引言侧颅底肿瘤通常需要神经外科医生和神经科医师之间的合作以进行手术方法。三种主要的经骨手术方法是乙状窦后(RS),跨迷宫(TL),和中间窝(MF)。文献反映了关于这些方法的各种闭合技术和术后并发症的相对匮乏。我们进行了系统的回顾,比较了每种方法的闭包技术。方法采用OvidMEDLINE(1990-2016)对经侧颅底手术的患者进行了系统评价。RS,或MF方法。如果研究包含至少10名患者,描述了他们的闭合技术,并提供了有关术后并发症的数据。结果共回顾了1403项研究。其中,53项研究符合纳入标准,在这项分析中总共有10,466名受试者。TL法脑脊液漏的平均发生率为5.3%,9%的RS方法,MF方法为6.2%。在MF入路中,各种闭合技术对术后伤口并发症没有显着影响。确定了影响RS和TL方法术后伤口并发症的多种因素。结论侧颅底手术的闭合技术较多。本综述确定了几种可能影响侧颅底手术术后伤口并发症发生率的技术。
Introduction Tumors of the lateral skull base often require collaboration between neurosurgeons and neurotologists for the surgical approach. The three main transosseous surgical approaches are retrosigmoid (RS),
translabyrinthine (TL), and middle fossa (MF). The literature reflects a relative paucity regarding the various closure techniques for these approaches and the postoperative complications. We have performed a systematic
review comparing closure techniques from each approach. Methods A systematic
review was performed using Ovid MEDLINE (1990-2016) on closure technique and postoperative complications for patients undergoing lateral skull base surgery via the TL, RS, or MF approach. Studies were included if they contained at least 10 patients, described their closure technique, and provided data on postoperative complications. Results A total of 1,403 studies were reviewed. Of these, 53 studies met inclusion criteria yielding a total of 10,466 subjects in this analysis. The average rate of cerebrospinal fluid leak was 5.3% in the TL approach, 9% in the RS approach, and 6.2% in the MF approach. There was no significant effect of various closure techniques on postoperative wound complications in the MF approach. Multiple factors were identified which affected postoperative wound complication in the RS and TL approaches. Conclusion There are a plethora of closure techniques for lateral skull base surgery. Several techniques were identified in this
review that may affect the postoperative wound complication rates in lateral skull base surgery.