脑脊液鼻漏的开颅手术经验总结

The craniotomy experience summary of cerebrospinal rhinorrhea

目的总结开颅手术治疗脑脊液鼻漏的诊治经验,验证开颅手术治疗脑脊液鼻漏的效果。方法回顾性分析北京天坛医院2012年10月至2014年07月63例开颅手术治疗脑脊液鼻漏的临床资料,术前均采用CT脑池造影进行定位,53例采取冠切开颅,单侧15例,双侧38例,6例采取经眉弓入路,4例采取额颞断颧弓入路。结果 63例脑脊液鼻漏患者行开颅手术治疗,2例手术修补失败,成功修补61例,手术治愈率97%(61/63)。结论脑脊液鼻漏的开颅手术治疗是一种安全、有效的治疗方法,具有鼻内镜不可替代的作用。

Objective To summarize the experience of cerebrospinal fluid rhinorrhea repaired by transcranial approach. Methods Clinical data were analyzed retrospectively of 63 cases of cerebrospinal fluid （CSF） rhinorrhea treated by transcranial approach from October 2012 to July 2014 in Beijing Tiantan Hospital all patients were under CT cisternography for positioning before operation. 53 patients were under coronal craniectomy, 15 patients were under unilateral craniectomy, 38 patients were under bilateral craniectomy, 6 patients were under supraorbital approach, 4 patients were under frontotemporal zygomatic approach. Results CSF rhinorrhea resolved after initial surgery in 61 of 63 patients, giving a success rate of 97%. 2 cases were failed. Conclusion Cerebrospinal fluid rhinorrhea repaired by transcranial approach is a reliable and effective method with an irreplaceable role of endoscopic.