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本文作者报告由于蝶窦内的脑膜脑膨出造成的脑脊液鼻漏(CSFR)1例:男性,51岁。从1976年8月起常有左侧水样鼻涕流出,向下时则加重。翌年3月初诊时发现,头前倾则左鼻内即有液体滴出。检验滴出液证实为CSFR。过去史:1974年10月曾患化脓性脑膜炎而在内科住院治疗。无外伤及颅脑手术史。全身检查包括神经、内分泌、脑脊液等均正常。鼻腔检查:除粘膜普遍轻度水肿外,无特殊改变。X线照片见蝶鞍扩大,左蝶窦内有阴影。气脑造影可见蝶鞍内充满空气。同位素脑池扫描证实脑脊液经颅底向鼻内溢出,但不能确认脑脊液漏出的途径及部位。为此,乃改用棉球分别放入嗅裂、中鼻道及总鼻道内;再经3～4腰椎间穿刺注入靛卡红5ml于蛛网膜下腔内,10～25分钟后比较各部位棉球的染色程度,发现嗅裂的棉球染色稍浓。考虑为左蝶窦病变引起的CSFR。乃行鼻中隔矫正术及双鼻腔侧壁整复术,经左鼻腔开放前、后筛窦并钳除左蝶窦前壁后,即见一表面血管怒张之囊样肿物,来自蝶窦上外后方。穿刺抽出水样透明液体约1ml,检验证实含糖。穿刺后囊肿缩小,乃将其拉出,切除其根部。用大腿肌膜覆盖,并用肌肉充填蝶窦。切除之组织切片,除蝶窦粘膜外,见有
The authors report one case of cerebrospinal fluid rhinorrhea (CSFR) due to meninges in the sphenoid sinus: male, 51 years old. From August 1976 onwards, the left side of the water sample often ran out of noses, and then increased downward. The following year, when the first visit in March found that the left front of the head is tilted liquid drops. Test droplet confirmed CSFR. Past history: October 1974 had purulent meningitis and hospitalization in medicine. No trauma and craniocerebral surgery history. Whole body examination including nerves, endocrine, cerebrospinal fluid are normal. Nasal examination: In addition to mucosal general mild edema, no special changes. See X-ray enlargement of the sella, left sphenoid sinus there. Cerebral angiography shows the sella is filled with air. Isotope cistern scan confirmed cerebrospinal fluid transcranial base to the nasal overflow, but can not confirm the way and parts of cerebrospinal fluid leakage. To this end, instead of cotton balls were put into the olfactory fissure, the nasal passages and the total nasal tract; and then by 3 ~ 4 lumbar intercostal injection of indacarbol 5ml in the subarachnoid space, 10 to 25 minutes after the comparison of various parts The degree of staining of the cotton ball, found that sniff cracked cotton ball slightly thicker staining. Consider CSFR caused by left sphenoidopathy. Is the nasal septum corrective surgery and double nasal wall surgery, the left nasal opening before and after the ethmoid sinus and forceps anterior wall of the left sphenoid sinus, that see a surface of the vascular anger cystic mass from the sphenoid sinus Outside the rear. Piercing out of water-like transparent liquid about 1ml, the test confirmed that sugar. After puncturing the cyst shrinks, it is pulled out, the removal of its roots. Cover with thigh muscle, and use the muscle to fill the sphenoid sinus. Cut the tissue section, in addition to the sphenoid mucosa, see