鼻窦内窥镜手术致脑脊液鼻漏的处理

目的探讨鼻科手术中发生脑脊液鼻漏的治疗方法。方法对15例鼻颅底区手术中发生的脑脊液鼻漏患者，及时在鼻腔内窥镜引导下，经鼻腔用阔筋膜、肌肉浆及下鼻甲粘膜瓣，生物蛋白胶，明胶海绵等材料进行颅底脑膜漏口修补术13倒。结果全部一次修补成功；2例术后发现的脑脊液鼻漏患者因漏口〈3mm，采用保守治疗而愈。结论手术中脑脊液鼻漏一旦发生应立即修补，其修补方法较多。如果确为术后发现，也可先保守治疗，无效再手术。经鼻腔内窥镜脑脊液鼻灞修补术成功率高、效果好、微创，应推广。

Treatment of cerebrospinal fluid rhinorrhea caused by endoscopic sinus surgery

Objective To explore the treatment of cerebrospinal fluid rhinorrhea caused by endoscopic sinus surgery. Methods Cerebrospinal fluid rhinorrhea caused by endoscopic sinus surgery occurred in 15 cases. Under nasal endoscopic guidance, orificium fistulae of skull base - meninges were repaired with fascia lata, muscle and inferior concha mucosal flap, fibrin glue and gelatin sponge in 13 cases. Results Repairs of orificium fistulae of skull base -- meninges were all successful through one surgery. Of 15 cases, cerebrospinal fluid rhinorrhea was found after operation in 2 cases, and the orifieium fistulae were less than 3ram, so that conservative treatment was adopted. Conclusions Once cerebrospi- nal fluid rhinorrhea was found during operation, we should immediately repair it, and there are many repair methods. If cerebrospinal fluid rhinorrhea was found after operation, conservative treatment should firstly be adopted. When the cerebrospinal fluid rhinorrhea had no response to conservative treatment, surgery should be carried out. Trans--nasal endoscopic cerehrospinal fluid rhinorrhea repair possesses high successful rate, good therapeutic effect, mini--invasion and wide application.