How is flat skull base to return a responsibility?

summary

Flat skull base is a common congenital bone malformation in the craniocervical region. When it exists alone, it usually does not appear symptoms and is often complicated with skull base depression. The middle cranial fossa, the base of the anterior cranial fossa and the clivus of the cranial base were depressed to the cranial fossa, making the cranial base angle greater than 145 °， It has diagnostic significance. How is flat skull base to return a responsibility?

How is flat skull base to return a responsibility?

Examination, tomography and CT scan are helpful to understand the shape and relationship of the bony structure, and determine the developmental defects. CTM (myelography plus CT) and MRI are necessary to understand the location and degree of nerve compression. MRI can also be used to observe the lesions inside the nerve structure, sometimes it can replace CTM and myelography.

Flat skull base is a common congenital bone malformation in the craniocervical region. If it exists alone, it usually has no symptoms, and is often complicated with skull base depression. The diagnosis is mainly based on the angle of skull base measured by lateral skull film, that is, the angle formed by sella turcica and clival lock. In the lateral skull position, the angle formed by the line from the nasal root to the center of sella turcica and the line from the center of sella turcica to the anterior edge of foramen magnum, The normal value of adults is 109-145 degrees, with an average of 132 degrees. Flat skull base is a common congenital bone malformation in the craniocervical region. When it exists alone, it usually does not appear symptoms and is often complicated with skull base depression.

The function of cerebellum, brain stem and vestibule are easily involved in congenital skull base depression. The symptoms and signs of vertigo, nystagmus, Ⅸ, Ⅻ and other neurological damage, spinal cord dysfunction and vertebrobasilar insufficiency may occur.

matters needing attention

Asymptomatic basilar depression does not need treatment, but should be followed up regularly. Patients with nerve compression symptoms need surgical treatment. If the posterior margin of foramen magnum is compressed, the posterior enlarged decompression of foramen magnum should be performed. If the posterior arch of atlas is removed at the same time, the occipitocervical fusion should be performed at the same time. However, ventral compression of the brainstem or spinal cord is common and often accompanied by congenital atlantooccipital fusion or odontoid process deformity. At this time, the front decompression is appropriate. The anterior arch and odontoid process of atlas can be excised under direct vision. If necessary, the vertebral body of axis and the lower clivus can be excised at the same time. However, the exposure of this surgical approach is not very clear, and special instruments such as automatic retractor, light source, pneumatic drill and so on are needed. Because decompression is in the front and more stable structures are destroyed, posterior occipitocervical fusion is usually required first.