Department of Otolaryngology, University Hospital of Modena, Modena, Italy.
Acta Otorhinolaryngol Ital. 2009 Aug;29(4):191-6.
Aim of this report is to describe the long-term results of endoscopic endonasal repair of cerebrospinal fluid leak using a septal mucoperichondrial graft. A case series of 52 patients operated for cerebrospinal fluid rhinorrhea between 1990 and 2006 is presented. All patients underwent surgical treatment for endoscopic endonasal closure of a cerebrospinal fluid leak using a septal mucoperichondrial graft. No lumbar drain and fluorescein tests were used. The intra-operative localization of the fistula was aided by Valsalva's manoeuvre by the anaesthetist. The success rate, after the first attempt, was 88.5% (46/52 patients); for the remaining 11.5% (6/52 patients), a second attempt was necessary which proved successful in 5 cases, raising the overall success rate to 98.1% (51/52 patients). Relapse occurred in only one case (1.9%), after the second attempt. In conclusion, a free mucoperichondrial graft offered good results for cerebrospinal fluid leak repair. In the Authors' experience, a high success rate can be achieved without the use of intrathecal fluorescein and lumbar drain.
本报告旨在描述使用鼻中隔黏膜软骨移植物经内镜鼻内修复脑脊液漏的长期结果。本研究回顾性分析了 1990 年至 2006 年间因脑脊液鼻漏接受内镜鼻内手术治疗的 52 例患者。所有患者均采用鼻中隔黏膜软骨移植物行内镜鼻内闭合术治疗脑脊液漏。术中未使用腰椎引流和荧光素试验。麻醉师通过瓦氏动作协助术中瘘口定位。首次尝试的成功率为 88.5%（52 例患者中的 46 例）；对于其余 11.5%（52 例患者中的 6 例），需要进行第二次尝试，其中 5 例成功，总体成功率提高至 98.1%（52 例患者中的 51 例）。第二次尝试后仅 1 例（1.9%）复发。总之，游离黏膜软骨移植物在修复脑脊液漏方面效果良好。作者经验表明，不使用鞘内荧光素和腰椎引流也能获得较高的成功率。
