婴幼儿先天性基底型脑膜脑膨出的诊断及鼻内镜手术治疗  

Diagnosis and nasal endoscopic surgery of congenital basal meningoencephaloceles in infants

作　　者：陈坤 李磊[1] 孟国珍[1] 杨军[1] 侯东明[1] CHEN Kun;LI Lei;MENG Guozhen;YANG Jun;HOU Dongming(Department of Otolaryngology&Head and Neck Surgery,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092

出　　处：《山东大学耳鼻喉眼学报》2021年第1期77-81,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：上海交通大学科技创新专项资金多学科交叉项目(ZH2018ZDA11)。

摘　　要：目的探讨婴幼儿先天性基底型脑膜脑膨出的诊断及鼻内镜手术治疗的安全性和有效性。方法回顾性分析8例婴幼儿先天性基底型脑膜脑膨出的临床资料。术前进行鼻窦CT和MRI检查,全部病例经鼻内镜下脑膜脑膨出切除术及颅底修复重建术,术后随访手术疗效。结果8例病例包括经筛型6例、蝶咽型2例。手术均一次性成功,无并发症出现。术后随访6~74个月未见复发。结论对于持续性鼻塞、鼻溢伴有鼻腔或鼻咽部新生物的婴幼儿,应考虑先天性基底型脑膜脑膨出的可能。鼻窦CT及MRI检查具有重要的诊断意义。鼻内镜下膨出物切除术及颅底修复重建术是一种安全、有效的手术方式,并且具有良好的临床效果。Objective The aim of this study is to investigate the diagnosis of congenital basal meningoencephalocele in infants and the safety and effectiveness of nasal endoscopic surgery.Method A retrospective analysis of the clinical data of 8 cases of congenital basal meningoencephalocele in infants admitted at the Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine between April 2014 and December 2019 was conducted.Preoperative sinus CT and MRI examinations were performed,and all cases underwent endoscopic meningoencephalocele resection and skull base reconstruction.Results Six patients presented with transethmoidal meningoencephalocele and 2 transsphenoidal meningoencephaloceles.The operation was successful at one time without complications.There were no recurrences after 6~74 months of follow-up.Conclusion For infants with persistent nasal obstruction and nasal overflow with neoplasms in the nasal cavity or nasopharynx,the possibility of congenital basal meningoencephalocele should be considered.Sinus CT and MRI examinations have important diagnostic significance.Nasal endoscopic resection of the bulge and reconstruction of the skull base is a safe and effective operation and has a good clinical effect.

关 键 词：先天性脑膜脑膨出 婴幼儿 鼻内镜手术 颅骨缺损 颅底修复 

分 类 号：R714[医药卫生—妇产科学]