鼻内镜下自体材料修补脑脊液鼻漏的临床应用

Study on intranasal endoscopic repair of cerebrospinal fluid rhinorrhea with autologous material

目的总结鼻内镜下自体材料对脑脊液鼻漏的治疗经验,探讨修补方法。方法回顾分析12例脑脊液鼻漏病人治疗过程,对脑脊液鼻漏的修补方法进行探讨。结果 12例脑脊液鼻漏病人中,医源性2例,外伤性8例,自发性脑脊液鼻漏2例。经CT或MRI及鼻内镜下寻找漏出部位,发现位于额窦4例,位于筛顶2例,位于蝶窦6例。以鼻中隔粘膜鼻黏膜修复7例,以钩突修复5例。均一次修复成功。结论鼻内镜下脑脊液鼻漏采用自体材料修补方法简单,损伤小,成功率高,并发症少。

Objective To summarize endoscopic management of cerebrospinal rhinorrhea and explore the method of reparing. Methods 12 cases of eerebrospinal rhinorrhea treated by endoscopic approach were retrospectively analyzed. Results The age of the 12 patients was from 17 to 45. Aetiology included surgical trauma （2 cases）, accidental trauma （8 cases） and idiopathic （2 cases）. All patients were scanned by computed tomography and magnetic resonance imaging. The fistulas of CSF located in frontal sinua （4 cases）, ethmoidal roof （2 cases） and sphenoid sinus （6 cases）. The autologous materials were used of repairing fistulas of eerebrospinal rhinorrhea, including nasal mucosa of septal mucosa （5 cases）, uncinate process （4 cases）. All repairs were successful at the first attempt. Conclusion Endoscopic repair for cerebrospinal fluid rhinorrhea is simple and less injurious, has a high success rate and few complications.