外伤性脑脊液鼻漏的鼻内镜治疗

摘要

Objective: To investigate the effect of nasal endoscopic treatment of traumatic cerebrospinal fluid rhinorrhea. Methods: The clinical data of 36 cases in our hospital from June 2005 to October 2010 were reviewed retrospectively, such as the clinical manifestations, imaging data and surgical methods. Results: All the 36 cases patients showed skull base bone defect under high-resolution three-dimensional CT examinations, 29 cases were found that meningeal tissue herniated into the sinus by MRI examination. The finding by intraoperative endoscopy and the performance of preoperative imaging were consistent. None of the 36 cases showed recurrence after nasal endoscopic repair of cerebrospinal fluid leakage with a follow-up of 6 to 24 months. Conclusion: Meningeal tissue herniated into the sinus is the key reason leading to unhealed cerebrospinal fluid rhinorrhea in skull injury. High -resolution three -dimensional CT examination combined with MRI examination is a safe and effective method to determine the position of leakage. Endoscopic repair is the preferred method of cerebrospinal fluid rhinorrhea.%目的:探讨外伤性脑脊液鼻漏的鼻内镜治疗效果.方法:回顾我院2005年6月～2010年10月36例外伤性脑脊液鼻漏的临床资料,分析其临床表现、影像学资料及手术方法.结果:36例患者高分辨三维CT检查提示颅底骨质缺损,MRI检查其中29例发现有脑膜组织疝入鼻窦,术中鼻内镜检查与术前影像学检查结愈果一致,所有病例均行鼻内镜下脑脊液漏修补术,术后随访6～24个月,未见复发.结论:脑膜组织疝入鼻窦是外伤性脑脊液鼻漏不能愈合的主要原因,高分辨三维CT检查结合MRI检查是确定脑脊液鼻漏漏口位置安全、有效的方法,鼻内镜下脑脊液鼻漏修补术是治疗脑脊液鼻漏的首选方法.