【摘要】：目的:總結(jié)腦脊液鼻漏的治療經(jīng)驗(yàn)。方法:回顧性分析16例腦脊液鼻漏患者的臨床資料,探討腦脊液鼻漏的病因、影像學(xué)特點(diǎn)及漏口位置、大小、修復(fù)方法對(duì)療效的影響。結(jié)果:16例患者中自發(fā)性腦脊液鼻漏10例,外傷性腦脊液鼻漏2例,感冒后出現(xiàn)腦脊液鼻漏3例,腦膜腦膨出伴腦脊液鼻漏1例。CT檢查明確漏口位置11例,磁共振水成像檢查明確漏口位置7例。漏口位于額竇3例,鼻腔頂部3例,篩頂6例,蝶竇4例。手術(shù)均在鼻內(nèi)鏡下完成,修補(bǔ)材料均采用自體材料;均一次修復(fù)成功,無(wú)手術(shù)并發(fā)癥發(fā)生。隨訪10~42個(gè)月,無(wú)一例復(fù)發(fā)。結(jié)論:術(shù)前應(yīng)用CT和磁共振水成像能準(zhǔn)確判斷腦脊液鼻漏漏口的位置、大小,術(shù)中修補(bǔ)材料的選擇、漏口周?chē)浦泊驳奶幚砑靶扪a(bǔ)材料與移植床的完全接觸是確保手術(shù)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.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院耳鼻咽喉科;
【基金】：衛(wèi)生行業(yè)科研專(zhuān)項(xiàng)(No:201202005) 吳階平醫(yī)學(xué)基金(No:LC1345) 湖北省分子影像重點(diǎn)實(shí)驗(yàn)室課題(No:02.03.2013-64)
【分類(lèi)號(hào)】：R765

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本文編號(hào)：2235477