颅外修补术治疗脑脊液鼻漏(附18例报告)

Extracranial Repair for Cerebraosapinal Fluid Rhinorrhea (a Report of 18 Cases)

目的探讨颅外修补术治疗脑脊液鼻漏的最佳方法。方法回顾性分析2004年1月至2007年1月采用不同颅外修补方法治疗18例脑脊液鼻漏患者的临床资料,并对脑脊液鼻漏的诊断、漏口的定位、修补材料、手术方式的选择等进行了讨论。结果18例中保守治愈3例;手术治疗15例,其中12例内镜下修补一次成功,1例失败的经第二次鼻内镜手术治愈,2例额窦漏口采用鼻外进路一次修补成功。随访6个月～3年,无复发。结论脑脊液鼻漏的颅外修补术应根据具体情况选择合适的径路。内镜下修补术通常是脑脊液鼻漏的首选外科治疗方法。

Objectives To study the extracranial repair methods to treat cerebraosapinal fluid （CSF） rhinorrhea. Method The clinical data of 18 patients with CSF rhinorrheas treated by extracranial repair in our departement from January, 2004 to January, 2007 were analyzed retrospectively. The diagnosis, the location of rhinorrhea mouth, the methods of the operation and the materials for repair were discussed. Results Of 18 patients with CSF rhinorrheas, 3 were conservatively treated and 15 underwent surgery. The rhinorrheas in 12 patients were successfully repaired on the first operation by endoscope-assisted surgery. One patient underwent the second endoscope-assisted surgery because the first surgery did not successfully repair the rhinorrhea. The rhinorrheas, of which, the months were in the frontal sinuses, were successfully repaired by the surgery through the extranasal approach in 2 patients. No rhinorrhea recurred in all the patients during following up from 6 months to 3 years. Conclusions The proper approach should be selected for successful repair of the rhinorrhea according to the condition in the patients with CSF rhinorrheas. The endonasal endoscope-assisted surgery is the best method to treat CFS rhinorrhea.