The role of MR and endoscopy in postoperative management of skull base reconstruction by vascular pedicle septal flap 【作者】 张维天; 庄奇新; 殷善开; 程付伟; 郭金宝;
【Author】 ZHANG Weitian1 ZHUANG Qixin2 YIN Shankai1 CHENG Fuwei1 GUO Jinbao1(1Department of Otorhinolaryngology,No.6 People’s Hospital Affiliated to Shanghai Jiaotong University;Institute of Otorhinolaryngology,Shanghai Jiaotong University,Shanghai,200233,China;2Department of Interventional Imaging,No.6 People’s Hospital Affiliated to Shanghai Jiaotong University)
【机构】 上海交通大学附属第六人民医院耳鼻咽喉科; 上海交通大学耳鼻咽喉科研究所; 上海交通大学附属第六人民医院介入影像科;
【摘要】 目的:探讨核磁共振(MR)与内镜检查在带血管蒂鼻中隔黏骨膜瓣颅底修复术后管理中的意义。方法:回顾性分析8例应用带血管蒂的鼻中隔黏骨膜瓣内镜下修复颅底硬膜缺损的资料。其中7例术后(术后5~7d)和近期随访(术后3~7个月)MR和内镜检查资料完整,1例因金属植入物而行CT和内镜检查。2种检查方法配合应用,掌握与颅底重建成败相关的信息,包括术后颅内及颅底修复局部、组织瓣供区和鼻腔鼻窦黏膜术后转归状况,以掌握愈合规律,提高重建成功率。结果:MR结合内镜检查可以准确获取带血管蒂鼻中隔瓣重建颅底术后颅内和修复局部的关键信息。MR可以排除术后常见的颅内并发症如颅内血肿、脑水肿或气颅,显示颅底缺损的位置及大致范围,提示组织瓣的位置及其与硬膜缺损边缘之间的重叠覆盖状态,定位术后脑脊液漏口。在术后和近期随访加强MR中,中隔瓣在颅底大致呈"C"形,7例中隔瓣均匀强化明显,提示血供佳。术后内镜检查证明7例中隔瓣无缺血坏死。6例组织瓣同颅底骨质愈合佳,1例内镜检查发现MR提示的脑脊液漏口并处理。中隔瓣在术后有一定程度的水肿和充血,近期随访时消失,组织瓣有缩小、变薄的征象,1例行CT和内镜检查者,中隔瓣发生坏死,... 更多还原
【Abstract】 Objective:To explore the significance of MR and endoscopy in the postoperative management of skull base reconstruction with a vascular pedicle nasoseptal mucoperiosteal flap.Method:The immediate,and delayed postoperative MR imaging scans and endoscopic data of 8 patients who underwent endonasal endoscopic reconstruction of skull base dural defects with a vascular pedicle nasoseptal mucoperiosteal flap were retrospectively studied.Among the 8 patients,7 cases have integrated immediate,delayed pos... 更多还原 【关键词】 颅底; 外科组织瓣; 脑脊液鼻漏; 核磁共振成像; 内镜检查; 【Key words】 skull base; surgical flap; cerebrospinal fluid rhinorrheas; magnetic resonance imaging; endoscopy;
【分类号】R764.9
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