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| A case of skull base invagination misdiagnosed as nasopharyngeal carcinoma |
| RUAN Qing-rong GU Li-ming▲ WANG Fu-ping |
| Department of Critical Care Medicine,the Sixth Affiliated Hospital of Kunming Medical University (Yuxi People′s Hospital),Yunnan Province,Yuxi 653100,China |
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Abstract Skull base invagination is a common malformation in the craniocervical region.It refers to the bone tissue of skull base surrounding the occipital foramen invaginated into the cranial cavity,leading to stenosis of occipital foramen,causing brainstem,medulla oblongata and cervical spinal cord,cerebellum,cranial nerve and peripheral blood vessels to be compressed,and then clinical manifestation will appear.Currently,its pathogenesis has not been clarified,but abnormal embryonic development is mostly considered.There are many types of classifications.It can be divided into primary disease and secondary disease according to the etiology.The disease has a trait of long incubation period and strong concealment.There may be no obvious symptoms at the initial stage of the disease.With the increase of age,the clinical symptoms occur after the bone structure changes.The clinical manifestations are mainly nerve compression symptoms,and characteristic appearance can be accompanied.Currently,the diagnosis mainly depends on imaging findings such as plain radiographs,CT and magnetic resonance imaging (MRI).For patients with suspected skull base invagination,MRI should be preferred.If the patient does not have obvious clinical symptoms,conservative treatment and regular follow-up visits are necessary.However,when clinical symptoms occur,surgery must be performed as soon as possible to alleviate the compression.In this paper,we shared a case of misdiagnosis with dysphagia as the first symptom.Through a retrospective study of recent years′ knowledge related to skull base invagination,this misdiagnosis is analyzed and discussed to deepen the understanding of the skull base invagination and improve clinical vigilance.Hopefully early diagnosis and early treatment of the disease can be achieved.
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| [1] |
文同龙，徐兆万，孙丽媛.颅底凹陷症分型的再研究及临床意义[J].潍坊医学院学报，2016，38（3）：166-169.
|
| [2] |
汤四昌，盛伟斌.颅底凹陷症的外科手术治疗[J].中华临床医师杂志（电子版），2012，6（21）：290-291.
|
| [3] |
Goel A，Bhatjiwale M，Desai K，et al.A study based on 190 surgically treated patients[J].J Neurosurg，1998，88（6）：962-968.
|
| [4] |
Menezes AH，VanGilder JC，Graf CJ，et al.Craniocervical abnormalities.A comprehensive surgical approach[J].J Neurosurg，1980，53（4）：444-455.
|
| [5] |
Smoker WR，Khanna G.Imaging the craniocervical junction[J].Childs Nerv Syst，2008，24（10）：1123-1145.
|
| [6] |
王建华，尹庆水，夏虹，等.颅底凹陷症的分型及其意义[J].中华脊柱脊髓杂志，2011，21（4）：290-294.
|
| [7] |
Goel A.Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation[J].J Neurosurg Spine，2004，1（3）：281-286.
|
| [8] |
张秋航，严波，郭宏川，等.内镜经口入路齿状突切除治疗颅底凹陷[J].中国微侵袭神经外科杂志，2014，30（7）：658-662.
|
| [9] |
郑虎林，陈晨.35 例颅底凹陷症治疗体会[J].实用心脑肺血管杂志，2014，22（9）：122-123.
|
| [10] |
袁慧敏，武春明，刘佳欢，等.颅底凹陷症的临床研究进展[J].中医正骨，2016，28（12）：42-45.
|
| [11] |
贾建平，陈生弟.神经病学[M].7 版.北京：人民卫生出版社，2013：405-406.
|
| [12] |
叶菲，杨烜，胡银，等.颅底凹陷症1 例报告及文献综述[J].中国伤残医学，2014，22（2）：318.
|
| [13] |
白民学，邱成林，刘俊.颅底凹陷症的磁共振成像诊断及分型[J].实用医学影像杂志，2018，19（4）：364-366.
|
| [14] |
刘鑫，孙兆忠.颅底凹陷症影像学特点及手术策略研究进展[J].滨州医学院学报，2017，40（4）：291-293.
|
| [15] |
张宗宝，潘文，张锦祥.X 线平片、MRI 对颅颈交界部畸形的诊断价值[J].罕少疾病杂志，2009，6：26-27.
|
| [16] |
郭团茂，曹伟宁.伴颈髓损伤的颅底凹陷合并颅颈交界区多发混合畸形1 例[J].疑难病杂志，2018，17（5）：522-523.
|
| [17] |
王泽忠，杨广夫，鱼博浪，等.颅底凹陷症的MR 诊断[J].实用放射学杂志，1995，2：77-79.
|
| [18] |
程飞.复杂颅底凹陷畸形的手术治疗体会[J].医药论坛杂志，2012，33（4）：75-76.
|
| [19] |
郑虎林，陈晨.不同手术方式在寰枕畸形合并颅底凹陷治疗中的应用效果观察[J].现代诊断与治疗，2016，27（2）：262-263.
|
| [20] |
吕超亮，宋跃明.颅底凹陷症外科手术治疗的手术入路研究进展[J].现代诊断与治疗，2011，26（3）：467-470.
|
|
|
|
