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一种新型鼻内镜辅助方法用于封闭脑脊液鼻漏。

A Novel Nasal Endoscopy-Assisted Method for Sealing Cerebrospinal Fluid Rhinorrhea.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

J Craniofac Surg. 2024;35(5):1507-1508. doi: 10.1097/SCS.0000000000010278. Epub 2024 May 14.

Abstract

Cerebrospinal fluid (CSF) rhinorrhea is one of the most common complications after trans-sphenoidal surgery. At present, transcranial or endoscopic surgery for CSF leakage requires general anesthesia to remove autologous fat or fascia to repair the leak, which is traumatic and costly. The authors present a case of a 25-year-old male patient with pituitary adenoma who experienced CSF rhinorrhea 10 days after undergoing endoscopic resection of the tumor. The authors innovatively sequential filled the leak with a gelatin sponge soaked in povidone-iodine solution and iodinated gauze under outpatient nasal endoscopy. The follow-up of 6 months showed no recurrence of CSF leakage. CSF leakage is the most common complication of trans-sphenoidal surgery. The authors suggest that for small cerebrospinal fluid leaks in the early stage after trans-sphenoidal surgery, the leakage should be first filled with gelatin sponge and iodoform gauze sequentially under outpatient nasal endoscopy, which may achieve a complete cure.

摘要

脑脊液(CSF)鼻漏是经蝶窦手术后最常见的并发症之一。目前,针对 CSF 漏的经颅或内镜手术需要全身麻醉以去除自体脂肪或筋膜来修复漏口,这既具有创伤性又花费高。作者报告了 1 例 25 岁男性垂体瘤患者,该患者在肿瘤内镜切除术后 10 天发生 CSF 鼻漏。作者创新性地在门诊鼻内镜下,依次用浸透聚维酮碘溶液的明胶海绵和碘仿纱布填塞漏口。6 个月的随访显示无 CSF 漏复发。CSF 漏是经蝶窦手术最常见的并发症。作者建议,对于经蝶窦手术后早期较小的脑脊液漏,应首先在门诊鼻内镜下依次用明胶海绵和碘仿纱布填塞漏口,可能达到完全治愈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b37/11198945/9a6840ba829f/scs-35-1507-g001.jpg

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