Kosteljanetz M, von Buchwald C, Poulsgård L, Rasmussen N, Wagner A
H:S Rigshospitalet, Neurocentret, neurokirurgisk afdeling, HovedOrtoCentret, øre-naese-hals-kirurgisk klinik.
Ugeskr Laeger. 2001 Aug 6;163(32):4201-3.
Conventionally, cranionasal cerebrospinal fluid (CSF) fistulas have been closed by repair of the dural defect via an open craniotomy. These techniques may be cumbersome, not without complications, and far from successful. In recent years, endoscopic techniques have been developed in the field of nasal surgery and neurosurgery. Furthermore, by means of computer-aided surgery or neuronavigation, it is possible to identify the surgical track with a high degree of accuracy and, by the same token, identify the defect in the cranium.
By combining the endoscopic technique with computer-aided surgery, we have operated on six patients with cranionasal CSF fistulas endonasally. The fistula was confirmed before surgery by subaracnoidal injection of fluorescein.
The surgery was successful and without any complications in all six cases.
The method is recommended as the operation of first choice for cranionasal CFS fistulas, as compared to transcranial surgery. It is probably more efficient and with fewer complications than conventional surgery. A collaboration between neurosurgeons and ENT surgeons, like ours, can be recommended.
传统上，颅鼻脑脊液瘘通过开颅手术修复硬脑膜缺损来闭合。这些技术可能操作繁琐，并非没有并发症，而且远非总能成功。近年来，鼻科手术和神经外科领域已开发出内镜技术。此外，借助计算机辅助手术或神经导航，可以高度精确地确定手术路径，同样也能确定颅骨缺损。
通过将内镜技术与计算机辅助手术相结合，我们对6例颅鼻脑脊液瘘患者进行了鼻内镜手术。术前通过蛛网膜下腔注射荧光素确认瘘口。
所有6例手术均成功且无任何并发症。
与经颅手术相比，该方法被推荐为颅鼻脑脊液瘘的首选手术方式。它可能比传统手术更有效且并发症更少。像我们这样的神经外科医生和耳鼻喉科医生之间的合作是值得推荐的。
