FIELD: medicine; neurosurgery.
SUBSTANCE: invention can be used for decompression of the posterior cranial fossa with Chiari malformation type 1. A skin incision is made in the cervical-occipital region along the midline, and soft tissue dissection is made along the white line. Using a bur, the outer part of the occipital bone in the area of trephination is ground down, after which the inner part of the occipital bone is bitten out with pliers, the arch of the first cervical vertebra is resected, and the atlanto-occipital membrane is removed. An incision is made in the dura mater from the level of the projection of the cerebellar hemisphere to the level of the first cervical vertebra, preserving the arachnoid membrane of the cistern magna. Expansive plastic surgery of the dura mater is performed. The surgical wound is tightly sutured layer by layer and the presence of postoperative complications is monitored. The outer part of the occipital bone, ground down with a bur, is the outer bone plate and the spongy substance of the occipital bone, and the inner part of the occipital bone, bitten by the nippers, is the inner bone plate of the occipital bone. The incision of the dura mater can be S-shaped or linear, and expansive plastic surgery of the dura mater is performed using an autograft of the fascia lata of the femur. To monitor the presence of postoperative complications, high-resolution computed tomography of the brain is performed in the multislice computed tomography mode with a slice thickness of 0.5 mm, and to monitor the presence of postoperative complications, magnetic resonance imaging of the brain is performed in T1, T2, FLAIR modes without any contrast enhancement.
EFFECT: method minimizes the risk of damage to the dura mater and the arachnoid membrane of the cistern magna, reduces the number of postoperative complications and improves the outcomes of surgical treatment due to the safety of trephination of the occipital bone and arch of the first cervical vertebra and expansive plastic surgery of the dura mater.
6 cl, 4 dwg, 1 ex
