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首页> 外文期刊>Cureus. >Revision Surgery Technique in the Treatment of Refractory Subcutaneous Cerebrospinal Fluid Collection Combined with Intracranial Infection Following Posterior Fossa Surgery
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Revision Surgery Technique in the Treatment of Refractory Subcutaneous Cerebrospinal Fluid Collection Combined with Intracranial Infection Following Posterior Fossa Surgery

机译：修复手术技术治疗难治性皮下脑脊液液结合后窝手术后颅内感染

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Objective Cerebrospinal fluid (CSF) leakage remains the most common and serious complication following posterior fossa surgery. Persistent subcutaneous CSF collections can cause wound dehiscence and predispose patients to intracranial infection. Management with conservative treatment fails in up to 40% of patients, and revision surgery remains the last resort. We hereby introduce a novel surgical technique using muscle graft or pedicled trapezius muscle flaps to repair dura and skull base defect for the treatment of subcutaneous CSF collections refractory to conservative management. Methods A retrospective chart review was conducted for six patients who presented to our institution from 2012 to 2020, with subcutaneous CSF collections following posterior fossa surgeries and had undergone revision surgeries after unsuccessful management with conservative treatments.?Patient demographics, etiologies, culture results, revision procedures, follow-ups, and recurrences of fluid collections were collected. Results Of these six patients, two underwent repair of dura and skull base defect with pedicled trapezius muscle flaps, and four had arachnoid fistula repaired with autologous muscle graft. All six patients fully recovered. CSF leakage and subcutaneous fluid collections were resolved. No recurrences occurred upon the last follow-ups. Conclusion A revision surgery using muscle graft or pedicled trapezius muscle flaps to repair the dura and skull base defect is effective at treating persistent cerebrospinal fluid leakage and subcutaneous fluid collection refractory to conservative treatment.
机译：物镜脑脊液（CSF）泄漏仍然是后窝手术后最常见和最严重的并发症。持续性皮下CSF收集可引起伤口裂缝和易患患者颅内感染。患有保守治疗的管理失败，高达40％的患者，并且修订手术仍然是最后的手段。我们特此介绍了一种使用肌肉移植物或支架梯形肌襟翼的新型手术技术，以修复Dura和颅底缺陷，用于治疗皮下CSF收集对保守管理的难治性。方法采用回顾性图表审查，为2012年提交给我们的机构的六名患者，涉及后窝手术后的皮下CSF收集，并在与保守治疗不成功的管理后经历了修订手术。??存放人口统计，病因，文化结果，修订收集程序，随访和液体收集的复发。结果这六名患者，两次接受了死胡子和颅底缺陷的经历修复，肌肉瓣和四肢患有自体肌肉移植物修复的蛛网膜瘘。所有六名患者完全恢复。解决了CSF泄漏和皮下液体收集。最后的后续后期没有发生复发。结论使用肌肉移植物或支架梯形肌皮瓣修复修复硬脑膜和颅底缺陷的修正手术是治疗持续脑脊液泄漏和皮下流体收集难治的保守治疗的难以有效。

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