以內視鏡修補自發性腦脊髓液鼻漏－病例報告

Endoscopic Repair for Spontaneous Cerebrospinal Fluid Rhinorrhea – Case Report

翁群超(Chun-Chao Weng) ； 李達人(Ta-Jen Lee) ； 黃俊生(Tsun-Sheng Huang)

《中華民國耳鼻喉科醫學會雜誌》 33卷1期 (1998/02) Pp. 77-80

https://doi.org/10.6286/1998.33.1.77

摘要

腦脊髓液鼻漏大多由外傷和手術引起，而自發性腦脊髓液鼻漏屬於較少見的病例，因為容易引起腦膜炎，所以正確的早期診斷和治療就顯得非常重要。本科於民國85年5月間，經歷1名35歲女性病患，主訴右鼻孔不斷流出清澈鼻液，尤其頭低下時更明顯，無任何頭部外傷或手術的病史。經本院用含顯影劑的電腦斷層腦池攝影檢查後，顯示右蝶竇外側壁有瘻管存在，且蝶竇中有腦脊髓液聚集，經診斷為自發性腦脊髓液鼻漏。本科利用鼻竇內視鏡及影像系統，定位出腦脊髓液瘻管在蝶竇中所在之位置，成功地修補之，並術後追蹤18個月無復發現象。

關鍵字

自發性腦脊髓液鼻漏 ； 鼻竇內視鏡手術

並列摘要

Spontaneous CSF rhinorrhea is rare. The most likely cause comprises congenital or acquired duralosseous defect in the setting of either transiently increased intracranial pressure or normal CSF pressure fluctuations. Contrast CT cisternography is the most effective method for localizing the fistula. The endoscopically transnasal approach has been more successful than intracranial approach when used appropriatedly and also avoids the increased morbidity of a craniotomy.

並列關鍵字

Spontaneous cerebrospinal fluid rhinorrhea ； endoscopic sinus surgery