Wielgosz R, Mroczkowski E
Kliniki Laryngologicznej Szpitala Alfrieda Kruppa w Essen, Niemcy.
Otolaryngol Pol. 1995;49(6):525-31.
The authors describe two female patients with CSF-leakage. The first patient showed spontaneous CSF rhinorrhea from a leak in the posterior wall of the sphenoid sinus and the second one showed a traumatic fistula in "lamina cribrosa" area. The treatment of choice is closure of the CSF leakage by nasal surgeon (intranasal and with help of binocular microscope under hypotensive anaesthesia) using either intranasal-transseptal or intranasal-transethmoidal approach). This preserves olfaction and avoids the risk of a neurosurgical or paranasal methods. The diagnosis of CSF rhinorrhea can be established by beta-2 transferrin test, isotope scanning or fluorescence endoscopy. The high-resolutions CT is the best method for localization of the bone defect. The intranasal interposition of fascial or conchal grafts with use of fibrigen glue in cases of small defect (< 1-2 cm) is always successful.
作者描述了两名脑脊液漏的女性患者。首例患者表现为蝶窦后壁漏口导致的自发性脑脊液鼻漏，第二例患者在“筛板”区域出现外伤性瘘管。首选的治疗方法是由鼻科医生（在降压麻醉下经鼻并借助双目显微镜）采用经鼻 - 鼻中隔或经鼻 - 筛窦入路封闭脑脊液漏。这样可保留嗅觉并避免神经外科或鼻旁手术方法带来的风险。脑脊液鼻漏的诊断可通过β - 2转铁蛋白检测、同位素扫描或荧光内镜检查来确立。高分辨率CT是定位骨缺损的最佳方法。对于小缺损（<1 - 2厘米）病例，使用纤维蛋白胶经鼻置入筋膜或鼻甲移植物总是成功的。
