经眶内窥镜入路修复额窦脑脊液漏：病例系列研究。

Transorbital Endoscopic Approach for Repair of Frontal Sinus Cerebrospinal Fluid Leaks: Case-Series.

机构信息

Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, U.S.A.

出版信息

Laryngoscope. 2021 Aug;131(8):1753-1757. doi: 10.1002/lary.29161. Epub 2020 Oct 3.

DOI:10.1002/lary.29161

PMID:33009848

Abstract

OBJECTIVES

To highlight the feasibility and evaluate the outcomes of the transorbital endoscopic approach (TOEA) in the management of frontal sinus cerebrospinal fluid (CSF) leaks.

STUDY DESIGN

Retrospective case series.

METHODS

The database of patients with frontal sinus CSF leaks managed with TOEA from January 2017 through December 2019 at our institution was reviewed. Two videos of clinical case examples are presented.

RESULTS

Sixteen patients (10 males, 6 females, mean age 53; range 21-61 years) underwent TOEA through the superior eyelid corridor for the repair of frontal sinus CSF leak. The most common etiology of the CSF leak was trauma (nine cases; 56.3%), followed by injury from iatrogenic causes in six cases (37.5%), and spontaneous leak in one case (6.2%). Average defect size was 8.8 mm (range 2.0-20.8 mm). Ten patients were revision cases who had undergone prior nontransorbital CSF leak repair at outside institutions. All patients underwent successful repair via TOEA without postoperative complications. Complete resolution was maintained in all cases. Mean follow-up period was 11 months (range 6-22 months).

CONCLUSIONS

TOEA is a safe minimally disruptive alternative for definitive management of frontal sinus CSF leak in well-selected primary or revision cases. Further studies are necessary to define its indications and outcomes.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:1753-1757, 2021.

摘要

目的

强调经眶内窥镜入路（TOEA）在处理额窦脑脊液（CSF）漏中的可行性，并评估其结果。

研究设计

回顾性病例系列。

方法

回顾了 2017 年 1 月至 2019 年 12 月在我们机构通过 TOEA 治疗额窦 CSF 漏的患者数据库。呈现了两个临床病例示例的视频。

结果

16 名患者（10 名男性，6 名女性，平均年龄 53 岁；范围 21-61 岁）通过上眼睑通道接受 TOEA 治疗，以修复额窦 CSF 漏。CSF 漏的最常见病因是创伤（9 例；56.3%），其次是 6 例医源性损伤（37.5%），1 例自发性漏（6.2%）。平均缺损大小为 8.8mm（范围 2.0-20.8mm）。10 例患者为在其他机构接受过非经眶 CSF 漏修复的翻修病例。所有患者均通过 TOEA 成功修复，术后无并发症。所有病例均完全缓解。平均随访时间为 11 个月（范围 6-22 个月）。