“小骨片”支架成形术修补额窦大缺损的初步探讨

目的探究“小骨片”支架成形术在修补额窦(FS)大缺损的应用。方法回顾性研究哈尔滨医科大学附属第一医院神经外科2021年5月—2023年8月间收治的10例行前额底入路并使用“小骨片”支架进行FS重建的患者。结果10例患者中，2例颅咽管瘤、1例垂体瘤、1例胶质瘤、1例动脉瘤、5例脑膜瘤；4例患者彻底清除FS黏膜，6例患者黏膜无特殊处理，术后随访1～26个月，平均10.3个月，随访显示所有患者均无脑脊液漏、术后感染或粘液囊肿。结论“小骨片”支架成形术简单、有效，可以恢复FS的形态，保留生理功能，避免术后并发症。

Objective To explore the application of “small bone pieces” stenting in reconstruction of large frontal sinus(FS) defects. Methods 10 patients admitted to Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University from May 2021 to August 2023, who underwent FS reconstruction using “small bone pieces” stenting via the anterior frontal floor approach were analyzed retrospectively. Results 10 patients included 2 craniopharyngiomas, 1 pituitary tumor, 1 glioma, 1 aneurysm, and 5 meningiomas. 4 patients had severe mucosal violation requiring removal, while 6 with no special treatment for mucosa. Postoperative follow-up was 1 month to 26 months, with an average of 10.3 months. Clinical follow-up showed no cerebrospinal fluid leak, postoperative infection, or mucoceles in any patient. Conclusion Reconstruction with “small bone pieces” stenting is simple and effective, and it can restore the FS morphology, preserve physiological functionality, and avoid postoperative complications.