Shi Jian-Bo, Chen Feng-Hong, Fu Qing-Ling, Xu Rui, Wen Wei-Ping, Hou Wei-Jian, Guo Jie-Bo, Zhang Xiang-Min, Xu Geng
Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China.
ORL J Otorhinolaryngol Relat Spec. 2010;72(1):56-62. doi: 10.1159/000275675. Epub 2010 Mar 24.
To clarify the utility of a safe and effective endoscopic procedure for closing frontal sinus cerebrospinal fluid (CSF) leaks.
A retrospective review of all 15 patients seen at our hospital from 2002 to 2008 whose CSF leak originated within the frontal sinus or frontal recess. A transnasal endoscopic or combined transfrontal endoscopic approach was used to repair the CSF leak. RESULTS AND SURGICAL OUTCOMES: Four defects originated in the frontal recess and 11 involved the posterior wall of the frontal sinus. Nine patients were repaired by a direct endoscopic approach and 4 patients were repaired after widening the frontal recess endoscopically. Two patients were repaired using the combined transfrontal and transnasal approach. The leak was stopped in 14 cases (93%) after the first operation. One patient (7%) required a second repair 1 month after initial surgery and has remained well after 27 months. Complications included a frontal lobe abscess and a frontal sinus obstructive mucocele. These 2 patients were successfully treated without further complications. Patient follow-up ranged from 4 to 44 months (mean 30 months).
Most frontal CSF leaks can be successfully closed by an endoscopic surgical approach.
阐明一种安全有效的内镜手术治疗额窦脑脊液漏的效用。
回顾性分析2002年至2008年在我院就诊的15例脑脊液漏起源于额窦或额隐窝的患者。采用经鼻内镜或联合经额内镜入路修复脑脊液漏。结果与手术结果：4处缺损起源于额隐窝，11处累及额窦后壁。9例患者采用直接内镜入路修复，4例患者经内镜扩大额隐窝后修复。2例患者采用经额和经鼻联合入路修复。首次手术后14例（93%）漏口停止。1例患者（7%）在初次手术后1个月需要二次修复，术后27个月情况良好。并发症包括额叶脓肿和额窦阻塞性黏液囊肿。这2例患者均成功治疗，无进一步并发症。患者随访时间为4至44个月（平均30个月）。
大多数额窦脑脊液漏可通过内镜手术成功闭合。
