Cranial Osteoma Resection

Skull osteoma grows slowly, and can be divided into exogenous, stenosis and endogenous according to the location and growth of the skull. Some people think that trauma can also promote their growth. The benign of this tumor is the majority, and some even stop spontaneously during the growth process, and its tissue structure is similar to normal bone. Skull osteoma is more common in the frontal and parietal bones, humerus and occipital bones, and the skull base is less common. Occurs in young and middle-aged. Smaller people have no symptoms, or are occasionally touched. The larger ones may have head discomfort, pain, dizziness, numbness, etc., and the local ridges are round or elliptical, hemispherical or flat. Generally, the surface is smooth, no adhesion to the scalp, no tenderness or mild tenderness. If the osteoma is located at the base of the skull, symptoms of cranial nerve involvement may occur, and X-ray examination can confirm the diagnosis. For slow-growing and asymptomatic small osteomas, there is no need to deal with it. For those who are larger and grow faster, the patient has a mental burden, local discomfort and affecting the cosmetic surgery. Skull tumors are a benign osteoma, but there is also the possibility of turning to malignancy, so it is necessary to remove the skull tumor when it is benign. Treatment of diseases: skull osteoma Indication 1. The intracranial growth of osteoma has symptoms of brain compression. 2. The osteoma is large, the diameter is more than 2cm, and there is discomfort or affects the appearance. 3. Malignant tumor of the skull. 4. The nature of the skull tumor is unknown. 5. Although the osteoma is small, the patient's mental burden is heavy, and surgery can also be considered. Contraindications 1. There are infectious diseases in the scalp, such as sputum, sputum, etc., should be suspended. 2. Malignant tumors have spread throughout the body, and skull tumor surgery has no meaning. Preoperative preparation Prepare a variety of sharp osteotomes, sometimes need to prepare skull forming materials. Surgical procedure Incision Depending on the size and location of the osteoma, a straight incision, an "S" shaped incision, an arcuate incision, and a bone shaped incision can be selected. Cut the skin, cap-like diaphragm and muscles to fully expose the edges of the osteoma. 2. Osteomatosis exposure The periosteum was dissected, and the periosteum was peeled off with the periosteal stripper to fully expose the osteoma and the invaded skull, and the bone surface was hemorrhage, and then the bone wax was applied to stop bleeding. 3. Osteoma resection If the osteoma is not large, the osteochondral can be removed with a sharp osteotome along the tangential direction of the outer skull plate to retain the inner plate. After chiseling, it surrounds the osteoma and covers a circle of dry brain cotton to protect healthy tissue. The tumor bed is coated with a 10% formaldehyde solution (or a little bit of phenolic acid), and then washed with physiological saline to remove the brain cotton or burn the tumor bed with electrocoagulation. If there is bleeding, bone wax can be used to stop bleeding. For larger osteomas, when it is difficult to use the chiseling method, several bone holes can be drilled on the osteoma with a cranial drill, so as not to drill through the inner plate. Then, use a rongeur to bite the osteoma tissue between the bone holes, and cut it with a bone chisel, and then treat the tumor bed by the above method. When there is bleeding, stop bleeding with bone wax. In the osteoma that needs to be removed together with the inner plate, 4 to 6 holes are drilled in the normal skull around the osteoma. The skull is bitten by a rongeur around the osteoma for a week, or cut with a milling cutter or a wire saw. Osteosarcoma bone flap, and with a periosteal stripper, pick up the bone flap of the osteoma, all remove the osteoma, bleeding at the edge of the bone window, to stop bleeding with bone wax. The bone defect can be repaired with a repair material such as medical silicone rubber or titanium steel sheet. 4. Incision suture After completely stopping bleeding, the rubber hollow drainage was placed under the incision, and then the scalp incision was sutured by layer. If the bone flap is used to remove the osteoma, the drainage tube should be outside the incision, and a small incision should be made to suture the aponeurosis and skin layer by layer, and remove it 48 hours after operation. complication 1. Rebleeding, hematoma formation, can cause disturbance of consciousness, and even hemiplegia. 2. Incision infection or skull infection.