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内镜下经鼻脑脊液漏修补术 被引量:20

Transnasal endoscopic repair of cerebrospinai fluid rhinorrhea
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摘要 目的介绍鼻内镜下经鼻脑脊液漏修补的手术方法,并就相关问题进行讨论。方法鼻内镜下经鼻手术修补脑脊液鼻漏35例,外伤性20例,自发性12例,医源性3例,术前根据临床表现、实验室检查、辅助以颅底CT扫描、脑池造影等获得诊断,采用自体阔筋膜片修补颅底缺损。结果本组35例均在术后3-32个月进行随访,其中1次手术修补成功32例,2次手术修补成功1例,1次手术失败后拒绝再次手术2例,手术成功率94%,无颅内出血、颅内感染,无神经功能受损等并发症。结论鼻内镜下经鼻脑脊液漏修补成功率高、手术创伤小,可以作为脑脊液鼻漏的首选手术方法。 Objectives To introduce the surgical method of transnasal endoscopic repair of cerebrospinal fluid rhinorrhea and discuss the related questions. Methods A total of 35 patients with CSF rhinorrhea (20 traumatic, 3 iatrogenic, and 12 spontaneous) were treated. Diagnosis was achieved according to clinical manifestation, laboratory test and with the help of CT with or without cistemography, fascia lata was used to plug the defects. Results CSF rhinorrhea was resolved during the first attempt in 32 of 35, 1 was successfully repaired after the second attempt, the other 2 refused to accept the revision surgery and were lost in follow up. The successful rate is 94%. No major complications, such as intracranial hemorrhage, infection and nerve function deficit were encountered. Conclusions Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea should be the first choice of operative method for CSF rhinorrhea because of its high successful rate, minimal invasion.
出处 《中华神经外科杂志》 CSCD 北大核心 2006年第6期349-350,共2页 Chinese Journal of Neurosurgery
关键词 脑脊液鼻漏 经鼻 修补 内镜 Cerebrospinal fluid rhinorrhea Transnasal Repair Endoscopy
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参考文献6

  • 1Kirtane MV, Gantham K, Upadhyaya SR, et al. Endoscopic CSF rhinorrhea closure: our experience in 267 cases. Otolaryngology-Head and Neck Surgery, 2005, 132:208 - 212.
  • 2Kubo S, Toshihiko H, Yoshimine T, et al. Repair of intractable cerebrospinal fluid rhinorrhea with mucosal flaps and recombinant human basic fibroblast growth factor: technical case report. J Neurosurg, 2005, 56: 627.
  • 3Mcmains KC, Gross WG, Kountakis SE, et al. Endoscopic management of cerebrospinal fluid rhinorrhea. Laryngoscope, 2004,114: 1833-1837.
  • 4刘丕楠,张亚卓,艾林,何乐,于锐才.内窥镜下经鼻腔-蝶窦入路切除垂体腺瘤的解剖学研究[J].中华神经外科杂志,2000,16(1):16-18. 被引量:76
  • 5Hegazy HM, Carrau RL, Snyderman CH, et al. Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a meta-analysis.Laryngoscope, 2000, 111: 1166-1172.
  • 6Zweig JL, Carrau RL, Celin SE, et al. Endoscopic repair of cerebrospinal fluid leaks to the sinonasal tract: Predictos of success.Otolaryngology-Head and Neck Surgery, 2000, 123: 195-201.

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