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目的:探讨脑脊液鼻漏的诊断,治疗方法及其效果。方法:回顾性分析2003-01-2008-09收入武汉大学人民医院耳鼻咽喉头颈外科和神经外科的24例脑脊液鼻漏患者临床资料,耳鼻咽喉头颈外科18例,神经外科6例。结果:随访4～72个月24例患者均获治愈,保守治疗6例,手术治疗共18例,其中经鼻内镜下手术12例,鼻外入路4例,显微镜下经鼻入路2例。结论:经鼻内镜修补术在治疗经保守治疗无效的脑脊液鼻漏中具有安全,有效,创伤小,复发率低,术后头面部无切口的优点,尤其适用于漏口位于筛板和蝶窦区的患者。而对于复杂、缺损口较大、鼻内镜不易观察到漏口的脑脊液鼻漏,应选择鼻外或颅内入路术式进行修补。
Objective: To investigate the diagnosis, treatment and effect of cerebrospinal fluid rhinorrhea. Methods: The clinical data of 24 patients with cerebrospinal fluid rhinorrhea admitted to Department of Otorhinolaryngology-Head and Neck Surgery and Neurosurgery, Wuhan University People’s Hospital, 2003-01-2008-09 were reviewed retrospectively. Eighteen cases of otorhinolaryngology head and neck surgery and 6 cases of neurosurgery were retrospectively analyzed. RESULTS: Twenty-four patients were cured within 4 to 72 months of follow-up. Among them, conservative treatment was performed in 6 cases and surgery was performed in 18 cases. Among them, 12 cases underwent endoscopic sinus surgery, 4 cases under nasal approach and 2 cases under nasal approach under microscope example. Conclusion: Endoscopic repair of nasal endoscopic rhinorrhea in the treatment of ineffective cerebrospinal fluid rhinorrhea with conservative treatment is safe, effective, less trauma, low recurrence rate, the advantages of no head incision after surgery, especially for leakage in the sieve plate and butterfly Sinus area patients. For complex, larger defect, nasal endoscopy is not easy to observe the leakage of cerebrospinal fluid rhinorrhea, nasal or intracranial approach should be selected surgical repair.