CAJ | 학술논문

目的探讨外伤性迟发性脑脊液鼻漏的发病原因及临床诊治特点.方法回顾性分析中山大学附属第一医院院2000-2008年收治的13例外伤≥3个月后出现脑脊液鼻漏患者的临床资料,重点分析术前CT及MRI扫描的结果 ,结合术中所见,分析两者之间的关系.结果 13例患者颅底均有陈旧性骨折,MRI扫描显示其中11例有软组织自颅底缺损处疝入鼻窦.术中鼻内镜检查见骨质缺损最小约为0.1 cm×0.2 cm;最大约为1.2 cm×1.5 cm,漏口部位与CT检查结果一致,其中11例漏口处可见暴露的硬脑膜及坏死组织.所有病例均采用经鼻内镜下脑脊液鼻漏修补术,术后随访12～36个月,未见复发.结论脑膜组织经颅底缺损疝入鼻窦为外伤后脑脊液鼻漏迟发的关键因素,CT、MRI检查有助于明确漏口位置,其治疗宜采用鼻内镜下脑脊液鼻漏修补术.
목적 탐토외상성지발성뇌척액비루적발병원인급림상진치특점.방법 회고성분석중산대학부속제일의원원2000-2008년수치적13예외상≥3개월후출현뇌척액비루환자적림상자료,중점분석술전CT급MRI소묘적결과 ,결합술중소견,분석량자지간적관계.결과 13례환자로저균유진구성골절,MRI소묘현시기중11례유연조직자로저결손처산입비두.술중비내경검사견골질결손최소약위0.1 cm×0.2 cm;최대약위1.2 cm×1.5 cm,루구부위여CT검사결과 일치,기중11례루구처가견폭로적경뇌막급배사조직.소유병례균채용경비내경하뇌척액비루수보술,술후수방12～36개월,미견복발.결론 뇌막조직경로저결손산입비두위외상후뇌척액비루지발적관건인소,CT、MRI검사유조우명학루구위치,기치료의채용비내경하뇌척액비루수보술.
Objective To explore the etiological factor,diagnostic localization and treatment of delayed cerebrospinal fluid(CSF)rhinorrhea.Methods The medical records of 79 patients who had undergone endoscopic repair of CSF rhinorrhea between 2000 and 2008 were reviewed.Thirteen patients with CSF leaks occurred 3 months after head trauma.All 13 patients with delayed CSF leak were retrospectively evaluated with CT or MRI and SHrgically treated.The operative findings were compared with the results of CT or MRI to estimate the diagnostic value of imaging technique.Results Bonv defects had been found on CT scanning in all 13 patients.Neural tissue herniation into the nasal sinuses was found in 11 patients during the surgery.The sizes of the leak ranged from 0.1 cm×0.2 cm to 1.2 cm×1.5 cm.Reconstruction of the skull base was done throush endoscopic approach.No complications were found.Thirteen patients were followed up from 12-36 months.and none was recurrence.Conclusions Herniation of mucosal tissue into the nasal sinuses after skull base defects could result in delayed CSF leak.CT and MRI can clearly show the skull base defects and neural tissue herniation.Endoscopic closure of CSF leaks was both safe and effective.