草刈機による左頭蓋・顔面損傷の1症例
草刈機による頭蓋・顔面損傷に内視鏡を用いた再建術が有効だった1例を報告する. 60歳男性. 草刈機操作中に転倒, 刈刃が左顔面を直撃し搬送された. 左前額から眼球・頬部に至る切創あり, CTでは左前頭骨から眼窩・頬骨の骨損傷に, 左前頭葉挫傷・気脳症を合併した. 脳神経外科・眼科・形成外科で緊急手術を実施. 切創直下の骨欠損部の上端に穿頭し, 眼窩までの幅3cmを開頭した. 硬膜損傷部より硬性鏡を挿入, 左前頭葉の血腫・骨片の除去, 前頭蓋底の損傷硬膜の剝離・切除・縫縮, 前頭洞粘膜の剝離と有茎の骨膜組織の充塡を行った. 経過は良好で, 内視鏡での観察により, 元の切創を用いた小術野から深部の...
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| Published in | 脳神経外科ジャーナル Vol. 28; no. 2; pp. 84 - 89 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脳神経外科コングレス
2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.28.84 |
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| Abstract | 草刈機による頭蓋・顔面損傷に内視鏡を用いた再建術が有効だった1例を報告する. 60歳男性. 草刈機操作中に転倒, 刈刃が左顔面を直撃し搬送された. 左前額から眼球・頬部に至る切創あり, CTでは左前頭骨から眼窩・頬骨の骨損傷に, 左前頭葉挫傷・気脳症を合併した. 脳神経外科・眼科・形成外科で緊急手術を実施. 切創直下の骨欠損部の上端に穿頭し, 眼窩までの幅3cmを開頭した. 硬膜損傷部より硬性鏡を挿入, 左前頭葉の血腫・骨片の除去, 前頭蓋底の損傷硬膜の剝離・切除・縫縮, 前頭洞粘膜の剝離と有茎の骨膜組織の充塡を行った. 経過は良好で, 内視鏡での観察により, 元の切創を用いた小術野から深部の硬膜・頭蓋底の処置が可能であった. |
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| AbstractList | 草刈機による頭蓋・顔面損傷に内視鏡を用いた再建術が有効だった1例を報告する. 60歳男性. 草刈機操作中に転倒, 刈刃が左顔面を直撃し搬送された. 左前額から眼球・頬部に至る切創あり, CTでは左前頭骨から眼窩・頬骨の骨損傷に, 左前頭葉挫傷・気脳症を合併した. 脳神経外科・眼科・形成外科で緊急手術を実施. 切創直下の骨欠損部の上端に穿頭し, 眼窩までの幅3cmを開頭した. 硬膜損傷部より硬性鏡を挿入, 左前頭葉の血腫・骨片の除去, 前頭蓋底の損傷硬膜の剝離・切除・縫縮, 前頭洞粘膜の剝離と有茎の骨膜組織の充塡を行った. 経過は良好で, 内視鏡での観察により, 元の切創を用いた小術野から深部の硬膜・頭蓋底の処置が可能であった. |
| Author | 松岡, 賢樹 津野, 隆哉 岡田, 憲二 太田, 剛史 政平, 訓貴 福田, 真紀 竹村, 光広 |
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| References | 11) Thorp BD, Sreenath SB, Ebert CS, Zanation AM : Endoscopic skull base reconstruction : a review and clinical case series of 152 vascularized flaps used for surgical skull base defects in the setting of intraoperative cerebrospinal fluid leak. Neurosurg Focus 37 : 1-7, 2014. 2) Archer JB, Sun H, Bonney PA, Zhao YD, Hiebert JC, Sanclement JA, Little AS, Sughrue ME, Theodore N, James J, Safavi-Abbasi S : Extensive traumatic anterior skull base fractures with cerebrospinal fluid leak : classification and repair techniques using combined vascularized tissue flaps. J Neurosurg 3 : 647-656, 2016. 13) Tsai TY, Lee LA, Chao WC, Lee YC : Bidirectional management of a transnasal intracranial chopstick transecting optic nerve. J Craniofac Surg 29 : 398-402, 2018. 6) Feldman JS, Farnoosh S, Kellman RM, Tatum SA 3rd : Skull base trauma : clinical considerations in evaluation and diagnosis and review of management techniques and surgical approaches. Semin Plast Surg 31 : 177-188, 2017. 10) Shadymov AB, Rykunov IA : On the formation of open skull fractures inflicted by cutting objects. Sud Med Ekspert 57 : 52-56, 2014. 15) Zhao D, Tao S, Zhang D, Qin M, Bao Y, Wu A : “Five-layer gasket seal” watertight closure for reconstruction of the skull base in complex bilateral traumatic intraorbital meningoencephaloceles : a case report and literature review. Brain Inj 32 : 804-807, 2018. 8) Milton J, Rugino A, Narayan K, Karas C, Awuor V : A case-based review of the management of penetrating brain trauma. Creus 9 : 1-7, 2017. 16) Zweckberger K, Jung C, Unterberg A, Schick U : Transorbital penetrating skull-base injuries : two severe cases with wooden branches and review of the literature. Cent Eur Neurosurg 72 : 201-205, 2011. 3) Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger J ; Surgical Management of Traumatic Brain Injury Author Group : Surgical management of depressed cranial fractures. Neurosurgery 58 (3 Suppl) : S56-60, 2006. 1) Adams AS, Francis DO, Russell PT : Outcomes of outpatient endoscopic repair of cerebrospinal fluid rhinorrhea. Int Forum Allergy Rhinol 11 : 1126-1130, 2016. 4) Zhang D, Chen J, Han K, Yu M, Hou L : : Management of penetrating skull base injury : a single institutional experience and review of the literature. Biomed Res Int 2017 : 2838167, 2017. 14) Wu R, Ye Y, Liu C, Yang C, Qin H : Management of penetrating brain injury caused by a nail gun : three case reports and literature review. World Neurosurg 112 : 143-147, 2018. 7) Ghadersohi S, Ference EH, Detwiller K, Kern RC : Presentation, workup, and management of penetrating transorbital and transnasal injuries : A case report and systematic review. Am J Rhinol Allergy 31 : 29-34, 2017. 9) Piski Z, Büki A, Nepp N, Burián A, Révész P, Gerlinger I : Closure of nasocranial fistulas with “bath-plug” technique and multilayer reconstruction. Ideggyogy Sz 69 : 211-216, 2016. 5) Ehrlich G, Kindling S, Wenz H, Hänggi D, Schulte DM, Schmiedek P, Seiz-Rosenhagen M : Immediate titanium mesh implantation for patients with postcraniotomy neurosurgical site infections : safe and aesthetic alternative procedure? World Neurosurg 99 : 491-499, 2017. 12) Turco L, Cornell DL, Phillips B : Penetrating bihemispheric traumatic brain injury : a collective review of gunshot wounds to the head. World Neurosurg 104 : 653-659, 2017. |
