婴幼儿先天性基底型脑膜脑膨出的诊断及鼻内镜手术治疗

目的 探讨婴幼儿先天性基底型脑膜脑膨出的诊断及鼻内镜手术治疗的安全性和有效性。 方法 回顾性分析8例婴幼儿先天性基底型脑膜脑膨出的临床资料。术前进行鼻窦CT和MRI检查,全部病例经鼻内镜下脑膜脑膨出切除术及颅底修复重建术,术后随访手术疗效。 结果 8例病例包括经筛型6例、蝶咽型2例。手术均一次性成功,无并发症出现。术后随访6~74个月未见复发。 结论 对于持续性鼻塞、鼻溢伴有鼻腔或鼻咽部新生物的婴幼儿,应考虑先天性基底型脑膜脑膨出的可能。鼻窦CT及MRI检查具有重要的诊断意义。鼻内镜下膨出物切除术及颅底修复重建术是一种安全、有效的手术方式,并且具有良好的临床效果。

Diagnosis and nasal endoscopic surgery of congenital basal meningoencephaloceles in infants

Objective The aim of this study is to investigate the diagnosis of congenital basal meningoencephalocele in infants and the safety and effectiveness of nasal endoscopic surgery.Method A retrospective analysis of the clinical data of 8 cases of congenital basal meningoencephalocele in infants admitted at the Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine between April 2014 and December 2019 was conducted.Preoperative sinus CT and MRI examinations were performed,and all cases underwent endoscopic meningoencephalocele resection and skull base reconstruction.Results Six patients presented with transethmoidal meningoencephalocele and 2 transsphenoidal meningoencephaloceles.The operation was successful at one time without complications.There were no recurrences after 6~74 months of follow-up.Conclusion For infants with persistent nasal obstruction and nasal overflow with neoplasms in the nasal cavity or nasopharynx,the possibility of congenital basal meningoencephalocele should be considered.Sinus CT and MRI examinations have important diagnostic significance.Nasal endoscopic resection of the bulge and reconstruction of the skull base is a safe and effective operation and has a good clinical effect.