论文部分内容阅读
目的总结经鼻内镜鼻颅底缺损修补的经验,评价鼻颅底缺损的病因、部位和经鼻内镜鼻颅底修补术的效果及关键技术。方法回顾性分析1998年1月至2006年6月69例鼻颅底缺损经鼻内镜颅底修补患者的临床资料,着重分析颅底缺损的病因、部位、手术效果及关键技术。结果随访6个月至11年,主要病因是外伤性颅底骨折(32例)、颅底或鼻-鼻窦占位性病变切除后(28例)和医源性颅底损伤(9例);主要部位在筛窦,其次是蝶窦;一次手术成功率为91.3%(63/69),最终成功率为95.7%(66/69)。结论经鼻内镜鼻颅底缺损修补术效果理想,缺损处彻底清创、制作缺损缘创面和修补物嵌塞于颅底内侧面是手术成功的关键,游离肌肉和筋膜是理想的修补材料。
Objective To summarize the experience of nasal endoscopic nasal skull base defect repair and evaluate the etiology and location of nasal skull base defect and the results of nasal endoscopic nasal skull base repair and its key technologies. Methods The clinical data of 69 patients with nasal skull base defect repaired by endoscopic skull base repair from January 1998 to June 2006 were analyzed retrospectively. The etiology, location, operative effect and key techniques of skull base defect were analyzed emphatically. Results The patients were followed up for 6 months to 11 years. The main causes were traumatic skull base fracture (32 cases), skull base or nasosinus space occupying lesion (28 cases) and iatrogenic skull base injury (9 cases). The main site was in the ethmoid sinus, followed by the sphenoid sinus. The success rate of one operation was 91.3% (63/69) and the final success rate was 95.7% (66/69). Conclusion Endoscopic nasal skull base defect repair is effective and the debridement is completely debridement. It is the key to the success of the operation to make the defect rim wound and prosthesis implanted in medial skull base. Free muscle and fascia are the ideal repair materials .