두개저병변의 수술적치료 및 재건후 장기추적관찰에 대한 고찰 = Contemplations on long term follow up after operative treatment and reconstruction of skull base lesions

다국어 초록 (Multilingual Abstract)

Purpose Skull base regions are composed of complex anatomic structures that are prone to fatal complications such as meningitis, cerebrospinal fluid leakage, and injuries in vessels and nerves. The proper reconstruction based on keen analysis of the lesion and the patient’ s status facilitates the restoration of the anatomical structures and minimizes complications. Patients and methods A retrospective review of patients who underwent reconstruction of skull base lesions was carried out. Cases from September 1992 to August 2011 were reviewed and their postoperative results were evaluated. Results The medical records of forty-seven patients were retrospectively analyzed . Based on the Irish classification of skull base, nineteen cases had lesions in region I, seven cases in region II, eleven cases in region III, seven cases in region I + II, and three cases in region I + II + III. Thirty free flaps and seventeen bone grafts were performed for reconstruction of the skull base. Free flap was selected over bone graft for patients who either had a history of adjuvant therapy, or had lesions in region II, III, or I + II. Conclusion The various, complex defects in skull base were successfully reconstructed by one-stage operation. Free flap was preferred over bone graft and pedicled flap. However, the surgeons should decide the methods of reconstruction through analysis of the location of the lesions, contents of defect, sealing ability between intracranial space and nasopharynx, and the history of or postoperative possibility of adjuvant therapy.

목차 (Table of Contents)

• 서론 재료 및 방법 결과 증례 1 증례 2 고찰 결론