脑脊液鼻漏修补术修补材料的选择

Surgical materials for repairing of cerebrospinal fluid rhinorrhea

目的：探讨脑脊液鼻漏各种修补材料的特点，选取最佳修补材料。方法：回顾分析1999年3月至2005年3月间收治的36例持续性脑脊液鼻漏的临床资料。结果：36例均经内窥镜手术治愈，其中1次修补成功31例，术中采用大腿阔筋膜修补19例，均获成功；鼻中隔黏骨膜修补9例，成功7例，失败2例；下鼻甲黏膜修补3例，成功1例，失败2例；颞筋膜修补5例，成功4例，失败1例；2次修补均获成功。随访2个月．3年，未见复发。取材部位愈合良好，无感染及鼻中隔穿孔。结论：阔筋膜成功率最高，术中可根据具体情况选择合适的修补材料。

Objective： To find out the best material in cerebrospinal rhinorrhea repairing. Methods： The clinical data of 36 cases treated by different repairing materials from March 1999 to March 2005 were retrospectively analyzed. Results： Thirty-six patients were treated with transnasal endoscopic surgery. The leg fascia lata, the middle turbinate mucoperiostemn, the mucosa of inferior nasal concha and the temporal fascia were used for fistula repairing respectively in 19, 9, 3 and 5 cases, and the success rate was 100%, 77.8%, 33.3% and 80.0% respectively. During a follow-up from 2 months to 3 years, no relapse and infection were found. Conclusion： Fascia lata is most suitable for repairing of fistula. Proper repairing material should be selected according to the situation.