择期神经外科并发症后骨瓣吸收(附一例)

E. Rostorguev, N. S. Kuznetsova, G. N. Yadryshnikova
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引用次数: 0

摘要

Сraniotomy是现代选择性神经外科手术的一个组成部分,它包括切割游离骨瓣,以便在手术结束时重新植入病理颅内结构。择期神经外科手术结束后,无严重脑水肿或癌性骨破坏的情况下,在钻孔窗内采用多种固定方法进行骨瓣移植是恢复颅骨形状、脑脊液动力学和脑灌注的标准手术。根据文献,择期神经外科开颅术后无菌性炎症伴骨瓣吸收的发生率并没有明确定义。对PUBMED数据库中医学出版物的分析显示,择期开颅手术后骨瓣吸收的报道很少,在图书馆数据库中搜索后没有发现任何报道。因此,关于择期神经外科开颅术后骨瓣吸收的报道数量有限,且该过程的病理生理机制尚不清楚。然而,所述的开颅并发症可导致骨瓣脱位、局部疼痛综合征的发展、外观缺陷和脑脊液动力学紊乱。这篇文章描述了一个在上矢状窦中间三分之一处切除脑膜瘤的开颅手术后骨瓣部分吸收的例子,这需要多次重复的神经外科干预。治疗结束时,切除部分吸收的骨瓣,植入单独的钛网植入物。
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Bone flap resorption after complications of in elective neurosurgery (case study)
Сraniotomy is an integral part of modern elective neurosurgery which involves cutting a free bone flap to provide access to pathological intracranial structures with its reimplantation at the end of surgery.Bone flap grafting in the trepanation window with various fixation methods in the end of elective neurosurgery in the absence of severe cerebral edema or cancer-induced bone destruction is a standard procedure that restores the skull shape, cerebrospinal fluid dynamics and cerebral perfusion.According to the literature, the incidence of aseptic inflammation with subsequent resorption of the bone flap after craniotomy in elective neurosurgery is not clearly defined.An analysis of medical publications in the PUBMED database showed few reports of bone flap resorption after elective craniotomy, and no reports were found after the search in the eLibrary database.Thus, the number of reports on the bone flap resorption after craniotomy in elective neurosurgery is limited, and the pathophysiology of this process remains unclear.However, the described complication of craniotomy can lead to the dislocation of a bone flap, the development of a local pain syndrome, a cosmetic defect, and disturbances in cerebrospinal fluid dynamics.The article describes an example of partial resorption of a bone flap after craniotomy for the removal of meningioma in the middle third of the superior sagittal sinus, which required a number of repeated neurosurgical interventions. The treatment was finished with the removal of a partially resorbed bone flap and implantation of an individual titanium mesh implant.
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