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脳神経外科医への道 Vol. 46

卒後3年めの当科レジデント、城 泰輔先生が書いた初めての論文が「脳神経外科」誌に掲載されました。頭蓋骨縫合早期癒合症の治療にあたって、3Dプリンターを用いて、導出静脈と頭蓋骨の3次元実体モデルを作成することで、静脈流出路を損傷せずに頭蓋形成術を実施するための方法論を報告させていただきました。城先生はじめ、レジデントの先生たちには、論文を書くことが明日の診療へのフィードバックになることを実感してほしいと願っています。

城 泰輔、赤井卓也、富田隆浩、黒田 敏
血管付き頭蓋骨モデルを用いた導出静脈発達症例における後方延長術の戦略策定。
脳外46: 877-882, 2018

The Long & Winding Road To Be A Neurosurgeon Vol. 46

Our resident, Dr. Taisuke Shiro published his first paper as follow:

Taisuke Shiro, Takuya Akai, Takahiro Tomita, Satoshi Kuroda
Three dimensional skull model with vascular structures for the occipital expansion in patients with developed occipital emissary veins.
No Shinkei Geka 46: 877-882, 2018

Abstract
We report an application of three dimensional skull model with vascular structures for the occipital expansion in a patient with developed occipital emissary veins. A 15-year-old boy visited dentist for orthodontics, and was pointed out mid-face hypoplasia. He had ventriculo-peritoneal shunt at age of 10 months. At visit to our institution, he had exophthalmos, low visual acuity, reversed bite and developmental retardation. And he had sleep apnea and was supported by continuous positive airway pressure at night. Computed tomograms and magnetic resonance images demonstrated brachycephalus, chronic tonsillar herniation, midface hypoplasia, and well developed occipital emissary veins. We chose the occipital expansion for expecting lowering intracranial pressure, and made three dimensional skull model with vascular structures and shunt tube. On this model, we wrote scalp incision and craniotomy lines avoiding injury of veins and shunt tube. The operation was completed under this plan. Patients with syndromic craniosynostosis frequently have developed emissary veins and previous shunt operation. The three dimensional skull model with vascular structures will be expected to reduce operation risks.

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