CN102028561B - Basis cranii repairing body - Google Patents

Abstract

The present invention relates to a surgical article, in particular to a skull base prosthesis, which is characterized in that the prosthesis consists of a fungus-shaped support (1) made of medical silica gel and a fungus-shaped support (1) made of medical silica gel. The stalk-shaped expansion body (2) is connected up and down to form a mushroom shape, wherein the expansion body (2) is a hollow thin-walled structure, and a conduit (3) extends upward from the middle of the bottom surface, and the conduit (3) The upper end is connected with the support body (1), and the outer wall of the lower end is integrated with the bottom surface of the expansion body (2), so that the space in the expansion body (2) is annular; the annular space in the expansion body (2) is filled with There is medical polymer water-absorbing resin equivalent to 1-5% of the volume of the annular space, and the wall of the conduit (3) is provided with a water inlet hole (4) communicating with the annular space in the expansion body (2) . The cranial base prosthesis of the present invention can not only be used for cranial base repair with large defects, but also requires a relatively small surgical approach.

Description

a skull base prosthesis

technical field

The invention relates to surgical supplies, in particular to a repairing material for repairing skull base defects.

Background technique

Neuroendoscopy is a technology that uses endoscopes with a diameter of 0.2-0.6 cm to treat intracranial lesions. With the development of neuroendoscopic techniques, it has become a routine treatment to resect tumors in the sellar region and parasellar region of the skull base through extended transsphenoidal approach. However, large skull base bone, dura mater, and local soft tissue defects often occur after resection of the lesion, which increases the possibility of postoperative complications such as cerebrospinal fluid leakage, meningitis, pneumocranium, and encephalocele. Cerebrospinal fluid leakage is the most common complication after the enlarged transsphenoidal approach. In order to prevent cerebrospinal fluid leakage, it is necessary to reconstruct the defect of the skull base after surgery. At present, there are many clinical methods for the reconstruction of skull base defects after transsphenoidal enlarged approach surgery. For example, when the skull base defect is less than 0.5cm, it can be repaired by filling with mucosa and gelatin sponge; skull base defect When the defect size is 0.5-1.2 cm, it can be repaired by filling with mucosa, gelatin sponge and artificial dura mater; when the skull base defect is larger than 2.0 cm, artificial dura mater and bioprotein glue can be used to repair the dura mater defect , In addition, it is necessary to use autologous tissue or titanium alloy mesh to repair the bony defect of the skull base (ie fistula). However, the application of autologous tissue in clinical practice will cause fat liquefaction, and at the same time, the autologous tissue will increase the pain of the patient and prolong the operation time; when the titanium alloy mesh is used, due to its relatively fixed shape, when the fistula is large Therefore, it is necessary to expand the surgical approach to put it in, which not only increases the workload of the operation, but also increases the pain of the patient.

Contents of the invention

In view of the deficiencies in the prior art, the technical problem to be solved by the present invention is to provide a surgical article for repairing a skull base defect under a neuroendoscope, which can not only repair a skull base injury with a large defect area, but also require less surgical access. Relatively small.

The technical scheme that the present invention solves the above problems is as follows:

A skull base prosthesis, characterized in that the prosthesis is made of a fungus-shaped support made of medical silica gel and a fungus-shaped expansion body made of medical silica gel connected up and down to form a fungus, wherein , the expansion body is a hollow thin-walled structure, a conduit extends upward from the middle of its bottom surface, the upper end of the conduit is connected to the support body, and the outer wall of the lower end is integrated with the bottom surface of the expansion body, so that the space in the expansion body is annular ; The annular space in the expansion body is filled with medical polymer water-absorbing resin equivalent to 1% to 5% of the volume of the annular space, and the wall of the catheter is provided with a water inlet communicating with the annular space in the expansion body hole.

In the cranial base prosthesis according to the present invention, the diameter of the bottom surface of the expansion body is larger than the diameter of the joint surface with the supporting body, so as to further improve the anti-falling effect.

A skull base prosthesis according to the present invention, wherein the medical high-molecular water-absorbent resin can be a super-absorbent material obtained by chemically modifying the natural high-molecular material chitosan and its derivatives. The specific preparation method can refer to the preparation method disclosed in the invention patent No. 200410080300.1 to prepare by yourself, or it can be a similar product purchased on the market.

In the cranial base prosthesis of the present invention, the medical polymer water-absorbing resin filled in the expansion body can not only quickly absorb hundreds or even thousands of times its own weight of water to form a hydrogel to expand, but also Pressurized water will not precipitate. Therefore, during the operation, water can be injected into the expansion body through the water inlet on the catheter so that the volume can expand rapidly, and the closure of the skull base fistula can be realized. In addition, medical silica gel not only has good strength, but also has good biocompatibility, so it can be in contact with the defective dura mater for a long time, and can provide strong support for the regeneration of meningeal cells at the skull base.

