鼻內視鏡「鑲箝法」修補急性腦脊髓液鼻漏

Transnasal Endoscopic Repair of Acute Cerebrospinal Fluid Rhinorrhea - An Interposition Technique

林復森(Fu-Sen Lin) ； 侯勝博(Sheng-Po Hao) ； 葉秉文(Ping-Wen Yeh) ； 黃俊生(Tsung-Sheng Huang)

《中華民國耳鼻喉科醫學會雜誌》 31卷3期 (1996/06) Pp. 258-261

https://doi.org/10.6286/1996.31.3.258

摘要

本篇報告包含3名急性腦脊髓液鼻漏之病例，造成其顱底缺損之原因為基底腦膨出及副鼻竇手術後。本報告之病例均以單一鼻竇內視鏡手術治癒，顧及經淜修補之高失敗率及罹病率，我們認為由郭練之耳鼻喉專科醫師施以顱外經鼻內視鏡「鑲箝法」可將篩狀板(cribriform plate)及篩竇頂部(foveaethmoidalis)缺損所造成的腦脊髓液鼻漏病變做適當之處理。

關鍵字

腦脊髓液鼻漏 ； 鑲箝法

並列摘要

Operation-induced acute cerebrospinal fluid (CSF) rhinorrhea is still a great challenge to ENT doctors; we newly developed a transnasal endoscopic “interposition technique” for the repair of leaks, this technique was created from the idea of skull base surgery, “lyodura” as a graft put precisely between dura and skull, with benefit of intracranial pressure, the graft can then be well positioned over the defect site.
Three patients with acute cerebrospinal fluid leaks comprise this study. The etiology of CSF leaks in this series included one case of basal encephalocele, and two cases after functional endoscopic sinus surgery. CSF rhinorrhea was immediately documented by nasal sinoscopy under direct vision. Resolution of CSF rhinorrhea was achieved in all patients with the same endoscopic procedure. We consider this newly created endoscopic approach-the interposition technique being an appropriate method in diagnosis and treatment of acute CSD rhinorrhea.

並列關鍵字

cerebrospinal fluid rhinorrhea ； interposition technique