经鼻内窥镜手术治疗先天性脑膜脑膨出

目的：探讨鼻内镜下手术修补颅底鼻内型先天性脑膨出的可行性。方法：根据CT及MRI等影像学资料，应用不同角度的高解像度内镜及图像监视系统探查鼻内颅底脑膜脑澎出病灶及骨壁缺损情况，切除疝入鼻内的变性脑组织和脑膜（如膨出不多可回纳者则不用切除），刮除骨缺损边缘及周围粘膜，用肌浆、筋膜、鼻粘膜及生物材料修补骨壁和脑膜缺损。结果：2例位于筛顶的脑膜脑膨出1次手术成功。1例蝶窦侧壁脑膜脑膨出并蝶窦和筛顶两处脑脊液鼻漏者，先后3次手术成功。1例蝶窦侧壁脑膜脑膨出骨缺损较大者，3次手术成功。结论：鼻内镜下经鼻入路进行颅底鼻内型先天性脑膜脑膨出修补术，具有安全、简便、损伤小、并发症少等优点.

Transnasal Endoscopic Operation for Congenital Meningoencephalocele

Objective:To explore the feasibility of treating intranasal congenital meningoencephalocele under nasal endoscope.Methods:According to CT scan and MRI image materials,the meningoencephalocele focus and skull base defects were explored by high resolution endoscope and digital image system.The denatured meningoencephalocele in nasal cavity or sinus were removed and the defected skull base was repaired with aponeurosis and mussel mud or some other biological materials.Results:Two cases of meningoencephalocele located in ethmoid plate were resected and repaired succcessful with one time endoscopic surgery.One case of meningoencephalocele with two defections and cerebrospinal fluid in sphenoid sinus lateral wall and ethmoid plate was reparied successful with three times operations.The last case of meningoencephalocele has a macro defection in sphenoid sinus lateral wall.This case was finally repaired successful with three times surgery.Conclusions:Treatment of congenial meningoencephalocele under nasal endosope was safe,simple,less complication and results well,even failure in once or twice time,the repair operation can be repeated again.