肥満と中頭蓋骨の安全性と関連性 自発的な脳脊髄液漏洩の修復
Hunter L Elms1, Douglas J Totten1, William R Schneider1
1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine.
まとめ
3級肥満の患者は,自発的な脳脊髄液漏れのために中部頭蓋骨の修復を受けていますが,合併症のリスクは増加していません. 肥満患者でも 治療は成功しています
科学分野:
- 神経外科
- 耳鼻喉科
- 肥満 医学
背景:
- 自発的な脳脊髄液漏れ (sCSF- Ls) は手術が必要になる可能性があります.
- 中間頭蓋骨穴 (MCF) の修復は,側頭骨のCSF漏れに対する一般的な外科的アプローチです.
- MCF修復後のアウトカムに対する病的な肥満の影響は十分に確立されていません.
研究 の 目的:
- 3級肥満 (BMI > 40 kg/ m2) の患者は,sCSF- Lsに対するMCF修復後に合併症のリスクが高いかどうかを判断する.
- 合併症の発生率と 肥満の発生率を比較する
主な方法:
- 高等学術センターでの回顧的なコホート研究
- 側頭骨のCSF漏れのためにMCF骨切除を施した成人患者 (> 18歳) を含む.
- 合併症は米国外科協会の重症度評価を用いて評価され,90日以内の不治の割合は肥満クラス間で比較された.
主要な成果:
- 合計124人の142人のCSF- Lを分析し,41. 9%が3級肥満であった.
- 最初の手術は97. 2%で成功し,平均滞在時間は2. 4日でした.
- 合併症の発生率,重症度,滞在期間,または継続的な漏れ率の有意な違いは,BMIのカテゴリー間で観察されなかった.
結論:
- クラス3の肥満は,MCF修復を必要とするsCSF- Lの患者で一般的です.
- MCFの修復は,経験豊富なセンターで,病的な肥満の患者に安全かつ効果的に実施できます.
- この患者群では高い成功率と低い合併症率を達成できます.
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