带蒂中鼻甲黏膜瓣在鼻内镜修复脑脊液鼻漏手术中的应用

The application of pedicled middle turbinate mucosal flap in transnasal endoscopic repair of cerebrospinal fluid rhinorrhea

目的:探讨带蒂中鼻甲黏膜瓣在经鼻内镜修复脑脊液鼻漏手术中的应用及疗效。方法:回顾分析15例脑脊液鼻漏患者,其中单纯脑脊液鼻漏13例(86.7%),脑脊液鼻漏伴脑膜脑膨出2例(13.3%)。术中根据瘘口位置采用经鼻内镜下带蒂中鼻甲黏膜瓣进行修复,其中漏口位于筛顶5例(33.3%),漏口位于筛板8例(53.3%),漏口位于蝶窦外侧隐窝2例(13.3%)。结果:术后随访4~24个月,手术成功率为100%,术区黏膜上皮化良好,未出现脑脊液鼻漏复发及其他并发症。结论:带蒂中鼻甲黏膜瓣修复脑脊液鼻漏手术成功率高,鼻腔损伤小,值得临床推广。

Objective:To investigate the application and efficacy of pedicled middle turbinate mucosal flap in transnasal endoscopic repair of cerebrospinal fluid rhinorrhea.Methods:15 patients with cerebrospinal fluid rhinorrhea were retrospectively analyzed,including 13 patients with simple cerebrospinal fluid rhinorrhea(86.7%)and 2 patients with cerebrospinal fluid rhinorrhea with meningoencephalocele(13.3%).According to the location of the fistula,the pedicled middle turbinate mucosal flap under nasal endoscopy was used to repair cerebrospinal fluid rhinorrhea,in which 5 cases(33.3%)had leakage at the top of the sieve and 8 cases(53.3%)had leakage at the sieve plate.Two cases had leakage at the lateral racess of sphenoid sinus.Results:All cases of cerebrospinal fluid rhinorrhea were repaired successful and the mucosa epithelialized well in the operative area.There was no recurrence of cerebrospinal fluid rhinorrhea or other complications during the follow-up period of 4-24 months(average 13 months).Conclusion:The pedicled middle turbinate mucosal flap has a high success rate for repairing cerebrospinal fluid rhinorrhea,and the nasal cavity damage is small,which is worthy of clinical promotion.