Yang Lijun, Wu Jianliang, Zhang Gengshen, Zhao Zongmao, Fan Zhenzeng, Wang Baozhi
From the *Department of Human Anatomy, Hebei Medical University, Shijiazhuang; and †Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
J Craniofac Surg. 2013;24(5):1646-9. doi: 10.1097/SCS.0b013e3182902de6.
In this study, we examined the effectiveness of percutaneous injected fibrin glue as a treatment for frontal sinus cerebrospinal fluid (CSF) rhinorrhea in a series of 4 cases. All 4 patients had fracture in the posterior wall of the frontal sinus. The anterior wall of the frontal sinus was punctured following high-resolution computed tomography imaging. In 3 out of 4 patients with defective skull due to prior frontal craniotomy, direct percutaneous puncture of the frontal sinus was used. Fibrin glue was injected to close the fistula and to seal the rhinorrhea. Surgery procedures lasted for 15-35 minutes (average 27.6 min). Rhinorrhea was stopped in all patients after the surgery, with no recurrence at a 10-month follow-up visit. In 1 case, the glue was expelled by coughing at 2 days after the surgery but was completely stopped with no recurrence after a second attempt. One patient with no recurrence at a 10-month follow-up died of tumor relapse at 12 months. In summary, fibrin glue could be used as a novel treatment for frontal sinus CSF rhinorrhea.
在本研究中，我们对4例额窦脑脊液鼻漏患者采用经皮注射纤维蛋白胶治疗，观察其疗效。4例患者均有额窦后壁骨折。在高分辨率计算机断层扫描成像后，经皮穿刺额窦前壁。4例中有3例因既往额部开颅手术导致颅骨缺损，采用直接经皮穿刺额窦。注入纤维蛋白胶以封闭瘘口并止住鼻漏。手术过程持续15 - 35分钟（平均27.6分钟）。术后所有患者鼻漏均停止，在10个月的随访中无复发。1例患者术后2天因咳嗽排出胶水，但再次注射后完全止住且无复发。1例在10个月随访时无复发的患者在12个月时死于肿瘤复发。总之，纤维蛋白胶可作为额窦脑脊液鼻漏的一种新的治疗方法。
