鼻内镜下治疗经蝶脑膜脑膨出致脑脊液鼻漏3例

The diagnosis and treatment of cerebrospinal rhinorrhea caused by transsphenoidal cephaloceles through transnasal endoscopic surgery

目的：探讨经蝶脑膜脑膨出致脑脊液鼻漏的诊断及经鼻内镜下修补的可行性，总结修补的成功经验。方法：鼻内镜下切除经蝶脑膜脑膨出3例，并以肌肉、筋膜、人工硬膜等填塞致脑脊液鼻漏的颅底缺损部位。结果：3例患者均一次手术治愈，其中1例术后并发颅内感染（脑膜炎），余均无并发症发生，随访6个月～3年，仅1例因医源性原因于术后半年复发，二次修补成功，余无复发。结论：经鼻内镜手术治疗经蝶脑膜脑膨出所致脑脊液鼻漏是可行的，并且是微创的、安全的。

Objective：To inquire into the feasibility of transnasal endoscopic surgery for the diagnosis and treatment of cerebrospinal rhinorrhea caused by transsphenoidal meningoencephaloceles. Method： Three cases of cerebrospinal rhinorrhea caused by transsphenoidal meningoencephaloceles were managed by transnasal endoscopic surgery, Different repair materials such as muscle, fascia, artificial dural material were applied into the defect site. Result：All cases were successful treated, 1 of them complicated with meningitis, the others were cured without any complication. One reoccurred after 6 months and was successful repaired after second surgery during 1-3 year follow-up. Conclusion： The treatment of transnasal endoscopic surgery for cerebrospinal rhinorrhea caused by transsphenoidal cephaloceles is a feasible, mini wound and safe approach.