带有真皮下血管网脂肪片Ⅰ期重建颅底缺损  

Study on one stage reconstruction of cranial base defects with preserved subcutaneous vascular network fat-graft

作　　者：刘文胜[1] 祁永发[1] 唐平章[1] 王晓雷[1] 陈默启[1] 李德志[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院头颈外科,北京100021

出　　处：《中国耳鼻咽喉头颈外科》2011年第6期281-283,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探索颅底手术缺损后重建,提供一种简便可靠的颅底缺损重建并降低手术并发症的方法。方法使用带有真皮下血管网脂肪片对19例颅底缺损的患者进行Ⅰ期缺损修复,通过临床观察和MRI检查判断重建效果。结果 19例患者中18例脂肪片修复成功,3例出现轻度脑脊液漏,1例出现严重颅内感染并脂肪片脱落。远期均获得满意效果。结论带有真皮下血管网脂肪片Ⅰ期重建颅底缺损,显著简化了前中颅底缺损的重建过程,减少手术创伤,降低颅底手术的并发症,对颅底手术的发展特别是经颌面部的颅底手术,起到积极的促进作用。OBJECTIVE The purpose of this study is to provide a new reliable cranial base reconstruction which is more simple and easier than the conventional method after tumor resection.METHODS Nineteen patients（12 male,7 female）with the skull base defects after tumors resection underwent cranial base reconstruction with preserved subcutaneous vascular network fat-graft which was obtained from abdominal wall and a split-thickness skin graft applied to line the underface of the fat-graft at the same time.Postoperatively,routine follow-up and MRI scan were performed on all patients at regular intervals.RESULTS The successful cranial base reconstruction was achieved in 18 of 19 patients with preserved subcutaneous vascular network fat-graft.The fat-graft was lost in one old patient with serious diabetes and a serious meningitis was developed.Minor cerebrospinal fluid leakage occurred in 3 patients and recovered after two weeks postoperatively.All patients developed no delayed complications.CONCLUSION Our experience has demonstrated that the cranial base reconstruction with preserved subcutaneous vascular network fat-graft is much more simple,easier and lower incidence of complications than the conventional local pedicle flaps.

关 键 词：颅底 外科手术 重建 

分 类 号：R651.1[医药卫生—外科学]