鼻内窥镜诊治脑脊液漏的临床研究

目的 探讨鼻内窥镜手术治疗脑脊液鼻漏临床相关因素。方法 对17例（19漏）内窥镜下修补脑脊液鼻漏患者的临床资料作回顾性分析。结果 脑脊液鼻漏17例中，外伤性15例，自发性2例，内窥镜下瘘口修补术一次性治愈15例，成功率88.2%，失败2例，再次修补成功，其中1例颅内高压术后腰穿持续引流减压。结论 内窥镜手术修补脑脊液鼻漏准确、微创；冠位CT薄层扫描对术前瘘口解剖定位有重要意义；影响手术效果的因素与修补材料的固定有关，与修补材料本身无明显关系；术后适当腰穿引流对于临床提示颅内压高、修补区薄弱病例仍需采用。

Transnasal Endoscopic Treatment of Cerebrospinal Fluid Rhinorrhea

Objective To investigate the clinically related factors for transnasal endoscopic treatment of cerebrospinal fluid (CSF) rhinorrhea. Methods The clinical data of 17 cases of CSF rhinorrhea undergoing transnasal endoscopic treatment were retrospectively analyzed. Results In 17 cases of CSF rhinorrhea, 15 cases were traumatic and 2 were spontaneous. 15 cases were cured (88.2 %) after transnasal endoscopic repairment and 2 subject to repeated repairment. Conclusion Transnasal endoscopic repairment of CSF rhinorrhea was accurate and microtraumatic. Thin cut CT can identify bony abnormalities within the sinuses or skull base. The operative outcome was related with the fixation of the graft used, but not with the graft itself. Postoperative lumbar drainage is available for those patients with increased intracranial pressure and weakness of repairment area.