自发性脑脊液鼻漏临床分析

Clinical analyses of spontaneous cerebrospinal fluid rhinorrhea

目的探讨自发性脑脊液鼻漏的诊治方法。方法回顾性分析13例自发性脑脊液鼻漏的临床特征、影像学特点及诊治方法与疗效。结果13例自发性脑脊液鼻漏患者,通过询问病史,收集鼻漏出液行葡萄糖定性定量检测,鼻内镜检查和CT、MRI影像学检查均得以确诊,保守治疗无效,均行鼻内镜下修补术,术后随访6个月～6年,均无复发,无脑膜炎等并发症,手术修补成功率100%。结论葡萄糖定性定量检测、鼻内镜检查及CT、MRI影像学检查是诊断自发性脑脊液鼻漏的主要方法,鼻内镜下寻找漏口及修补术具有微创、并发症少及成功率高等优点,是自发性脑脊液鼻漏的首选治疗方法。

OBJECTIVE To investigate the best approach of diagnosis and treatment of spontaneous cerebrospinal fluid rhinorrhea. METHODS The clinical data of 13 cases with spontaneous cerebrospinal fluid rhinorrhea performed in our hospital from 1998 to 2007 were analyzed retrospectively. RESULTS The diagnosis of spontaneous cerebrospinal fluid rhinorrhea was established for these 13 cases on a set of diagnostic program, including qualitative determination of sugar in the nasal leakage, nasal endoscopy, CT and MRI scan. All the patients were failed with conservative treatment. All of the 13 patients were cured by surgical repairing under nasal endoscope for follow up of 6 months to 6 years. CONCLUSION The diagnosis program for spontaneous cerebrospinal fluid rhinorrhea includes qualitative determination of sugar in the nasal leakage, nasal endoscopy, CT and MRI scan. Transnasal endoscopic management is the best method for repairing spontaneous cerebrospinal fluid rhinorrhea.