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目的:探讨脑脊液鼻漏的最佳治疗方法。方法:45例经鼻内镜行脑脊液鼻漏修补术患者,42例经鼻进路,3例经鼻及鼻外双进路。采用患者自体游离阔筋膜、捣碎的肌肉,剥去骨质带骨膜的中鼻甲或下鼻甲作为修补移植物,修补采用内贴修补法、堵塞修补法、外贴修补法和充填修补法。结果:1次性手术修补成功44例(97.8%)。术后并发脑膜炎3例,额窦区感染皮瓣下积液1例。45例住院治疗7～30d,平均11d。随访5个月～7年,无复发。结论:对于前颅底小瘘口和鞍底、斜坡处瘘口的脑脊液鼻漏,经鼻内镜脑脊液鼻漏修补具有明显优势。修补方式、方法和修补材料的正确选择是修补成功的关键。
Objective: To explore the best treatment of cerebrospinal fluid rhinorrhea. Methods: Forty-five patients underwent endoscopic rhinorrhea repair by nasal endoscopy. Forty-two patients underwent transnasal approach and three received nasal and nasal route. Patients with free fascia lata, mashed muscles, stripped of the periosteum of the middle turbinate or inferior turbinate as a repair of the graft, repair the use of intramural repair method, plug repair method, patch method and fill the external repair method. Results: One-time surgical repair in 44 cases (97.8%). Postoperative patients with meningitis in 3 cases, frontal sinus infection in 1 case of effusion. 45 cases of hospitalized 7 ~ 30d, an average of 11d. Follow-up of 5 months to 7 years, no recurrence. Conclusion: For the leakage of cerebrospinal fluid rhinorrhea at the fistula at the anterior skull base and the sella at the base of the sella, the transnasal endoscopic rhinorrhea repair has obvious advantages. The correct choice of repair methods, methods and repair materials is the key to successful repairs.