神经内镜切除垂体瘤在临床中的应用越来越广泛,相比显微镜下手术,切口微创,术后恢复快,但术中易造成的颅底结构破坏常导致脑脊液漏的发生。脑脊液鼻漏系指脑脊液经破裂或缺损的蛛网膜、硬脑膜和颅底骨板流入鼻腔或鼻窦。由于术中不能及...神经内镜切除垂体瘤在临床中的应用越来越广泛,相比显微镜下手术,切口微创,术后恢复快,但术中易造成的颅底结构破坏常导致脑脊液漏的发生。脑脊液鼻漏系指脑脊液经破裂或缺损的蛛网膜、硬脑膜和颅底骨板流入鼻腔或鼻窦。由于术中不能及时发现漏口,会导致术后出现脑脊液鼻漏,从而引发一系列相关并发症。本文分析术后脑脊液鼻漏的相关危险因素研究进展进行综述,为临床提供参考。Neuroendoscopic removal of pituitary tumors is increasingly utilized in clinical settings. Compared to microsurgery, this technique offers less invasive incisions and faster postoperative recovery, yet it often results in damage to the skull base structure, which can lead to cerebrospinal fluid leakage. Cerebrospinal fluid rhinorrhea occurs when cerebrospinal fluid flows into the nasal cavity or sinuses through a ruptured or damaged arachnoid membrane, dura mater, or skull base bone. Failing to promptly identify the leak during surgery can result in postoperative cerebrospinal fluid rhinorrhea, which can trigger a host of related complications. This article reviews the advancements in research on the risk factors associated with postoperative cerebrospinal fluid rhinorrhea, offering insights for clinical reference.展开更多
目前经鼻内镜下手术的应用在临床中越来越得到重视,但脑脊液的鼻漏是常见并发症,术前充分评估、术中仔细操作及恰当处理是避免术后脑脊液漏发生的关键,而对发生术后脑脊液漏的患者,需采取恰当的治疗措施。其中,垂瘤术后鞍区修补可选择...目前经鼻内镜下手术的应用在临床中越来越得到重视,但脑脊液的鼻漏是常见并发症,术前充分评估、术中仔细操作及恰当处理是避免术后脑脊液漏发生的关键,而对发生术后脑脊液漏的患者,需采取恰当的治疗措施。其中,垂瘤术后鞍区修补可选择的方法之一,是利用颈内动脉系统的筛动脉为蒂,以筛脉为蒂的NSF,利用健康的、未被手术破坏的NSF和鼻下鼻道黏膜,在经蝶垂体瘤手术已破坏鼻中隔后动脉的情况下,对鼻腔内隔膜膜瓣NSF (Nasoseptal flap)进行修补。达到修复颅底血管粘膜瓣的作用,经蝶垂体瘤手术已破坏鼻中隔膜。At present, the application of transnasal endoscopic surgery has been paid more and more attention in clinic, but cerebrospinal fluid rhinorrhea is a common complication. The key to avoid postoperative cerebrospinal fluid leakage is full preoperative evaluation, careful operation and appropriate treatment during operation. For patients with postoperative cerebrospinal fluid leakage, appropriate treatment measures should be taken. Among them, one of the optional methods for sellar region repair after prolapse tumor surgery is to use the ethmoid artery of the internal carotid artery system as the pedicle, the NSF pedicled with the ethmoid vein, and the healthy NSF and subnasal nasal mucosa that have not been damaged by surgery to repair the nasal septal membrane flap (NSF) under the condition that the posterior nasal septal artery has been damaged by transsphenoidal pituitary tumor surgery. To repair the skull base vascular mucosal flap, transsphenoidal pituitary tumor surgery has destroyed the nasal septum.展开更多
文摘神经内镜切除垂体瘤在临床中的应用越来越广泛,相比显微镜下手术,切口微创,术后恢复快,但术中易造成的颅底结构破坏常导致脑脊液漏的发生。脑脊液鼻漏系指脑脊液经破裂或缺损的蛛网膜、硬脑膜和颅底骨板流入鼻腔或鼻窦。由于术中不能及时发现漏口,会导致术后出现脑脊液鼻漏,从而引发一系列相关并发症。本文分析术后脑脊液鼻漏的相关危险因素研究进展进行综述,为临床提供参考。Neuroendoscopic removal of pituitary tumors is increasingly utilized in clinical settings. Compared to microsurgery, this technique offers less invasive incisions and faster postoperative recovery, yet it often results in damage to the skull base structure, which can lead to cerebrospinal fluid leakage. Cerebrospinal fluid rhinorrhea occurs when cerebrospinal fluid flows into the nasal cavity or sinuses through a ruptured or damaged arachnoid membrane, dura mater, or skull base bone. Failing to promptly identify the leak during surgery can result in postoperative cerebrospinal fluid rhinorrhea, which can trigger a host of related complications. This article reviews the advancements in research on the risk factors associated with postoperative cerebrospinal fluid rhinorrhea, offering insights for clinical reference.
文摘目前经鼻内镜下手术的应用在临床中越来越得到重视,但脑脊液的鼻漏是常见并发症,术前充分评估、术中仔细操作及恰当处理是避免术后脑脊液漏发生的关键,而对发生术后脑脊液漏的患者,需采取恰当的治疗措施。其中,垂瘤术后鞍区修补可选择的方法之一,是利用颈内动脉系统的筛动脉为蒂,以筛脉为蒂的NSF,利用健康的、未被手术破坏的NSF和鼻下鼻道黏膜,在经蝶垂体瘤手术已破坏鼻中隔后动脉的情况下,对鼻腔内隔膜膜瓣NSF (Nasoseptal flap)进行修补。达到修复颅底血管粘膜瓣的作用,经蝶垂体瘤手术已破坏鼻中隔膜。At present, the application of transnasal endoscopic surgery has been paid more and more attention in clinic, but cerebrospinal fluid rhinorrhea is a common complication. The key to avoid postoperative cerebrospinal fluid leakage is full preoperative evaluation, careful operation and appropriate treatment during operation. For patients with postoperative cerebrospinal fluid leakage, appropriate treatment measures should be taken. Among them, one of the optional methods for sellar region repair after prolapse tumor surgery is to use the ethmoid artery of the internal carotid artery system as the pedicle, the NSF pedicled with the ethmoid vein, and the healthy NSF and subnasal nasal mucosa that have not been damaged by surgery to repair the nasal septal membrane flap (NSF) under the condition that the posterior nasal septal artery has been damaged by transsphenoidal pituitary tumor surgery. To repair the skull base vascular mucosal flap, transsphenoidal pituitary tumor surgery has destroyed the nasal septum.
