periosteal sinus resection

The skull periosteal sinus is less common and occurs mostly in adolescents. The disease is essentially a vascular mass composed of venous blood vessels without muscle layer in the periosteum of the skull, and communicates with the intracranial large sinus (mostly the superior sagittal sinus) through the venous veins and blood vessels of different thicknesses. The reasons for its formation can be divided into three types: traumatic, congenital and spontaneous, which occur in the forehead and top. Its symptom characteristics are that the mass increases with the head position and cough, etc., and can shrink or disappear when lying or standing up, and the mass can also increase when the jugular vein is pressed. At the time of diagnosis, it was suggested that an angiogram or a local mass could be directly injected into the contrast agent to confirm the diagnosis. At present, many advocate surgical treatment. Treatment of diseases: skull sinus Indication 1. The mass gradually increased and did not improve after observation. 2. The mass has affected the appearance, and the patient has more symptoms. If the surgery does not solve the mental burden. Contraindications If the tumor mass is small and the nature is unknown, it may not be operated temporarily. Preoperative preparation 1. An angiogram should be performed in advance to clearly define the relationship with the intracranial and extracranial veins. 2. The skull is missing, and the skull forming material should be prepared. Surgical procedure Incision The valvular incision is selected, the flap is separated, and the blood vessel is adhered to the periosteum. 2. Reveal the periosteum sinus Because the periosteum sinus and the skull adhere tightly, after the flap is separated, the dark blue color protruding from the surface of the skull can be seen, and the mass is not shaped, and the touch is soft. 3. Excision of the periosteum If the range is not large, and the traffic with the intracranial large sinus is clear, the periosteum can be cut around the periosteum sinus, carefully separated, and the vein communicating with the sinus is ligated. Bone hemorrhage in the outer skull of the skull is treated with bone wax to stop bleeding, and all the periosteal sinus is removed. If the periosteum sinus has affected the skull, drill the hole when the periosteum is incision, bite off the skull for 1 turn, and open the bone flap carefully to find the vein that communicates with the intracranial sinus of the tumor, and properly ligature or electrocoagulation to stop bleeding. The affected skull is removed together. Repair the skull defect again. 4. Incision suture After completely stopping bleeding, a rubber drainage tube was placed in the incision to drain the aponeurosis and the skin. complication 1. Rebleeding, hematoma formation, can cause disturbance of consciousness, and even hemiplegia. 2. Incision infection or skull infection.