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目的总结分析鼻内镜手术修补脑脊液鼻漏的方法及临床疗效。方法回顾性分析郑州大学第一附属医院耳鼻咽喉头颈外科2004年8月-2008年10月收治的36例经鼻内镜手术修补的脑脊液鼻漏患者的完整临床资料,其中外伤性9例,医源性4例,自发性23例。其中4例经2～6周的保守治疗无明显好转后给予鼻内镜下修补术。结果全部病例均找到漏口,其中漏口位于筛窦筛顶者20例,嗅裂区4例,蝶筛区3例,蝶窦11例。34例均一次治愈,2例患者因遗漏漏口而分别行2次和3次鼻内镜修补手术。全部病例均无颅内并发症发生。随访8个月～3.5年,无复发。结论鼻内镜手术修补脑脊液鼻漏具有微创、视野清晰、定位准确、方法灵活、可重复、低并发症和高成功率的优势。
Objective To summarize and analyze the methods of nasal endoscopic repair of cerebrospinal fluid rhinorrhea and its clinical efficacy. Methods The clinical data of 36 patients with cerebrospinal rhinorrhea who underwent endoscopic sinus surgery were retrospectively analyzed from August 2004 to October 2008 in the Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University. Among them, 9 cases were traumatic, 4 cases of origin, 23 cases of spontaneous. Among them, 4 cases were treated with endoscopic sinus surgery after 2 to 6 weeks of conservative treatment without any significant improvement. Results All cases were found to have leaks, of which 20 cases were located in the ethmoid sinus, 4 cases were olfactory fissure, 3 cases were in the butterfly sieve, and 11 cases were sphenoid sinus. Thirty-four patients were cured at one time, and two patients underwent two and three endoscopic repair operations, respectively, due to missed leaks. No cases of intracranial complications in all cases. Follow-up 8 months ~ 3.5 years, no recurrence. Conclusions Endoscopic sinus surgery to repair cerebrospinal fluid rhinorrhea has the advantages of minimally invasive, clear vision, accurate positioning, flexible method, repeatable, low complication and high success rate.