自体游离肌瓣脂肪粒修补脑脊液鼻漏

１９９４年１月￣１９９５年１月，遇有术中脑脊液鼻漏２０例，年龄１８￣７６岁。其中颅面沟通性恶性肿瘤３例，垂体腺瘤１７例，均利用自体游离肌瓣脂肪粒及明胶海绵“三层一体法”行修补术。蝶筛窦骨质和硬脑膜缺损在１．５￣３．５ｃｍ，植入脂肪粒２￣３ｇ，肌瓣长２￣４ｃｍ，宽１．８￣２．５ｃｍ，厚０．５￣０．８ｃｍ，其成活率为１００％，效果满意。随访１￣１４个月，无不良反应或再漏者。讨论了移植组织的选择和制作过

ABSTRACTAUTOGENEOUS FREE MUSCLE FLAP AND GEL FOAM IN THE REPAIR OF CSF RHIN-ORRHEA

rom January,1 994 through March,1995,20 cases of CSP rhinorrhea happened duringoperation. The ages ranged from 20 to 76 years old. The types of tumors were:communicatingcranio-faclal malignant tumors in 3 and pituitary adenoma in 17.The CSF fistulas were all re-paired with antogeneous free muscle ftaps,fat grains and gel foam" three-in-one" method. T hedefects of sphenoid and ethmoid bones and the dura mater ranged from 1.5 to 3.5cm and the fill-ing materials used were 2 to 3 grams of fat grains and a muscle flap of 2-4cm in length,1.8-2.5cm in width and 0.5-0.8cm in thickness.The survival rate ftom the implantation was 100 percent,with satisfactory results.The patients were followed up for 1 to 14 months without any illeffect and recurrence of CSF rhinorrhea. The selection of the implanted materinl and its prepara-tion were discussed. The main points in the surgical technique were introduced,and the mecha-nism of the implanted tissue was discussed preliminarily.