我们治疗小儿脑膜脑膨出的技术和经验。方法:对2012年1月至2017年2月在我院三级保健中心就诊的19例儿童患者(年龄从40日龄婴儿到11.5岁儿童)进行回顾性研究。以鼻内脑膜脑膨出为表现的患者采用内窥镜入路,使用耳科显微仪器进行治疗。在详细的影像学和临床评估后,所有病例都进行了量身定制的修复,使用脂肪/筋膜/软骨,多层闭合。结果:除1例惊厥发作后死亡外,所有患者均成功修复和恢复。在我们的病例中,有2例鼻前庭有轻微的周向狭窄和粘连形成。结论:经鼻内镜修复脑膜脑膨出具有微创性。它避免了永久性嗅觉缺失,是一种美容。微型仪器和4毫米0°鼻内窥镜的组合提供了良好的视野和足够的工作空间。由于先天性脑膜脑膨出的缺陷较大,多层修复提供了良好的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience.

Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience.

Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience.

Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience.

Background: Pediatric patients presenting with a nasal mass is uncommon and a high index of suspicion for it to be a meningoencephalocele is essential. Majority of these are congenital and require early intervention owing to the risk of meningitis. Surgery in these cases is very challenging because of the risk of anesthesia and limited space.

Objective: This study aimed to describe our technique and experience in managing pediatric meningoencephaloceles.

Methods: A retrospective study of 19 pediatric patients (age ranging from 40-day-old infants to 11.5-year-old children) was conducted at our tertiary care center from January 2012 to February 2017. Patients presenting with an intranasal meningoencephalocele were treated by endoscopic approach, using otological microinstruments. After detailed imaging and clinical evaluation, a tailored repair, using fat/fascia/cartilage, a multilayer closure, was carried out in all cases.

Results: All patients had a successful repair and recovery, except for one death following an episode of convulsion. There was a minor circumferential narrowing of the nasal vestibule and synechia formation in 2 of our cases.

Conclusion: Transnasal endoscopic repair of meningoencephalocele is minimally invasive. It avoids permanent anosmia and is cosmetic. A combination of miniaturized instruments and a 4-mm 0° nasal endoscope gives excellent visual field and an adequate working space. Owing to the larger defects in congenital meningoencephaloceles, a multilayer repair provides excellent outcomes.

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来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
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