摘要
目的探讨带蒂帽状腱膜骨膜瓣在颅前底肿瘤术后颅底缺损重建中的应用价值。方法对21例经额颅内入路手术或颅面联合手术前颅底肿瘤患者采用帽状腱膜骨膜瓣重建颅底缺损，不带游离皮肤、骨片、钛网。修复最大缺损3cm×5cm。结果术后全部病例临床症状改善，1例术后第4天出现脑脊液漏，自然恢复，无手术死亡、脑膜脑膨出、颅内感染及其他严重并发症。随访1年至11年。存活1年以上者18例。3年以上者11例，5年以上者7例。死亡8例。1、3、5年生存率分别为18／21（85．7％）、11／17（64．7％）、7／13例（53．8％）。结论带蒂帽状腱膜骨膜瓣具有柔软、血供好、强度大等优点。可以有效分隔颅腔和鼻腔，是一种安全、简便、有效的前颅底重建方法，可用于较大颅底缺损的重建。
Objective To evaluate the efficacy of using a pedicled galooporicranial flap for reconstruction of anterior cranial base defect. Methods From March 1994 to November 2005, 21 patients who had tumors of the skull base underwent eraniofaeial resection or traneranial approach resection, and a pedieled galooperieranial flap was used to reconstruct the anterior cranial base defect. The galeoperieranial flap was only raised from the scalp after the tumor had been removed. It was then turmed inwardly and intraeranially and was transposed to lie between the skull base bone and the dura. No free skin, bone grafts or titanium mesh were used. The compound flaps covered the biggest defects 3cm×5cm. Results Clinical symptom were totally improved in all eases. None complication with eneephalomeningoeele and pneumoeephalus. Cerebrospinal fluid leaks occurred in one case within 4 days after surgery, and recovered spontaneously. All patients were followed up for from 1 year to 11 years after surgery. 8 patients died from recurrence or metastasis of tumor and other causes, 1-year survival rates was 18/21 （85.7%）;3-year survival rates was 11/17（64.7%）;5-year survival rates was 7/13（53.8%）. Conclusion The delicate nature and great pliability of a pedieled galeoperieranial flap make it competent for reconstructions of anterior skull base defects. Its ready availability, valid strength, and sufficient axial blood supply provide a satisfactory barrier for isolating the cranial cavity from the under lying respiratory tract, with minimal morbidity and mortality. It also suited for wide reconstruction of the anterior cranial base.
出处
《中华显微外科杂志》
CSCD
北大核心
2008年第1期30-32,共3页
Chinese Journal of Microsurgery
基金
广西壮族自治区卫生厅项目（Z1003111）
关键词
颅底
帽状腱膜
颅骨膜瓣
移植
显微外科手术
Skull base
Epieranial aponeurosis
Pericranial flap
Transplantation
Microsurgical operation
