关键词: 脑脊液鼻漏, 脑脊液断层显像, 鼻内镜外科手术

Abstract:

Objective    To analyze the sites of cerebrospinal fluid rhinorrhea (CFR) via endoscopic treatment. Methods    A total of 16 patients with CFR were included in the retrospective analysis. Preoperative endoscopy, multi-slices spiral CT (MSCT) and 3D reconstruction, and SPECT/CT fusion imaging were performed to determine the ventage location which was analyzed and compared with the surgical findings. Results    14 patients showed bone changes of the skull based on CT imaging and 3D reconstruction. 15 patients had abnormally concentrated radionuclide activity from base of the skull to the nasal part on SPECT/CT fusion imaging. Cerebrospinal fluid (CSF) leakage could be observed in 4 cases via endoscopic examination. And site in 15 cases proved surgically could be shown by the above examination in localization of the sites of CSF leakage. Only one case, which had a different site surgically proved different from pre-operative examination, was diagnosed as cerebrospinal fluid otorrhea (CFO). Conclusion    Pre-operative endoscopy, multi-slices spiral CT (MSCT) and 3D reconstruction, and SPECT/CT fusion imaging can effectively identify the ventages in surgical treatment of CFR, and lay the foundation for successful diagnosis and treatment. But it is necessary to pay attention to the possibility of CFO when treating CFR.

Key words: Cerebrospinal fluid rhinorrhea, CSF tomography, Endoscopic surgical procedures, operative