Platt Michael P, Parnes Steven M
Department of Otolaryngology, Head and Neck Surgery, Boston University, Boston, Massachusetts, USA.
Curr Opin Otolaryngol Head Neck Surg. 2009 Feb;17(1):28-32. doi: 10.1097/MOO.0b013e32831fb593.
Cerebrospinal fluid leak during endoscopic sinus surgery is a potentially devastating complication; however, identification and appropriate management can prevent unfavorable outcomes. The purpose of this review is to outline the recent advances in the management of cerebrospinal fluid leaks that occur during endoscopic sinus surgery.
The low incidence of this complication makes prospective and randomized study difficult. The expanding role for endoscopic skull base surgery has brought new techniques and advances in the treatment of skull base reconstruction and cerebrospinal fluid fistula repair that can be applied to intraoperative leaks that occur during sinus surgery. Recent reports have focused on the prevention, identification, repair materials, repair technique, and infectious sequelae related to this complication.
Several successful techniques that utilize a variety of materials are available for the repair of cerebrospinal fluid leaks encountered during sinus surgery. The clinical scenario will determine the appropriate use of repair material, technique, and postoperative care.
鼻内镜鼻窦手术期间脑脊液漏是一种潜在的灾难性并发症；然而，识别和适当的处理可预防不良后果。本综述的目的是概述鼻内镜鼻窦手术期间发生的脑脊液漏处理方面的最新进展。
该并发症的低发生率使得前瞻性和随机研究很困难。内镜颅底手术作用的不断扩大带来了颅底重建和脑脊液瘘修补治疗方面的新技术和进展，可应用于鼻窦手术期间发生的术中漏。最近的报告集中在该并发症的预防、识别、修补材料、修补技术及感染后遗症方面。
有几种利用各种材料的成功技术可用于修补鼻窦手术期间遇到的脑脊液漏。临床情况将决定修补材料、技术及术后护理的适当应用。
