经鼻内镜手术治疗鼻部脑膜脑膨出

目的　探讨经鼻内镜手术治疗鼻部脑膜脑膨出的可行性并确立临床处理的基本原则。方法　经鼻内镜下采用剪除、电切、切割等方式切除鼻内型脑膜脑膨出 5例 ,并根据颅底缺损的不同情况选择使用肌肉、筋膜、软骨、骨等一期修补颅底。结果　 5例均一次手术治愈 ,除 1例术后颅内感染 (脑膜炎 )外 ,无并发症发生 ,随访 1～ 5年无复发。结论　位于鼻腔内的脑膜脑膨出可以经鼻内镜手术完成 ,直径 0 5cm以下的颅底缺损可使用肌肉填塞和筋膜覆盖的方法修补 ,直径超过 0 5cm的颅底缺损应先使用软骨或骨封闭缺损 ,然后再用肌肉填塞和筋膜覆盖 ,以免复发。

Treatment of endonasal-encephalomeningocele by transnasal endoscopic surgery

Objective To inquire into the feasibility of transnasal endoscopic surgery for endonasal encephalomeningocele, and to put forward the basic management guidelines Method Five cases of endonasal encephalomeningocele were managed by transnasal endoscopic surgery Different surgical techniques were applied according to the size and shape of skull base defect At the same time,one stage repair of skull base defect was achieved by applying muscle, fascia, cartilage and bone Result All 5 patients were successfully treated without complication and relapse during 1 5 year follow up Conclusion Endonasal type encephalomeningocele can be managed by transnasal endoscopic surgery If the skull base defect is less than 0 5 cm,it can be repaired by packing muscle and fascia If the defect is larger than 0 5 cm, the cartilage or bone should be used to repair the skull base