经鼻内窥镜下脑脊液鼻漏修补术

Repairing of cerebrospinal rhinorrhea by intranasal endoscopic approach

目的总结鼻内窥镜下脑脊液鼻漏修补术的经验 ,提出该方法的可行性和优势。方法分析 1991至2 0 0 0年 8月采用鼻内窥镜下修补脑脊液鼻漏患者 5 4例资料。自发性脑脊液鼻漏 4例 ,外伤性 42例 ,医源性 8例。介绍修补术的方法 ,并就脑脊液鼻漏的诊断 ,手术适应证 ,手术中的关键问题等进行讨论。结果鼻内窥镜下脑脊液鼻漏修补术一次成功治愈占 92 % ( 5 0 / 5 4) ,失败的 4例经第二次或第三次手术后治愈。最后的治愈率为 10 0 %。有 1例伴有外伤性梗阻性脑积水患者 ,术后出现颅内高压的并发症 ,抢救成功。结论鼻内窥镜下修补术是脑脊液鼻漏的首选外科治疗方法。

Objective To summarize our experience in managing cerebrospinal fluid rhinorrhea(SFR) with intranasal endoscope. Methods\ Fifty four cases of SFR, including 4 spontaneous, 42 traumatic, and 8 iatrogenic SFR, were reviewed. Results \ Endoscopic repairing of cerebrospinal rhinorrhea was successful in 92%(50/54) after first operation. Four persistent leaks were closed after a second or a third operation. Ultimately, 100% of leaks were repaired by using endoscopic approach. Only one copmlication of intracranial hypertension occurred after operation. Conclusion\ Transnasal endoscopic repairing is the best surgical method for treating cerebrospinal rhinorrhea.