脑脊液鼻漏修补术成败的关键因素研究

发布时间：2018-09-10 20:03

【摘要】：目的:总结脑脊液鼻漏的治疗经验。方法:回顾性分析16例脑脊液鼻漏患者的临床资料,探讨脑脊液鼻漏的病因、影像学特点及漏口位置、大小、修复方法对疗效的影响。结果:16例患者中自发性脑脊液鼻漏10例,外伤性脑脊液鼻漏2例,感冒后出现脑脊液鼻漏3例,脑膜脑膨出伴脑脊液鼻漏1例。CT检查明确漏口位置11例,磁共振水成像检查明确漏口位置7例。漏口位于额窦3例,鼻腔顶部3例,筛顶6例,蝶窦4例。手术均在鼻内镜下完成,修补材料均采用自体材料;均一次修复成功,无手术并发症发生。随访10~42个月,无一例复发。结论:术前应用CT和磁共振水成像能准确判断脑脊液鼻漏漏口的位置、大小,术中修补材料的选择、漏口周围移植床的处理及修补材料与移植床的完全接触是确保手术成功的重要因素。
[Abstract]:Objective: to summarize the experience in the treatment of cerebrospinal fluid rhinorrhea. Methods: the clinical data of 16 patients with cerebrospinal fluid rhinorrhea were analyzed retrospectively. The etiology, imaging features, location, size and effect of repair methods of cerebrospinal fluid rhinorrhinorrhea (CSF rhinorrhinorrhea) were studied. Results there were 10 cases of spontaneous cerebrospinal fluid rhinorrhea, 2 cases of traumatic cerebrospinal fluid rhinorrhea, 3 cases of cerebrospinal fluid rhinorrhea after colds, 1 case of meningeocele with cerebrospinal fluid rhinorrhea. Magnetic resonance hydrography confirmed the location of leakage in 7 cases. The leakage was located in the frontal sinus in 3 cases, at the top of nasal cavity in 3 cases, at the ethmoidal apex in 6 cases, and in the sphenoid sinus in 4 cases. All the operations were performed under nasal endoscope, and the repair materials were all autologous materials, all of which were successfully repaired at one time, and no complications occurred. Follow-up for 10 ~ 42 months showed no recurrence. Conclusion: preoperative CT and magnetic resonance hydrography can accurately determine the location and size of cerebrospinal fluid rhinorrhea and the choice of repair materials during operation. The treatment of the transplantation bed around the leak and the complete contact between the repair material and the graft bed are important factors to ensure the success of the operation.
【作者单位】：华中科技大学同济医学院附属协和医院耳鼻咽喉科;
【基金】：卫生行业科研专项(No:201202005) 吴阶平医学基金(No:LC1345) 湖北省分子影像重点实验室课题(No:02.03.2013-64)
【分类号】：R765

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