鼻内镜及高分辨CT在脑脊液鼻漏诊治中的应用研究  

The application nasal endoscopy and high resolution CT in the diagnosis and treatment of cerebrospinal fluid rhinorrhea

作　　者：李吉洲 宋建京 王少波[1] 王学海[1] 韩丽[1] 

机构地区：[1]山东省威海市立医院耳鼻咽喉头颈外科,264200

出　　处：《中国临床实用医学》2010年第11期77-79,共3页China Clinical Practical Medicine

摘　　要：目的探讨经鼻内镜下脑脊液鼻漏修补术中准确寻找漏口及术后综合治疗的相关问题。方法收集我科2005—2009年经鼻内镜修补脑脊液鼻漏患者28例的临床资料，外伤后脑脊液鼻漏20例，特发性脑脊液鼻漏8例，通过螺旋薄层CT及鼻内镜下漏口处黏膜的特点确定漏口的位置，采用大腿阔筋膜作为修补材料。结果所有患者随访3个月以上，28例患者中，初次手术者27例，1例为再次手术者。漏口单独位于筛顶的11例，筛板的6例，蝶窦的6例，额窦开口处及额窦的4例，筛蝶窦均有漏口的1例，均一次性成功治愈。结论螺旋薄层CT及鼻内镜下漏口处苍白色水肿黏膜对确定漏口至关重要，术后采用综合治疗有利于保证漏口的修补成功。Objective To evaluate the endoscopic repair of cerebrospinal fluid rhinorrhea accurately and combined therapy after operation. Methods Collected our department endoscopic repair of cerebrospinal fluid rhinorrhea clinical data of 28 patients from 2005 to 2009, with post-traumatic cerebrospinal fluid rhinorrhea in 20 cases, idiopathic in 8 cases of cerebrospinal fluid rhinorrhea. By thin-layer spiral CT and endoscopic mucosal leakage characteristics of the mouth to determine the location of mouth leakage, using thigh fascia lata as a repair material. Results All 28 patients were followed up for more than 3 months, the initial surgery in 27 cases, 1 case was re-surgery. The sites of cerebrospinal fluid is located in the Ethmoid roof wall of 11 cases, 6 cases of cribriform plate, sphenoid sinus in 6 cases, frontal sinus openings in 4 cases, 1 case of Ethmoid and sphenoid sinus. All patients were successfully treated once. Conclusion Thin spiral CT and endoscopic drain mouth pale edema mouth mucosa is essential for determining the leakage. The combined treatment after operation will help ensure a successful surgical repair.

关 键 词：鼻内镜手术 高分辨CT 水肿黏膜 脑脊液鼻漏 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]