An 18-year-old male patient had developed epileptic seizures with loss of consciousness 3 years earlier, and despite subsequent drug treatment, he still had recurrent epileptic seizures. Imaging studies revealed a meningoencephalocele with protrusion of the temporal lobe from the middle cranial fossa to the lateral fossa of the sphenoid sinus. Since this was thought to be the focus of the temporal lobe epilepsy, he was admitted to our hospital for resection of the meningoencephalocele. The patient underwent transnasal endoscopic resection of the meningoencephalocele in the lateral fossa of the sphenoid bone, followed by multilayer skull base reconstruction using a pedicled middle turbinate mucosal (MT) flap. Postoperatively, the epileptic seizures disappeared, and the patient has recovered without cerebrospinal fluid leakage or wound complications. If the area is localized near the sphenopalatine foramen, such as the lateral fossa of the sphenoid sinus, an MT flap can be used instead of a nasal septal mucosal flap. Furthermore, by using a minimal transpterygoid approach and preserving the sphenopalatine artery and its branch, the middle turbinate artery, it was possible to use the MT flap during skull base reconstruction.
"},{"@language":"ja","@value":"症例は 18 歳、男性。3 年前に意識消失を伴うてんかん発作を発症、その後薬物治療を行うもてんかん発作を繰り返す状態であった。画像検査で中頭蓋窩から蝶形骨洞側窩に陥入する側頭葉の髄膜脳瘤を指摘され、側頭葉てんかんの焦点と考えられたため髄膜脳瘤切除目的に当院入院となった。経鼻内視鏡下に蝶形骨側窩の髄膜脳瘤を切除し、その後、有茎中鼻甲介粘膜弁を用いて多層での頭蓋底再建を行った。術後、てんかん発作は消失、髄液漏や創部の合併症なく経過している。蝶形骨洞側窩のように蝶口蓋孔近傍で限局した箇所であれば鼻中隔粘膜弁でなくても中鼻甲介粘膜弁での代用が可能で、minimal transpterygoid approach を用い、さらに蝶口蓋動脈とその分枝である中鼻甲介動脈を温存することで頭蓋底再建時に中鼻甲介粘膜弁の利用が可能となった。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410581003356491141","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MURAKAMI Daisuke"},{"@language":"ja","@value":"村上 大輔"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491145","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KUGA Daisuke"},{"@language":"ja","@value":"空閑 太亮"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院脳神経外科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491137","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KOMUNE Noritaka"},{"@language":"ja","@value":"小宗 徳孝"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"},{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491136","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MUKAE Nobutaka"},{"@language":"ja","@value":"迎 伸孝"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院脳神経外科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491140","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MIYAMOTO Yusuke"},{"@language":"ja","@value":"宮本 雄介"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"},{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491138","@type":"Researcher","foaf:name":[{"@language":"en","@value":"SUZUKI Tomoharu"},{"@language":"ja","@value":"鈴木 智陽"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491139","@type":"Researcher","foaf:name":[{"@language":"en","@value":"SAITO Yuichi"},{"@language":"ja","@value":"齋藤 雄一"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"},{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491142","@type":"Researcher","foaf:name":[{"@language":"en","@value":"HIGUCHI Ryota"},{"@language":"ja","@value":"樋口 良太"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491144","@type":"Researcher","foaf:name":[{"@language":"en","@value":"YOSHIMOTO Koji"},{"@language":"ja","@value":"吉本 幸司"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院脳神経外科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410581003356491143","@type":"Researcher","foaf:name":[{"@language":"en","@value":"NAKAGAWA Takashi"},{"@language":"ja","@value":"中川 尚志"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University"},{"@language":"ja","@value":"九州大学大学院医学研究院耳鼻咽喉科学分野"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"04477227"},{"@type":"EISSN","@value":"21851034"}],"prism:publicationName":[{"@language":"en","@value":"jibi to rinsho"},{"@language":"ja","@value":"耳鼻と臨床"},{"@language":"en","@value":"jibi to rinsho"},{"@language":"en","@value":"OTOLOGIA FUKUOKA"},{"@language":"ja","@value":"耳鼻"}],"dc:publisher":[{"@language":"en","@value":"JIBI TO RINSHO KAI"},{"@language":"ja","@value":"耳鼻と臨床会"}],"prism:publicationDate":"2023-03-20","prism:volume":"69","prism:number":"2","prism:startingPage":"116","prism:endingPage":"123"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2023177539"}],"availableAt":"2023-03-20","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E9%AB%84%E8%86%9C%E8%84%B3%E7%98%A4","dc:title":"髄膜脳瘤"},{"@id":"https://cir.nii.ac.jp/all?q=%E7%B5%8C%E9%BC%BB%E5%86%85%E8%A6%96%E9%8F%A1%E4%B8%8B%E9%A0%AD%E8%93%8B%E5%BA%95%E6%89%8B%E8%A1%93","dc:title":"経鼻内視鏡下頭蓋底手術"},{"@id":"https://cir.nii.ac.jp/all?q=%E9%A0%AD%E8%93%8B%E5%BA%95%E5%86%8D%E5%BB%BA","dc:title":"頭蓋底再建"},{"@id":"https://cir.nii.ac.jp/all?q=minimal%20transpterygoid%20approach","dc:title":"minimal transpterygoid approach"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%B8%AD%E9%BC%BB%E7%94%B2%E4%BB%8B%E7%B2%98%E8%86%9C%E5%BC%81","dc:title":"中鼻甲介粘膜弁"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2012429755"}]}