Gunaratne Dakshika Abeydeera, Singh Narinder Pal
Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
BMJ Case Rep. 2015 Apr 29;2015:bcr2014209157. doi: 10.1136/bcr-2014-209157.
Spontaneous cerebrospinal fluid (CSF) leaks in the sphenoid sinus are an uncommon but potentially significant condition associated with thin pneumatised bone, obesity and raised intracranial pressure. Despite advances in endoscopic sinus surgery, successful repair remains problematic due to limitations in visualisation, access and management of underlying aetiological factors. Utilisation of vascularised tissue in the primary repair process of sphenoid CSF leaks is yet to be well explored in the literature. In this series, we describe our surgical approach and explore related clinical, pathological and operative factors in three cases of spontaneous sphenoid sinus CSF leaks, successfully repaired on first attempt with the use of a vascularised nasoseptal flap.
蝶窦自发性脑脊液漏是一种罕见但可能较为严重的病症，与骨质气化薄弱、肥胖及颅内压升高有关。尽管内镜鼻窦手术取得了进展，但由于可视化、入路及潜在病因管理方面存在局限性，成功修复仍存在问题。蝶窦脑脊液漏一期修复过程中使用带血管组织的情况在文献中尚未得到充分探讨。在本系列病例中，我们描述了手术方法，并探讨了3例蝶窦自发性脑脊液漏患者的相关临床、病理及手术因素，这3例患者首次尝试使用带血管鼻中隔瓣即成功修复。
