复杂的面骨折的手术治疗
Giuseppe Talamonti1, Maria Fragale2, Erika Carrassi1
1Department of Neurosurgery, ASST Niguarda, Milan, Italy.
World neurosurgery
|December 29, 2023
概括
一个单阶段的结合神经外科 - 面外科手术有效治疗严重的面骨折,提供了优秀的神经和功能结果,降低了风险. 这种方法优先考虑患者的安全,并最大限度地减少像CSF泄漏这样的并发症.
科学领域:
- 神经外科 神经外科
- 面外科手术 面外科手术
- 创伤外科 手术 创伤外科
背景情况:
- 严重的面骨折带来了复杂的挑战,需要仔细管理内和面部损伤.
- 对前头骨底部和面部骨折的最佳治疗策略仍然是争论的主题.
研究的目的:
- 为了评估复杂的面骨折的单阶段结合神经外科 - 面外科手术策略的结果.
- 评估这种综合方法在治疗严重头部和面部创伤方面的安全性和有效性.
主要方法:
- 对33名患有复杂前脑和面部骨架骨折的患者进行了回顾性审查.
- 排除因内血栓或穿透性损伤需要紧急手术的患者.
- 通过神经外科和大面部团队进行标准化的单阶段手术重建.
主要成果:
- 报告了一例死亡;在手术期间持续观察到嗅觉损伤.
- 没有粘膜细胞,反复的脑脊液 (CSF) 泄漏或部感染病例.
- 在患者队列中实现了高度令人满意的功能和神经结果.
结论:
- 单阶段治疗提供了优势,包括减少脸部骨折减少和避免分阶段程序期间CSF泄漏的风险.
- 仔细考虑手术时间,理想情况下是创伤后10-14天,平衡神经外科和面部偏好,以获得最佳结果.
- 这种综合方法为复杂的面创伤提供了安全有效的解决方案.
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