| References_xml | – reference: 1) Adams AS, Francis DO, Russell PT : Outcomes of outpatient endoscopic repair of cerebrospinal fluid rhinorrhea. Int Forum Allergy Rhinol 11 : 1126-1130, 2016. – reference: 9) Piski Z, Büki A, Nepp N, Burián A, Révész P, Gerlinger I : Closure of nasocranial fistulas with “bath-plug” technique and multilayer reconstruction. Ideggyogy Sz 69 : 211-216, 2016. – reference: 2) Archer JB, Sun H, Bonney PA, Zhao YD, Hiebert JC, Sanclement JA, Little AS, Sughrue ME, Theodore N, James J, Safavi-Abbasi S : Extensive traumatic anterior skull base fractures with cerebrospinal fluid leak : classification and repair techniques using combined vascularized tissue flaps. J Neurosurg 3 : 647-656, 2016. – reference: 13) Tsai TY, Lee LA, Chao WC, Lee YC : Bidirectional management of a transnasal intracranial chopstick transecting optic nerve. J Craniofac Surg 29 : 398-402, 2018. – reference: 11) Thorp BD, Sreenath SB, Ebert CS, Zanation AM : Endoscopic skull base reconstruction : a review and clinical case series of 152 vascularized flaps used for surgical skull base defects in the setting of intraoperative cerebrospinal fluid leak. Neurosurg Focus 37 : 1-7, 2014. – reference: 16) Zweckberger K, Jung C, Unterberg A, Schick U : Transorbital penetrating skull-base injuries : two severe cases with wooden branches and review of the literature. Cent Eur Neurosurg 72 : 201-205, 2011. – reference: 8) Milton J, Rugino A, Narayan K, Karas C, Awuor V : A case-based review of the management of penetrating brain trauma. Creus 9 : 1-7, 2017. – reference: 7) Ghadersohi S, Ference EH, Detwiller K, Kern RC : Presentation, workup, and management of penetrating transorbital and transnasal injuries : A case report and systematic review. Am J Rhinol Allergy 31 : 29-34, 2017. – reference: 5) Ehrlich G, Kindling S, Wenz H, Hänggi D, Schulte DM, Schmiedek P, Seiz-Rosenhagen M : Immediate titanium mesh implantation for patients with postcraniotomy neurosurgical site infections : safe and aesthetic alternative procedure? World Neurosurg 99 : 491-499, 2017. – reference: 15) Zhao D, Tao S, Zhang D, Qin M, Bao Y, Wu A : “Five-layer gasket seal” watertight closure for reconstruction of the skull base in complex bilateral traumatic intraorbital meningoencephaloceles : a case report and literature review. Brain Inj 32 : 804-807, 2018. – reference: 3) Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger J ; Surgical Management of Traumatic Brain Injury Author Group : Surgical management of depressed cranial fractures. Neurosurgery 58 (3 Suppl) : S56-60, 2006. – reference: 12) Turco L, Cornell DL, Phillips B : Penetrating bihemispheric traumatic brain injury : a collective review of gunshot wounds to the head. World Neurosurg 104 : 653-659, 2017. – reference: 10) Shadymov AB, Rykunov IA : On the formation of open skull fractures inflicted by cutting objects. Sud Med Ekspert 57 : 52-56, 2014. – reference: 14) Wu R, Ye Y, Liu C, Yang C, Qin H : Management of penetrating brain injury caused by a nail gun : three case reports and literature review. World Neurosurg 112 : 143-147, 2018. – reference: 4) Zhang D, Chen J, Han K, Yu M, Hou L : : Management of penetrating skull base injury : a single institutional experience and review of the literature. Biomed Res Int 2017 : 2838167, 2017. – reference: 6) Feldman JS, Farnoosh S, Kellman RM, Tatum SA 3rd : Skull base trauma : clinical considerations in evaluation and diagnosis and review of management techniques and surgical approaches. Semin Plast Surg 31 : 177-188, 2017. |
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| Snippet | 草刈機による頭蓋・顔面損傷に内視鏡を用いた再建術が有効だった1例を報告する. 60歳男性. 草刈機操作中に転倒, 刈刃が左顔面を直撃し搬送された. 左前額から眼球・頬部に... |
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| Title | 草刈機による左頭蓋・顔面損傷の1症例 |
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