Ear, Nose, and Throat Services Department, King Abdul Aziz Medical City, Riyadh, Saudi Arabia.
Laryngoscope. 2011 May;121(5):909-13. doi: 10.1002/lary.21355. Epub 2011 Mar 29.
OBJECTIVES/HYPOTHESIS: Several techniques of endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea were prescribed. Defect localization was mandatory for all.
Prospective study.
A prospective study was conducted on nonaccidental CSF rhinorrhea. The sensitivity and specificity of image-guided navigation in localizing the defect were studied. The feasibility and reliability of the bath plug technique in repairing the defect were assessed. Six cases were included.
CFS rhinorrhea was spontaneous in four and iatrogenic in two. Two defects were in the fovea ethmoidalis, two in the cribriform plate, and two in the sphenoid. The repairing graft was successfully positioned in five cases. In one case a sphenoid obliteration was done. Image-guided navigation proved useful in localizing the defect with a sensitivity and specificity of 100%. All patients were available for follow-up (mean = 19 months). The overall success rate was 83%, and the mean number of surgeries per patient was one.
The bath plug was feasible for repairing the anterior skull base defects but not for all the sphenoid defects. It proved reliable as a single management in cases with normal intracranial pressure. The image-guided navigation overrides, in sensitivity and specificity, other methods of localization of the anterior skull base defects.
目的/假设：已经规定了几种内镜修复脑脊液（CSF）鼻漏的技术。所有技术都需要对缺陷进行定位。
前瞻性研究。
对非外伤性 CSF 鼻漏进行了前瞻性研究。研究了图像引导导航定位缺陷的敏感性和特异性。评估了浴盆塞技术修复缺陷的可行性和可靠性。共纳入 6 例患者。
4 例为自发性 CFS 鼻漏，2 例为医源性。2 个缺陷位于筛凹，2 个位于筛板，2 个位于蝶窦。5 例修复移植物成功定位。1 例进行了蝶窦填塞。图像引导导航在定位缺陷方面具有 100%的敏感性和特异性。所有患者均可进行随访（平均随访时间=19 个月）。总体成功率为 83%，平均每位患者的手术次数为 1 次。
浴盆塞可用于修复前颅底缺陷，但不适合所有蝶窦缺陷。在颅内压正常的情况下，作为单一治疗方法，其具有可靠性。图像引导导航在敏感性和特异性方面优于前颅底缺陷的其他定位方法。
