摘要
目的探讨鼻内镜下脑脊液鼻漏修补术的手术方法和治疗效果。方法2002年6月~2007年5月,对自发性脑脊液鼻漏14例和外伤性(包括医源性)脑脊液鼻漏28例,依据缺损部位位于额隐窝、筛顶及筛板、蝶窦顶或侧壁,在鼻内镜下采用不同方式显露漏口,修补材料包括鼻腔黏膜、颞肌肌筋膜、脂肪,修补物放置方法采用多层内置、外置或"浴缸塞"法。结果1次手术成功34例,首次成功率81.0%,2次成功4例,3次成功4例。首次修补成功率漏口≥10mm者(53.8%,7/13)明显低于漏口<10mm者(93.1%,27/29)(χ2=6.606,P=0.010)。术后并发症2例,1例为颅内感染,1例为脑积水,均治愈出院。42例随访6~36个月(平均14个月),无复发。结论鼻内镜下脑脊液鼻漏修补术是一种安全、有效和微创的手术方式,但并发症的预防和控制不容忽视。漏口大小对手术效果有影响,较大漏口(≥10mm)宜结合使用自体脂肪组织进行修补。
Objective To study the technique and clinical effect of naso-endoscopic surgery for cerebrospinal fluid(CSF)rhinorrhea.Methods From June 2002 to May 2007,14 patients with spontaneous CSF rhinorrhea and 28 patients with traumatic or iatrogenic CSF rhinorrhea were treated by naso-endoscopy.The CSF fistula was exposed via different surgical routes by naso-endoscopy according the sites of the lesions(including the cribriform plate or fovea ethmoidalis,sphenoid sinus,and frontal recess).Middle turbinate mucosa,f...
出处
《中国微创外科杂志》
CSCD
2008年第5期451-453,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
脑脊液鼻漏
内镜
Cerebrospinal fluid rhinorrhea
Endoscope
