鼻内镜下自体材料脑脊液鼻漏修补术(附16例临床分析)

doi:10.6040/j.issn.1673-3770.0.2016.377

摘要/Abstract

摘要： 目的评价采用自体材料经鼻内镜脑脊液鼻漏修补术的手术方法和治疗效果。方法回顾性分析2010年至2015年诊断为脑脊液鼻漏的16例患者的临床资料。所有患者行鼻内镜下脑脊液鼻漏修补术,其中自发性6例,外伤性5例,医源性5例。采用的修补材料有颞肌、颞肌筋膜、中鼻甲黏膜、中鼻甲骨、鼻中隔黏膜、下鼻甲黏膜、阔筋膜、腹部脂肪、钩突黏膜等,均为自体材料。结果 16例患者中,一次修补成功15例, 二次手术修补成功1例。术中及术后均未发生严重并发症。结论鼻内镜下自体材料脑脊液鼻漏修补术是一种安全、有效和微创的手术方式,成功率高。术前准确的漏口定位、选择合适的手术入路和适宜的修补材料是手术成功的关键。

关键词: 微创手术, 鼻窦, 前颅底, 脑脊液鼻漏, 鼻内镜外科

Abstract: Objective To evaluate the surgical technique and clinical effects of transnasal endoscopic repair of cerebrospinal fluid(CSF)rhinorrhea. Methods From 2010 to 2015, sixteen patients with CSF rhinorrhea were treated with transnasal endoscopic surgery, including 5 patients with traumatic CSF rhinorrhea, 6 patients with spontaneous CSF rhinorrhea, and 5 patients with iatrogenic CSF rhinorrhea. The temporalis muscle, temporalis fascial, middle turbinate mucosa and bone, nasal septum mucosa, inferior turbinate mucosa, fascia lata, abdominal fat, and uncinate process mucosa were used for repairing the CSF fistulae. Results Fifteen patients were successfully repaired after the first operation, and 1 after the second attempt. No serious complications were observed during and after the operation. Conclusion Transnasal endoscopic repair of CSF rhinorrhea is a safe, effective, minimally invasive, and high successful surgical procedure. Accurate leakage site identification before the operation, suitable surgical approach and repairing materials are critical to achieving successful result.

Key words: Minimally invasive surgical procedures, Paranasal sinuses, Anterior cranial fossa, Endoscopic sinus surgery, Cerebrospinal fluid rhinorrhea

中图分类号:

R765.24

王军民,陈海兵,陈曦,陆美萍,陈智斌,程雷. 鼻内镜下自体材料脑脊液鼻漏修补术(附16例临床分析)[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 37-41.

WANG Junmin, CHEN Haibing, CHEN Xi, LU Meiping, CHEN Zhibin, CHENG Lei. Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a clinical analysis of 16 cases.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 37-41.

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