摘要
目的 总结经鼻内镜联合鼻外额窦开窗径路修复额窦脑脊液鼻漏的手术经验.方法 回顾性分析自1996年至2009年中山大学附属第三医院收治的17例接受额窦脑脊液鼻漏修复术患者临床资料,重点分析经鼻内外联合径路修复术式的适应证、手术效果及关键技术.结果 17例患者中,9例首选经鼻内外联合径路修复均一次性成功,另外8例首选单纯经鼻内镜径路修复,其中5例修复成功,3例失败,失败病例再次经鼻内外联合径路修复成功.本组总共12例患者采用联合径路成功修复,术后恢复快,并发症少,颜面部瘢痕不明显.随访6个月至10年,无脑脊液鼻漏复发.结论 采用经鼻内外联合径路修复额窦脑脊液鼻漏不但可以弥补单纯经鼻内镜下操作的困难和不足,而且比单纯外径路微创,操作简单精细,有助于提高瘘口修复的成功率.
Objective To summarize the surgical experiences of treating the frontal sinus cerebrospinal fluid rhinorrhea （FS-CSFR） via combined transfrontal and intranasal endoscopic approaches. Methods We retrospectively analyzed the clinical data of 17 patients with FS-CSFR,received surgery in our hospital from 1996 to 2009, with emphasis on postoperative complications,clinical outcomes and key technology involved in surgery via combined transfrontal and intranasal endoscopic approaches. Results Of the 17 patients, 9 were successfully repaired after 1 surgery via combined transfrontal and intranasal endoscopic approaches; the other 8 were initially treated by endoscopic intranasal approach alone, of which 5 （62.5%） were successful and 3 failed. And then, the 3 patients subsequently underwent the surgery via combined transfrontal and intranasal endoscopic approaches and succeeded. These 12 patients with FS-CSFR, performed surgeries via combined transfrontal and intranasal endoscopic approaches were successfully repaired with quick recovery, mild complications, and no significant facial scars. Follow up was performed for 6 to 10 y and no CSFR recurrence was noted. Conclusion Surgery via combined transfrontal and intranasal endoscopic approaches offers advantages not only in overcoming the difficulty and defects of intranasal endoscopy but also in providing a few traumas and an easy approach, which helps the recovery.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第9期932-935,共4页
Chinese Journal of Neuromedicine
基金
基金项目：广东省科技计划项目（20098030801087）
关键词
额窦
脑脊液鼻漏
内镜检查
耳鼻喉外科手术
Frontal sinus
Cerebrospinal fluid rhinorrhea
Endoscopy
Otorhinolaryngologic surgical procedure
