儿童头颅先天性皮肤窦道的临床特征和手术疗效  

Clinical characteristics and surgical outcomes of cranial congenital dermal sinus in children

作　　者：王新法[1] 何俊平[1] 王刚[1] 高喆 钱静[1] 祝永杰[1] 邱德智 郑雷[1] 张瑞[1] Wang Xinfa;He Junping;Wang Gang;Gao Zhe;Qian Jing;Zhu Yongjie;Qiu Dezhi;Zheng Lei;Zhang Rui(Department of Neurosurgery,Children′s Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属儿童医院神经外科,南京210000

出　　处：《中华神经外科杂志》2022年第7期679-682,共4页Chinese Journal of Neurosurgery

基　　金：南京市卫生科技发展专项资金(YKK21148)。

摘　　要：目的探讨儿童头颅先天性皮肤窦道(CDS)的临床特征、诊疗经验及手术疗效。方法回顾性分析南京医科大学附属儿童医院神经外科2012年5月至2021年4月收治的24例头颅CDS患儿的临床资料。其中男15例,女9例;中位年龄为2岁;病变位于枕部14例、颞部7例、鼻根部3例。术前行头颅CT及其三维重建和(或)头颅MRI检查。所有患儿均行手术切除,定期随访。结果21例患儿一期全切除病变;3例先行脓肿切开引流术,二期行病变全切除术。术中显示,窦道终止于枕部骨膜者2例、硬脑膜7例、硬膜间腔11例、蛛网膜1例、枕大池1例,其余2例窦道终止于小脑,均引起小脑脓肿合并梗阻性脑积水。术后中位随访时间为58个月(6~114个月),随访期间均未再出现感染和颅内病变的复发。结论儿童头颅CDS窦道的深度决定了疾病的严重程度,严重可致脑脓肿和梗阻性脑积水。手术治疗疗效好。Objective To explore the clinical characteristics,diagnosis and treatment experience as well as surgical outcomes of cranial congenital dermal sinus(CDS)in children.Methods A retrospective study was conducted about the clinical data of 24 children with cranial CDS admitted to the Department of Neurosurgery,Children′s Hospital of Nanjing Medical University from May 2012 to April 2021.There were 15 males and 9 females with a median age of 2 years.The lesions were located in the occipital region in 14 cases,in the temporal region in 7 cases,and in the nasal root region in 3 cases.Head CT and 3D reconstruction and(or)head MRI were performed preoperatively.All patients underwent surgical resection and were followed up regularly.Results Twenty-one children underwent one-stage total resection;3 patients underwent abscess incision and drainage first,and second-stage total resection was performed.Intraoperative findings revealed that the sinus tract terminated in the occipital periosteum in 2 cases,in the dura mater in 7 cases,in the epidural space in 11 cases,in the arachnoid in 1 case,in the occipital cistern in 1 case,and in the cerebellum in 2 cases,resulting in cerebellar abscess and hydrocephalus.The median follow-up time after operation was 58 months(6-114 months),and there was no recurrence of infection or intracranial lesions during the follow-up period.Conclusions The depth of the sinus tract in children′s skull CDS determines the severity of the disease,which can lead to brain abscesses and obstructive hydrocephalus.Surgical outcome is favorable.

关 键 词：藏毛窦 先天畸形 儿童 神经外科手术 疾病特征 头颅 

分 类 号：R726.5[医药卫生—儿科]