Chiari畸形颅颈减压术后小脑下垂的后颅窝扩大成形术

目的报告颅颈减压术后小脑下垂应用颅骨成形术进行有效治疗的处理经验.方法对5例曾行后颅颈减压术,但术后临床症状加重有小脑下垂表现的Chiari畸形合并脊髓空洞症病人采用钛网实施后颅窝扩大成形术,男4例,女1例,平均年龄32.2岁.结果随访6～18月,平均13个月, 5例病人术后临床症状及体征均改善,复查MRI显示扩大成形的后颅窝容积稳定,成形良好,枕大池重建,脊髓空洞均有不同程度缩小,后颅窝容积有效扩大11.33～24.1ml,平均16.74ml.结论后颅窝扩大成形术扩大成形良好,临床效果满意,是治疗后颅颈减压术后小脑下垂的有效治疗方法.

Expansive posterior fossa cranioplasty on cerebellar ptosis following craniovertebral decompression for chiari malformation with syringomyelia

Objective To report the experience in the treatment of Cerebellar ptosis following Craniovertebral decompression for Chiari malformation with syringomyelia. Methods Expansive posterior fossa cranioplasty were applied on 5 patients(Four males and one female) The mean age of the patients was 32.2 years and the average amount of time between the initinal operation and expansive posterior fossa cranioplasty was 4.3 years. All patients presented neurological deficits caused by recurrent syringomyelia. Results The mean follow-up period was 13 months(range from 6 to 18 months).Five patients experienced good clinical outcomes with symptom relief. Post operative magnetic resonance imaging studies revealed a reduction in the size of the syrinx cavity and reconstruction of cisternal, The mean volume of posterior fossa was enlarged 16.74ml(range from 11.33mlto 24.1ml).Conclusion Expansive posterior fossa cranioplasty is effective in treating cerebellar ptosis following Craniovertebral decompression for Chiari malformation with syringomyelia.