The skull base prosthesis of the present invention has the following beneficial effects:

1. Since both the support body and the expansion body are made of medical silicone, and the expansion body is a hollow thin-walled structure, the entire prosthesis can be compressed before water injection, that is, it has a small initial volume, so there is no need to expand the surgical approach It can be placed into the skull base, especially when repairing large skull base defects.

2. The internal pressure generated after the medical polymer water-absorbing resin absorbs water and expands makes the outer surface of the expansion body closely fit the fistula opening, and the sealing effect is very remarkable.

3. The internal pressure generated after the medical polymer water-absorbent resin absorbs water and expands can cause the catheter to deform and shrink, automatically and quickly seal the water inlet, and prevent water from overflowing before it is completely absorbed by the medical polymer water-absorbent resin , which not only eliminates the procedure of blocking the water inlet, but also improves the effect of preventing water expansion.

Description of drawings

Fig. 1 and Fig. 2 are schematic structural views of a specific embodiment of the skull base prosthesis according to the present invention, wherein Fig. 1 is a front view, and Fig. 2 is a sectional view along A-A of Fig. 1 .

Fig. 3 is a usage state diagram of the embodiment shown in Fig. 1 and Fig. 2 .

Fig. 4 is a schematic structural view of another specific embodiment of the skull base prosthesis according to the present invention.

Detailed ways

Example 1

Referring to Figure 1 and Figure 2, the entire prosthetic body is in the shape of a fungus, the upper supporting body 1 is in the shape of a fungus, and the lower expansion body 2 is in the shape of a fungus handle, both of which are made of medical silicone and connected up and down by heat sealing together. As shown in FIG. 1 and FIG. 2 , the expansion body 2 is a hollow thin-walled structure, and the diameter of the joint surface with the support body 1 is smaller than the diameter of the bottom surface, and is in the shape of a truncated cone. A conduit 3 is extended upwards from the center of the bottom surface of the expansion body 2, and a water inlet hole 4 is provided on the pipe wall of the conduit 3. Its upper end is heat-bonded with the support body 1, and the outer wall of the lower end is integrated with the bottom surface of the expansion body 2. Make the space in the expansion body 2 ring-shaped. The annular space in the expansion body 2 is filled with medical polymer water-absorbing resin 5, and its filling amount is 1% of the volume of the annular space. Referring to Fig. 3, the conduit 3 communicates with the above-mentioned annular space through the water inlet hole 4, and after injecting water into the annular space through the conduit 3 through the water inlet hole 4, the medical polymer water-absorbent resin 5 expands rapidly, forcing the expansion body 2 to expand into a flat drum shape .

Example 2

Referring to Fig. 4, the difference between this embodiment and embodiment 1 is that the shape of the expansion body 2 is cylindrical; the support body 1 and the expansion body 2 are bonded together up and down with an adhesive; The filling amount of polymer water-absorbing resin 5 in the annular space of 2 is 5% of the volume of the annular space.

Below in conjunction with the accompanying drawings, the skull base prosthesis of the present invention is applied to the method of repairing the skull base defect after the pituitary tumor is resected through the enlarged disc operation approach and is described as follows:

Referring to Figures 1 to 3, under the guidance of the neuroendoscope, the prosthetic body is delivered to the sphenoid sinus through the enlarged disc surgery approach, and the supporting body 1 is placed into the pituitary fossa 8 through the fistula opening on the disc bone 6, The expansion body 2 stretches out of the fistula opening and stays in the sphenoid sinus. The upper surface of the supporting body 1 is in contact with the defective dura mater of the pituitary gland 7 and plays a supporting role on the dura mater. to the blocking effect. At this time, water is injected into the expansion body 2 through the conduit 3 in the expansion body 1 through the water inlet 4, and the medical polymer water-absorbing resin 5 in the expansion body 2 expands rapidly after absorbing water, and the fistula on the disc bone 6 is blocked; At the same time, the catheter 3 in the expansion body 2 is automatically attached and closed under the expansion pressure of the medical polymer water-absorbing resin 5 (see FIG. 3 ).

Claims (2)

1. a basis cranii repairing body is characterized in that, the expander that is gill fungus handle shape (2) that this repairing body is processed by supporting mass that is the gill fungus umbrella (1) that adopts medical silica-gel to process and employing medical silica-gel connects into the mushroom fungus shape up and down; Wherein, Described expander (2) is hollow thin-wall construction, and the middle part of its bottom surface extends upward a conduit (3), and the upper end of this conduit (3) is connected with supporting mass (1); The bottom surface of the outer wall of lower end and expander (2) fuses, and makes that the space in the expander (2) is annular; Be filled with 1～5% the medical high polymer water-absorbing resin that is equivalent to said annular space volume in the annular space in the described expander (2), the wall of described conduit (3) is provided with the inlet opening (4) that is communicated with the interior annular space of expander (2).

2. a kind of basis cranii repairing body according to claim 1 is characterized in that, the bottom surface diameter of described expander (2) is greater than the diameter of itself and supporting mass (1) faying face.

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