鼻内镜下脑脊液鼻漏的诊断及治疗

目的:总结脑脊液鼻漏的漏口诊断与经鼻内镜手术治疗的临床经验。方法:对36例确诊为脑脊液鼻漏患者的临床资料进行回顾性分析,36例患者术前均行CT检查及鼻内镜检查寻找漏口。34例行单纯鼻内镜修补术,2例行鼻内镜加额部联合进路修补术。结果:随访6月至6年,中位随访时间2.5年,34例1次治愈,一次成功率94.4%;2例复发,二次修补成功。结论:螺旋CT薄层扫描结合内镜检查可使脑脊液鼻漏漏口定位更准确;内镜下手术修补脑脊液鼻漏准确、微创、治愈率高。

Transnasal endoscopic treatment and diagnosis of cerebrospinal fluid

Objective:To summarize the clinical experience in diagnosing and managing cerebrospinal (CSF) rhinorrhea via transnasal endoscopic approach. Methods:A retrospective study of 36 patients with CSF rhinorrhea was conducted. Thirty six cases were all under CT and endoscopy for finding their fistulas. Thirty four patients were treated with transnasal endoscopic approach and two patients were treated with fronto-rhinal approach and endoscopic approach combination. Results:Postoperative follow-up lasted from 6 months to 6 years, comedian follow-up period of 2.5 year.34 cases were cured after the first attempt ( 94.4%) and 2 subject to repeated repairment. Conclusion:Transnasal endoscopic repairment of CSF rhinorrhea is accurate and micro-traumatic. Thin-section spinal CT approach and endoscopy make the leak locating more accurate.