Floris R, Salvatore C, Fraioli B, Pastore F S, Vagnozzi R, Simonetti G
Department of Radiology, University of Rome Tor Vergata, Italy.
Neuroradiology. 1998 Oct;40(10):690-4. doi: 10.1007/s002340050666.
Cerebrospinal fluid (CSF) leakage after trans-sphenoidal surgery is a troublesome complication with a risk of meningitis and pneumocephalus. We suggest CT-guided intrasphenoidal injection of fibrin sealant through a 12-gauge needle as a simple alternative to surgical management of CSF fistulae. We treated eight patients, operated via the trans-sphenoidal route (five pituitary adenomas, three craniopharyngiomas), for a postoperative CSF leak by CT-guided intrasphenoidal injection of fibrin sealant alone in three cases and fibrin sealant and autologous blood in 5. CT was obtained 10 days after the procedure in all cases. In four patients, the CSF leak was closed successfully at the first attempt. The procedure was repeated on the four remaining patients because only a reduction in leakage was obtained at the first attempt. This procedure preserves olfaction and avoids the risk of frontal lobe damage. It could therefore represent the treatment of choice in many cases of anterior cranial fossa postsurgical CSF leaks.
经蝶窦手术后脑脊液（CSF）漏是一种麻烦的并发症，存在脑膜炎和气颅的风险。我们建议通过12号针在CT引导下经蝶窦内注射纤维蛋白封闭剂，作为脑脊液瘘手术治疗的一种简单替代方法。我们治疗了8例经蝶窦入路手术的患者（5例垂体腺瘤，3例颅咽管瘤），其中3例仅通过CT引导经蝶窦内注射纤维蛋白封闭剂治疗术后脑脊液漏，5例采用纤维蛋白封闭剂和自体血治疗。所有病例均在术后10天进行CT检查。4例患者首次尝试即成功封闭脑脊液漏。其余4例患者因首次尝试仅使漏液减少而重复该操作。该操作可保留嗅觉并避免额叶损伤风险。因此，它可能是许多前颅窝术后脑脊液漏病例的首选治疗方法。
