【摘要】 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。更多还原

【Abstract】 Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008,among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months.All the cases were successfully cured,among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found.The 18 cases under surgery included endoscopic approach(12 cases),extra-nasal approach(4 cases),transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive,safety and efficiency of transnasal endoscopic technique for CSF leaks,but also without facial scarring after operation.Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak,located at the cribriform plate or the sphenoid sinus.The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak,or the leak site is not easily found with endoscopic.更多还原