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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。
Objective To explore the feasibility of nasal endoscopic surgery for the treatment of nasal encephalocele and to establish the basic principles of clinical treatment. Methods Endoscopic removal of endometrial encephalocele in 5 cases was performed by endoscopic resection, resection, incision and so on. According to the different conditions of skull base defect, muscle, fascia, cartilage and bone were used to repair the skull base . Results All the 5 cases were cured by one operation. No complications occurred except one case of postoperative intracranial infection (meningitis). No recurrence was observed in one to five years follow-up. Conclusion The intracerebral meningoencephalitis can be done by endoscopic sinus surgery. The skull base defect with diameter less than 0.5 cm can be repaired by muscle packing and fascia covering. The skull base defect with diameter more than 0 5 cm should be made with cartilage or Bone closure defects, and then covered with muscle packing and fascia to prevent recurrence.