Dizdar Senem Kurt, Salepci Egehan, Coktur Alican, Seyhun Nurullah, Turk Bilge, Turgut Suat
Department of Otorhinolaryngology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Department of Otorhinolaryngology, University of Health Sciences Türkiye, Erzurum Training and Research Hospital, Erzurum, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Apr 5;58(1):17-22. doi: 10.14744/SEMB.2023.35589. eCollection 2024.
Our aim in this study is to assess the effect of factors such as age, etiology, defect size, application of lumbar drainage and surgical technique on Cerebrospinal Fluid (CSF) fistula repair success rates.
The Electronic Medical Records (EMR) system of our clinic was retrospectively reviewed for cases that were operated between 2006 and 2020 for CSF fistula originating from anterior skull base with endoscopic transnasal technique. A total of 35 patients were included in the study. Patients were grouped according to the number of layers used in repair (two, three or four-layered reconstruction) and defect size (smaller than 5 mm, 5 to 10 mm and larger than 10mm), etiology, location of the defect and application of lumbar drainage as LD (+) and LD (-). Complications and CSF leak recurrence were compared between groups.
Recurrence rates in patients who had 2 layered reconstructions were significantly higher compared to patients who had 3 or 4 layered reconstructions (p=0.049). The recurrence rate in LD (+) group (41.7%) was significantly lower compared to LD (-) group (4.3%) (p=0.012). There were no significant difference in recurrence rates between groups in terms of age, defect size, defect location and etiology.
In endoscopic transnasal repair of anterior skull base-derived bos fistulas, planning the reconstruction at least 3 times and applying lumbar CSF drainage increases the success rates.
本研究的目的是评估年龄、病因、缺损大小、腰大池引流的应用以及手术技术等因素对脑脊液（CSF）瘘修补成功率的影响。
回顾性分析我院门诊电子病历系统中2006年至2020年期间采用鼻内镜经鼻技术治疗的前颅底脑脊液瘘患者的病例。共纳入35例患者。根据修补所用层数（两层、三层或四层重建）、缺损大小（小于5mm、5至10mm和大于10mm）、病因、缺损位置以及腰大池引流的应用情况（LD(+)和LD(-)）对患者进行分组。比较各组之间的并发症和脑脊液漏复发情况。
两层重建患者的复发率显著高于三层或四层重建患者（p=0.049）。LD(+)组的复发率（41.7%）显著低于LD(-)组（4.3%）（p=0.012）。在年龄、缺损大小、缺损位置和病因方面，各组之间的复发率无显著差异。
在前颅底源性脑脊液瘘的鼻内镜经鼻修补术中，至少进行三层重建并应用腰大池脑脊液引流可提高成功率。
