Visot A, Cophignon J, Derome P J
Sem Hop. 1980;56(3-4):158-66.
A series of 140 surgical cases of CSF rhinorrhea have been reviewed, their diagnostic difficulties outlined and the possible etiologies and the modes of surgical approach explained. The localization of the leak is difficult in traumatic cases but if one searches diligently for the source with polytomography of the skull base as well as utilizing repetitive radioisotope studies, one can definitely find the source of the rhinorrhea. If the patient presents with purulent meningitis, a fistulous tract, acquired or congenital, should be sought and if present resected. Only precise surgical technique in and around the skull base in cases of rhinorrhea, allows total definitive recovery without recurrent leak and prevents post operative rhinorrhea in routine basal and trans-sphenoidal neurosurgical procedures.
回顾了140例脑脊液鼻漏的外科手术病例，概述了其诊断难点，并解释了可能的病因及手术入路方式。在创伤性病例中，漏口的定位较为困难，但如果通过颅底断层摄影术仔细寻找漏口源头，并利用放射性同位素重复检查，就一定能找到鼻漏的源头。如果患者出现化脓性脑膜炎，应寻找后天性或先天性的瘘管，如有则予以切除。对于脑脊液鼻漏病例，只有在颅底及其周围采用精确的外科技术，才能实现完全彻底康复且无漏液复发，并在常规的颅底和经蝶窦神经外科手术中防止术后脑脊液鼻漏。
