Abstract：
During the past decades, different methods have been described for anterior skull base reconstruction. Regarding larger skull base defects, few investigators have described the use of bone grafts to foster support and prevent frontal lobe sagging, herniation, or falling. The aim of this study is to describe the use of a rib bone graft, which could be an option in these cases due to its rigidity and dimensions.
We retrospectively collected preoperative, intraoperative, and postoperative data at the last follow-up of 10 patients who underwent multilayer anterior skull base reconstruction, including rib bone graft, for large anterior cranial base defects at 2 tertiary care academic hospitals.
Eight patients underwent endoscopic craniectomy for sinonasal malignancies, and the other two underwent transnasal endoscopic surgery for congenital meningoencephalocele. Anterior skull base defects measured on average 3.8 cm ± 0.9 SD antero-posteriorly (range 2.5-5 cm) and 2.3 ± 0.9 SD latero-laterally (range 0.9-4 cm). Multilayer reconstruction was performed in all cases, including a rib bone graft positioned as intracranial extradural layer. No patient experienced thoracic complications during the postoperative period. No side effects related to the bone graft or meningoencephalocele occurrence were reported after a mean follow-up of 8.0 ± 6.3 months.
The use of a cortical rib bone graft could be a safe and effective option in skull base reconstruction when managing large defects after cancer removal.
We retrospectively collected preoperative, intraoperative, and postoperative data at the last follow-up of 10 patients who underwent multilayer anterior skull base reconstruction, including rib bone graft, for large anterior cranial base defects at 2 tertiary care academic hospitals.
Eight patients underwent endoscopic craniectomy for sinonasal malignancies, and the other two underwent transnasal endoscopic surgery for congenital meningoencephalocele. Anterior skull base defects measured on average 3.8 cm ± 0.9 SD antero-posteriorly (range 2.5-5 cm) and 2.3 ± 0.9 SD latero-laterally (range 0.9-4 cm). Multilayer reconstruction was performed in all cases, including a rib bone graft positioned as intracranial extradural layer. No patient experienced thoracic complications during the postoperative period. No side effects related to the bone graft or meningoencephalocele occurrence were reported after a mean follow-up of 8.0 ± 6.3 months.
The use of a cortical rib bone graft could be a safe and effective option in skull base reconstruction when managing large defects after cancer removal.
摘要：
目的：在过去的几十年中，已经描述了用于前颅底重建的不同方法。关于更大的颅底缺陷，很少有作者描述了使用骨移植物来促进支持，以防止额叶下垂，疝或坠落。这项研究的目的是描述肋骨骨移植的使用，在这些情况下，其刚度和尺寸可能是一个选择。
方法：我们回顾性收集术前，最后一次随访的10例患者的术中和术后数据，这些患者在两家三级护理学术医院接受了多层前颅底重建，包括肋骨骨移植治疗大的前颅底缺损。
结果：8例患者接受了鼻内镜下颅骨切除术治疗鼻窦恶性肿瘤，另外两人接受了经鼻内镜手术治疗先天性脑膜脑囊肿。前颅底缺损的前后平均测量为38.0mm±9.1SD（25-50mm），侧向平均测量为23.4±8.6SD（8.5-40mm）。在所有情况下都进行了多层重建，包括位于颅内硬膜外层的肋骨骨移植物。术后无患者出现胸部并发症。平均随访8.0个月±6.3SD后，未报告与骨性移植或脑膜脑膨出相关的副作用。
结论：当处理肿瘤切除后的大缺损时，皮质肋骨骨移植可能是颅底重建中安全有效的选择。
方法：我们回顾性收集术前，最后一次随访的10例患者的术中和术后数据，这些患者在两家三级护理学术医院接受了多层前颅底重建，包括肋骨骨移植治疗大的前颅底缺损。
结果：8例患者接受了鼻内镜下颅骨切除术治疗鼻窦恶性肿瘤，另外两人接受了经鼻内镜手术治疗先天性脑膜脑囊肿。前颅底缺损的前后平均测量为38.0mm±9.1SD（25-50mm），侧向平均测量为23.4±8.6SD（8.5-40mm）。在所有情况下都进行了多层重建，包括位于颅内硬膜外层的肋骨骨移植物。术后无患者出现胸部并发症。平均随访8.0个月±6.3SD后，未报告与骨性移植或脑膜脑膨出相关的副作用。
结论：当处理肿瘤切除后的大缺损时，皮质肋骨骨移植可能是颅底重建中安全有效的选择。
