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1、中华耳鼻咽喉头颈外科杂志2006年5月第41卷第5期ChinJOtorhinolaryngolHeadNeckSurg,May2006,Vol41,No.5351临床研究颅底术后骨质缺损的钛网重建倪志立刘海生曲秋懿吕海丽严波张秋航摘要!目的探讨钛网在颅底重建中的可行性和外科技术。方法回顾性分析2002年11月至2004年11月采用钛网修复的11例颅底缺损患者的临床资料及随访结果。结果11例患者中颅底肿瘤6例,颅底骨纤维异常增生症3例,脑膜脑膨出2例。手术入路:经颅面联合入路手术7例
2、,经额入路及扩大经额入路3例,经面中部掀翻入路1例。修补中、侧颅底2例,前、中颅底及蝶鞍6例,前颅底及眶板3例。术后短期内3例患者有少量无症状性颅内积气,未经治疗而自愈;1例患者发生短暂性脑脊液鼻漏,局部明胶海绵填塞及碘纺纱条压迫后自愈。术后平均随访144个月,无钛网移位和颅内感染等并发症。结论钛网用于颅底大型骨质缺损修复是安全的、可行的。关键词!钛,骨代用品;颅底;耳鼻喉外科手术UsingoftitaniummeshforthereconstructionofskullbasedefectNIZh
3、ili,LIUHaisheng,QUQiuyi,LHaili,YANBo,ZHANGQiuhangDepartmentofOtorhinolaryngologyHeadandNeckSurgery,XuanwuHospital,CapitalUniversityofMedicalScience,Beijing100053,ChinaCorrespondingauthor:NIZhili,Email:nzl55@sinacomAbstract!ObjectiveThepurposeofthis
4、studyistoevaluatethepossibilityandsurgicalprincipleoftitaniummeshusedforthereconstructionofskullbasebonedefectMethodsTheclinicaldataof11patientswithdefectofskullbasebonerepairedwithtitaniummeshwereretrospectivelyanalysedResultsAmong11patients,therewere6pat
5、ientswithskullbasetumor,3patientswithfibrosishyperplasia,2patientswithencephalomeningoceleThesurgicalapproachincludedcraniofacialapproachin7patients,transfrontalandextendedtransfrontalapproachin3patients,transmidfaceapproachin1patientTheanteriorandlaterals
6、kullbasewasrepairedin2patients,anteriorandmiddleskullbaseandsellarrepairedin6patients,anteriorskullbaseandorbitalfloorrepairedin3patientsInearlypostoperativeperiod,therewere3patientswithintracranialpneumatosis,butwithoutsymptom,and1patientwithtransientcerebr
7、ospinalleakageFollowingupforaverage144months,therewasnotitaniummeshdisplacementandintracranialinfectioninallpatientsConclusionsThetitaniummeshusedfortherepairofskullbasebonedefectwasbothpossibleandsafeKeywords!Titanium,bonesubstitutes;Skullbase;Otorh
8、inolaryngologicsurgicalprocedures近年来,影像诊断、颅底外科技术与手术器械的头状瘤恶变侵犯前颅底1例,筛窦癌2例,听神经纤进步与发展,推动了颅底外科技术的飞速发展。随维瘤病∀型、嗅沟脑膜瘤、嗅神经母细胞瘤、前颅底着手术范围的扩大,一期进行颅底重建,对于减少术骨巨细胞瘤各1例;颅底骨纤维异常增生症3例;经后脑膜脑膨出、脑脊液鼻漏、张力性气
