García-Uría J, Carrillo R, Serrano P, Bravo G
J Neurosurg. 1979 Apr;50(4):466-71. doi: 10.3171/jns.1979.50.4.0466.
The association of an empty sella with rhinorrhea is an unusual finding. Of 29 cases of empty sella observed by the authors, eight underwent surgery for rhinorrhea. None of the patients showed clinical evidence of increased intracranial pressure or hydrocephalus. Seven were cases of primary empty sella, the eighth was an acromegalic patient, who had received radiotherapy 4 years before. Except for this patient, the others showed no clinical signs of a previous tumor. In the surgical treatment of these patients, the authors used both the transfrontal and transsphenoidal approaches. In spite of generally accepted good results following surgical closure of this type of fistula, four patients needed more than one operation. The fistula closed in only three of them; in the last patient rhinorrhea persisted after three operations.
空蝶鞍与脑脊液鼻漏相关是一种不常见的发现。在作者观察的29例空蝶鞍病例中,8例因脑脊液鼻漏接受了手术。所有患者均无颅内压升高或脑积水的临床证据。7例为原发性空蝶鞍,第8例是一名肢端肥大症患者,4年前接受过放疗。除该患者外,其他患者均无既往肿瘤的临床体征。在这些患者的手术治疗中,作者采用了经额和经蝶两种入路。尽管这类瘘口手术封闭后普遍认为效果良好,但4例患者需要不止一次手术。其中只有3例瘘口闭合;最后1例患者在3次手术后仍有脑脊液鼻漏。