内镜下经鼻脑脊液漏修补术

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。

Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea

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 cisternography, 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.