神经内镜下外伤性脑脊液鼻漏修补的临床研究

Neuroendoscopic repair of traumatic cerebrospinal fluid rhinorrhea

目的探讨外伤性脑脊液鼻漏经鼻神经内镜下修补的手术要点及疗效。方法回顾性分析2010年12月至2013年12月山东大学齐鲁医院神经外科应用神经内镜经鼻入路治疗外伤性脑脊液鼻漏22例的临床资料,并就诊断、漏口定位、材料选择、修补方式及疗效等进行讨论。结果 21例一次性手术修补成功,随访8-24个月无复发;1例并发脑积水、颅内感染,自动出院,定为失败病例。结论经鼻神经内镜修补外伤性脑脊液鼻漏,手术创伤小,治愈率高,可作为前颅底外伤性脑脊液鼻漏手术修补的首选方法。

Objective To explore the surgical procedure and efficacy of transnasal neuroendoscopic repair of traumatic cerebrospinal fluid rhinorrhea（ CSFR）. Methods A retrospective analysis was performed on the clinical data of 22 cases with traumatic CSFR repaired by neuroendoscopy from December 2010 to December 2013. The diagnosis,location of rhinorrhea fistulas,methods of the operation,materials for repair and clinical efficacy were discussed. Results CSFR was repaired successfully during the first attempt in 21 of 22 cases,The twenty-one cases were follwed up for 8 to24 months postoperatively,and none of them had recurrence during this period. One case,who developed intracranial infection and acute obstructive hydrocephalus,gave up treatment and denoted as the failure case. Conclusion Transnasal neuroendoscopic repair of traumatic CSFR should be the first choice of operative method for traumatic CSFR because of its minimal invasion and high successful rate.