Kljajić Vladimir, Vuleković Petar, Vlaški Ljiljana, Savović Slobodan, Dragičević Danijela, Papić Vladimir
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, ENT Clinic, Hajduk Veljkova, Novi Sad, Serbia.
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic of Neurosurgery, Hajduk Veljkova, Novi Sad, Serbia.
Braz J Otorhinolaryngol. 2017 Jul-Aug;83(4):388-393. doi: 10.1016/j.bjorl.2016.04.024. Epub 2016 Jun 4.
Nasal liquorrhea indicates a cerebrospinal fluid fistula, an open communication between the intracranial cerebrospinal fluid and the nasal cavity. It can be traumatic and spontaneous.
The aim of this study was to assess the outcome of endoscopic repair of cerebrospinal fluid fistula using fluorescein.
This retrospective study included 30 patients of both sexes, with a mean age of 48.7 years, treated in the period from 2007 to 2015. All patients underwent lumbar administration of 5% sodium fluorescein solution preoperatively. Fistula was closed using three-layer graft and fibrin glue.
Cerebrospinal fluid fistulas were commonly located in the ethmoid (37%) and sphenoid sinus (33%). Most patients presented with traumatic cerebrospinal fluid fistulas (2/3 of patients). The reported success rate for the first repair attempt was 97%. Complications occurred in three patients: one patient presented with acute hydrocephalus, one with reversible encephalopathy syndrome on the fifth postoperative day with bilateral loss of vision, and one patient was diagnosed with hydrocephalus two years after the repair of cerebrospinal fluid fistula.
Endoscopic diagnosis and repair of cerebrospinal fluid fistulas using fluorescein intrathecally has high success rate and low complication rate.
鼻漏提示存在脑脊液瘘，即颅内脑脊液与鼻腔之间的开放性通道。它可由外伤引起，也可为自发性的。
本研究旨在评估使用荧光素进行脑脊液瘘内镜修复的效果。
这项回顾性研究纳入了2007年至2015年期间治疗的30例患者，男女均有，平均年龄48.7岁。所有患者术前均经腰椎注射5%荧光素钠溶液。采用三层移植物和纤维蛋白胶封闭瘘口。
脑脊液瘘常见于筛窦（37%）和蝶窦（33%）。大多数患者为外伤性脑脊液瘘（占患者的2/3）。首次修复尝试的报告成功率为97%。3例患者出现并发症：1例患者出现急性脑积水，1例在术后第5天出现可逆性脑病综合征伴双侧视力丧失，1例患者在脑脊液瘘修复两年后被诊断为脑积水。
鞘内注射荧光素进行脑脊液瘘的内镜诊断和修复成功率高、并发症发生率低。
