导航下经鼻内镜脑脊液鼻漏的修补(附14例报告)

Imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea in 14 cases

目的:探讨导航指导下经鼻内镜行脑脊液鼻漏修补的不同方法及疗效。方法:回顾分析14例脑脊液鼻漏患者在导航指引下用鼻内镜行不同修补方法的临床资料及术后疗效。结果:14例脑脊液鼻漏患者中,特发性脑脊液鼻漏3例,外伤性脑脊液鼻漏10例(其中术前发现脑脊液鼻漏6例,术中发现脑脊液鼻漏4例,均为复合性颅底骨折),医源性脑脊液鼻漏1例,漏口1 mm×1 mm^20 mm×10 mm大。采用外贴法修补9例,内贴法3例,筋膜加软骨法2例,在导航指引下,鼻内镜修补均一次成功。结论:导航指引下鼻内镜脑脊液鼻漏修补术具有漏口定位准确、创伤小、操作简单、视野清楚、成功率高、并发症少等优点,结合耳脑胶的使用,手术成功率大大提高。

Objective： To explore the effect of imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. Method： The clinical data of 14 cases subjected to imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea were retrospectively analyzed. Results： Of them, 10 were induced by trauma, 1 by iatrogenic cerebrospinal fluid rhinorrhea, and 3 by unknown causes. The fistulas were between 1 mm × 1 mm and 20 mm × 10 mm in size. Ten cases were repaired by the onlay method, 3 by underlay, and 2 by ＂Button with fascia＂. All were cured by one treatment under imaging-navigated transnasal endoscopic repair. Conclusion： Endoscopic technique under image navigation is great in identification, vision, complication and placement of a graft. The application of EC ear-brain glue increases the success rate of the operation.