METHOD FOR SEALING AND MAKING PLASTIC REPAIR OF CRANIUM BASE DEFECT

摘要

FIELD: medicine. SUBSTANCE: method involves performing plastic repair of dura mater encephali defect with unconstraint congruent graft. Broad femur fascia or plastic material like artificial dura mater encephali are used. The dura mater encephali of cranium base is sutured in the defect area along its boundary in four angular points using tread- like holders. The congruent graft is sutured in symmetrical way with one end of the thread-like holder making 2-3 mm wide deviation from the boundary. The graft size is to be selected 4-6 mm larger than the dura mater encephali defect size. Then the graft is descended towards the dura mater encephali defect area using the thread- like holders. The graft edges overlap the dura mater encephali defect edges on the cranium cavity side. The graft is fixed in this position with interrupted surgical sutures using the thread-like holders for fixing it. Large size dura mater encephali defect being greater than 10-15 mm in diameter, sutures fixing the graft attachment to the dura mater encephali defect edges are stitched in addition along the perimeter after descending and fixing the graft with the thread-like holders on the defect sides. Bone defect in the cranium base is covered with the congruent graft. Turkish saddle defect (in performing transnasal access ) is covered with bony portion of nasal septum. Cranium clivus defect is treated using bone shaving and/or congruent graft taken from iliac crest. No bone autograft being available, the bone defect is covered with hydroxyapatite implant. EFFECT: improved surgical treatment results in treating cranium base tumors; reliability in sealing cranial cavity; prevented complications. 7 cl, 8 dwg