CAJ | 학술논문

目的探讨神经内镜技术治疗脑脊液(CSF)鼻漏的方法和疗效. 方法分析深圳大学第一附属医院神经外科自2012年11月至2013年4月使用神经内镜技术治疗5例CSF鼻漏患者的临床资料,总结其诊断方法、手术方法及临床效果. 结果 5例CSF鼻漏患者中外伤性CSF鼻漏2例,医源性CSF鼻漏3例.外伤后CSF鼻漏术前均通过颅脑MR平扫、CT薄扫颅底重建及CT脑池造影确定漏口;医源性CSF鼻漏根据临床经验判定漏口位置,漏口分别位于额窦后壁、筛窦顶壁、鞍底、蝶筛隐窝、中颅底鞍旁交界区,术中均能直视下观察漏口,行漏口修补.术后患者CSF鼻漏均治愈,无并发症发生,随访3个月以上无复发. 结论术前影像学检查对CSF鼻漏口定位意义重大,神经内镜治疗CSF鼻漏具有微创、直观、修补成功率高等优点,可作为首选治疗方式.
목적 탐토신경내경기술치료뇌척액(CSF)비루적방법화료효. 방법 분석심수대학제일부속의원신경외과자2012년11월지2013년4월사용신경내경기술치료5례CSF비루환자적림상자료,총결기진단방법、수술방법급림상효과. 결과 5례CSF비루환자중외상성CSF비루2례,의원성CSF비루3례.외상후CSF비루술전균통과로뇌MR평소、CT박소로저중건급CT뇌지조영학정루구;의원성CSF비루근거림상경험판정루구위치,루구분별위우액두후벽、사두정벽、안저、접사은와、중로저안방교계구,술중균능직시하관찰루구,행루구수보.술후환자CSF비루균치유,무병발증발생,수방3개월이상무복발. 결론 술전영상학검사대CSF비루구정위의의중대,신경내경치료CSF비루구유미창、직관、수보성공솔고등우점,가작위수선치료방식.
Objective To explore the effect of neuroendoscopic techniques on treating cerebrospinal fluid (CSF) leakage.Methods Five patient with CSF leakage,admitted to our hospital from November 2012 to April 2013 and treated with surgery under neuroendoscope,were chosen in our study; their clinical data were retrospectively analyzed; the diagnostic methods,surgical methods and clinical effects were summarized.Results Two had traumatic CSF leakage and 3 had iatrogenic CSF leak.In patients with traumatic CSF leakage,brain MR,thin CT scan,skull base reconstruction and cistermography CT were used to determine the location of ventages,while the ventages in patients with iatrogenic CSF leakage can be determined according to clinical experience; the ventages located in the frontal sinus,the ethmoid sinus,the bottom of the saddle,the recessus sphenoethmoidalis,and the border area of middle skull base and parasellar.Direct observation of the ventages was achieved and repair was finished successfully.Follow up for at least three months showed no recurrence or complications.Conclusions Preoperative localization of the ventage of CSF leakage is every important; combination of brain MR,thin CT scan and skull base reconstruction and cistermography CT can accurately locate the ventage in patients with traumatic CSF leakage; for patients with iatrogenic CSF leakage,location of the ventage can be achieved according to clinical experiences.Neuroendoscopy is minimally invasive and having direct view and high success rate,which can be used as the preferred choice for CSF leakage.