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首页> 外文期刊>Neurosurgery >Circumferential Watertight Dural Repair Using Nitinol U-Clips in Expanded Endonasal and Sublabial Approaches to the Cranial Base
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Circumferential Watertight Dural Repair Using Nitinol U-Clips in Expanded Endonasal and Sublabial Approaches to the Cranial Base

机译：使用镍钛合金U型夹在颅底扩大的鼻内和阴唇下方法进行周向水密性硬膜修复

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摘要

In recent years, significant advances have been made in the field of expanded endonasal approaches that permit treatment of different cranial base intra-dural lesions.OBJECTIVE: To report our technique of cranial base dural repair by the application of nitinol U-Clips in endoscope-assisted extended endonasal or sublabial approaches. Closure techniques and postoperative cerebrospinal (CSF) leaks are reported. METHODS: We reviewed 11 patients with different kinds of cranial base tumors or vascular diseases (2 tuberculum sellae meningiomas, 1 planum sphenoidale meningioma,4 craniopharyngiomas, 1 recurrent clival chordoma, 1 esthesioneuroblastoma, 1 ethmoidal melanoma metastasis, 1 basilar trunk aneurysm) who underwent an endoscope-assisted extended endonasal or sublabial approach. Dural repair was performed using nitinol U-Clips to circumferentially suture AlloDerm or fascia lata directly to the existing dural borders. Lumbar drainage was not used in 9 patients and was used in 2 patients for5 days. Patients were evaluated for the appearance of CSF leaks.RESULTS: Postoperative CSF leak was observed in 1 patient (9%). This required a second transnasal repair.CONCLUSION: Circumferential dural closure with U-Clips is a useful adjunct to prevent CSF leaks after expanded endonasal or sublabial approaches to the cranial base for treatment of intracranial pathology.
机译：近年来，在扩大鼻内入路技术领域取得了显着进展，该技术可用于治疗不同的颅底硬膜内病变。辅助扩展鼻内或阴唇下入路。报道了封闭技术和术后脑脊液（CSF）泄漏。方法：我们回顾了11例患有不同类型颅底肿瘤或血管疾病的患者（2例蝶鞍脑膜瘤，1例蝶窦脑膜瘤，4例颅咽神经瘤，1例复发性脊索脊索瘤，1例食管神经母细胞瘤，1例筛窦黑色素瘤转移，1例基底干动脉瘤）内窥镜辅助的扩展鼻内或阴唇下入路。使用镍钛合金U形夹将硬膜真皮层或筋膜直接圆周缝合到现有硬脑膜边界，进行硬膜修复。 9例未使用腰椎引流，2例使用了5天。结果：1名患者（9％）观察到了术后脑脊液漏。结论：采用U形夹进行硬脑膜硬膜外封闭是预防脑脊液漏出的有效辅助手段，扩大了鼻内或阴唇下途径到达颅底的颅内病变治疗范围。

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