Treatment of cerebrospinal fluid rhinorrhea via transnasal endoscopic approach and its combination with frontal approach
10.3321/j.issn:1673-0860.2008.02.004
- VernacularTitle:脑脊液鼻漏经鼻内镜及其与额部联合进路的治疗
- Author:
Guang-Gang SHI
1
;
Zhao-Di WANG
Author Information
1. 山东大学山东省立医院
- Keywords:
Endoscopy;
Cerebrospinal fluid rhinorrhea;
Forehead
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2008;43(2):92-95
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience in diagnosing and managing cerebrospinal fluid(CSF)rhinorrhea via transnasal endoscopic approach and its combination with frontal approach.Methods A retrospective study of 58 patients with CSF rhinorrhea was conducted.Fifty eight cases were all under CT.Fifty six cases underwent surgical treatment. Among them,45 patients were treated with transnasal endoscopic approach.11 whose cerebrospinal fistulas located in back wall of frontal sinus and orbital-frontal part with fronto-rhinal approach.Two were without any surgical treatment.Among 56 cases who underwent surgical treatment,31 cases were under normal CT,of which 25 were accurate.Another 25 cases were under thin-section spiral CT scan and three-dimonsional reconstruction.of which 23 were accurate.Eight cases locating the fistulas inaccurately by CT found the fistulas by operation.Results Postoperative follow-up lasted from 6 months to 5 years,a median follow-up period of 3 years.Among 45 cases with transnasal endoscopic approach,43 were cured after the first attempt.one Was cured after the second attempt;one died because of the intracranial infection. Among 11 cases with fronto-rhinal deossification,10 were cured after the first attempt.one with orbital-frontal absence after the fifth attempt.Two left hospital and 1ost following-up without any surgical treatment.Conclusions Thin-section spiral CT scan and three-dimonsional reconstruction make the leak locating more accurate.Combination of frontal approach may deal with transnasal endoscopic surgery's demerit to the unreachable site and enhance the achievement ratio of the first attempt.
