前颅底中线区组织缺损的修复重建:附17例报告  

Reconstruction of anterior skull base defect by pedicle frontal muscle compound flap

作　　者：张虹[1] 陶远孝[1] 吴宇平[1] 廖文满[1] 吕杨成[1] 胡国华[2] 杨桂芬 朱力[4] 高国亮 吴家玉[1] 

机构地区：[1]四川省肿瘤医院头颈-颅底颅脑肿瘤外科,四川成都610041 [2]重庆医科大学第一附属医院耳鼻咽喉科,重庆400016 [3]攀枝花市攀钢总医院耳鼻咽喉科,四川攀枝花617023 [4]攀枝花市第五人民医院耳鼻咽喉科,四川攀枝花617000 [5]攀枝花市攀矿医院耳鼻咽喉科,四川攀枝花617063

出　　处：《中华神经医学杂志》2003年第4期272-273,共2页Chinese Journal of Neuromedicine

基　　金：四川省科技厅科研基金(01SY-051-45)

摘　　要：目的 探讨颅面联合手术中前颅底中线区组织洞穿性缺损Ⅰ期修复重建的一种新方法。方法 采用带血管蒂的额肌帽状腱膜复合组织瓣Ⅰ期修复重建了17例前颅底中线区大面积洞穿性组织缺损。其中正中单蒂额肌帽状腱膜复合组织瓣2例,正中双蒂额肌帽状腱膜复合组织瓣2例,正中双蒂额肌帽状腱膜颅骨膜裂层颅骨瓣13例。取瓣面积可达(80～120)mm×(100～150)mm。结果 用该瓣修复的17例患者无并发症发生。结论 正中带蒂额肌帽状腱膜复合组织瓣血管恒定、血供好、组织薄、可带硬性支撑并可弯曲成型、取瓣径路与手术一致,不影响美观。该组织瓣为修复前颅底中线区洞穿性缺损的一种新方法。Objective To evaluate the effect of the first stage reconstruction for anterioral skull base defect by pedicle frontal muscle compound flap after the operation with combined craniofacial approach. Methods Seventeen patients with frontal skull base defect due to tumor and fracture ( rudimentary cancer 5, malirnant melanoma 1, neurogliocytoma 1, ethoid sinus rhabdomyosarcoma 1, malignant papilloma 1, osteofibroma 3, osteoma 2, pituitary gland tumor 1, polypi with mould infection 1, underwend surgery 1) received the first stage reconstruction with the compound flap with pedicle frontal muscle galea aponeurosis pericranium. The size of compound flap obtained was (80-120) mm × (100-150) mm. Results All the reconstructions were successful in the 17 cases and no complications occurred during follow-up of 1-48 months. Conclusion With blood supply ample and stable, and their tissues thin, pliable and strong, the compound flaps with pedicle frontal muscle Galea aponeuroses pericranium is good in reconstructing frontal skull base defects.

关 键 词：前颅底中线区组织缺损 修复 单蒂额肌帽状腱膜复合组织瓣 颅面联合切除术 手术方法 

分 类 号：R739.41[医药卫生—肿瘤]