반복적인 두개내 감염에서 유리대망피판을 이용한 경질막 재건

• 영문명: Dural Reconstruction in Refractory Cranial Infection using Omental Free Flap
• 발행기관: 대한두개저학회
• 저자명: 이훈영(Hoon Young Lee) 은석찬(Seok Chan Eun) 한정호(Jung Ho Han) 방재승(Jae Seung Bang) 김재용(Chae Yong Kim) 박도중(Do-joong Park) 백롱민(Rong Min Baek)
• 간행물 정보: 『대한두개저학회지』제6권 제1호, 29~34쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2011.06.30

영문 초록

Purpose : Postoperative cerebrospinal fluid (CSF) leakage after neurosurgery could lead to potentially lethal complications. Reoperations, multiple operations, cranial radiotherapy and poor vascularization of the dura graft may lead to delayed healing of the suture site and resultant persistent CSF leaks. In this report, we present a technical experience of duroplasty with omental free flap. Methods : Between 2007 and 2011, the authors performed duraplasty in nine patients with recurrent subdural empyema and intracranial infection. The omental free flap transfer was intended for patients who could not be cured with conventional surgical debridement and lyophilized dura appliance. Patient ages ranged from 14 to 47 years (mean, 31.5 yr). There were five men and four women. Treatment was required for malignant tumors (n=4), cerebral hematomas (n=3) and the result of traumas (n=2). After harvesting the omentum laparoscopically, the flap was sutured to the dural defect in a watertight fashion. The most commonly used recipient vessels were the superficial temporal artery and vein. Results : The postoperative course was uneventful and flap survival was excellent in all patients. Cerebrospinal fluid leaks were controlled successfully. Patients were discharged with no evidence of wound discharge and there were no reports of infection or CSF leakage recurrence. Conclusion : Duraplasty using omental flap is an effective technique to control CSF leaks, especially when dura is poorly vascularized and less viable. The delicate nature and great pliability of the omental flap make it unique and competent for reconstructions of dural defects.

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키워드

CSF leakage Dural reconstruction Omental flap Cranial infections