Lai Yubin, He Xingchen, Wang Jian, Xu Min, Chen Xiaodong
Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of PLA Air Force Medical University,Xi'an,710032,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep;35(9):833-836. doi: 10.13201/j.issn.2096-7993.2021.09.014.
To investigate the application and efficacy of pedicled middle turbinate mucosal flap in transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. 15 patients with cerebrospinal fluid rhinorrhea were retrospectively analyzed,including 13 patients with simple cerebrospinal fluid rhinorrhea (86.7%) and 2 patients with cerebrospinal fluid rhinorrhea with meningoencephalocele (13.3%). According to the location of the fistula, the pedicled middle turbinate mucosal flap under nasal endoscopy was used to repair cerebrospinal fluid rhinorrhea, in which 5 cases (33.3%) had leakage at the top of the sieve and 8 cases (53.3%) had leakage at the sieve plate. Two cases had leakage at the lateral racess of sphenoid sinus. All cases of cerebrospinal fluid rhinorrhea were repaired successful and the mucosa epithelialized well in the operative area. There was no recurrence of cerebrospinal fluid rhinorrhea or other complications during the follow-up period of 4-24 months (average 13 months). The pedicled middle turbinate mucosal flap has a high success rate for repairing cerebrospinal fluid rhinorrhea, and the nasal cavity damage is small, which is worthy of clinical promotion.
探讨带蒂中鼻甲黏膜瓣在鼻内镜下脑脊液鼻漏修补术中的应用及疗效。回顾性分析15例脑脊液鼻漏患者,其中单纯脑脊液鼻漏13例(86.7%),合并脑膜脑膨出的脑脊液鼻漏2例(13.3%)。根据瘘口位置,在内镜下采用带蒂中鼻甲黏膜瓣修补脑脊液鼻漏,其中筛顶漏5例(33.3%),筛板漏8例(53.3%),蝶窦外侧壁漏2例。所有脑脊液鼻漏病例均修补成功,术区黏膜上皮化良好。在4~24个月(平均13个月)的随访期内,无脑脊液鼻漏复发及其他并发症发生。带蒂中鼻甲黏膜瓣修补脑脊液鼻漏成功率高,鼻腔损伤小,值得临床推广。