自发性脑脊液鼻漏的诊断与治疗

目的 探讨自发性脑脊液鼻漏的诊断和治疗方法.方法 回顾性研究17例自发性脑脊液鼻漏的诊断程序、内科治疗方法和鼻内镜下手术修补的效果.结果 17例自发性脑脊液鼻漏患者,经鼻腔溢出物糖定性定量检测、鼻内镜检查和CT、MRI影像学检查而得到确诊,保守治疗愈合2例,余15例经手术治疗而全部愈合.结论 鼻腔溢出物糖定性定量检测和CT、MRI检查是诊断自发性脑脊液鼻漏的主要方法,鼻内镜下经鼻进路手术修补漏口是最适合的治疗方法.

Diagnosis and treatment of spontaneous cerebrospinal fluid rhinorrhea

Objective To establish more reliable diagnostic program for spontaneous cerebrospinal fluid rhinorrhea and to explore better strategy for such a condition treated by simple surgery. Methods A retrospective study was carried out among 17 cases treated in our hospital from 1997 to 2005, via careful analysis on their diagnostic procedures, medical treating experience and surgical repairing outcome performed under nasal endoscope. Results The diagnosis of spontaneous cerebrospinal fluid rhinorrhea was established for these 17 cases based on a set of diagnostic program, including qualitative determination of sugar in the nasal leakage from cerebrospinal fluid, direct viewing from nasal endoscopy, and image displaying by CT and MRI. Then, they received treating program composed of either medical therapy or surgical procedures, with 2 cured only by no surgical therapy and 15 cured by operating procedures. Conclusions The main important diagnostic program for spontaneous cerebrospinal fluid rhinorrhea should be composed of qualitative determination of sugar in the nasal leakage and image displaying by CT and MRI, and it is the most appropriate therapy for such a condition through surgical repairing under nasal endoscope via trans-nasal approach.