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中华神经创伤外科电子杂志 ›› 2015, Vol. 01 ›› Issue (03) : 139 -141. doi: 10.3877/cma.j.issn.2095-9141.2015.03.004

临床研究

脑脊液鼻漏的开颅手术经验总结
王革生1, 高鲜红2, 李智2, 吕刚2,()   
  1. 1.100078,北京中医药大学东方医院神经外科
    2.100050,首都医科大学附属北京天坛医院神经外科
  • 收稿日期:2015-02-22 出版日期:2015-06-15
  • 通信作者: 吕刚

The craniotomy experience summary of cerebrospinal rhinorrhea

Gesheng Wang1, Xianhong Gao2, Zhi Li2, Gang Lyu2,()   

  1. 1.Beijing University of Chinese Medicine Dongfang Hospital,Beijing 100078, China
    2.Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University,Beijing 100050,China
  • Received:2015-02-22 Published:2015-06-15
  • Corresponding author: Gang Lyu
引用本文:

王革生, 高鲜红, 李智, 吕刚. 脑脊液鼻漏的开颅手术经验总结[J]. 中华神经创伤外科电子杂志, 2015, 01(03): 139-141.

Gesheng Wang, Xianhong Gao, Zhi Li, Gang Lyu. The craniotomy experience summary of cerebrospinal rhinorrhea[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2015, 01(03): 139-141.

目的

总结开颅手术治疗脑脊液鼻漏的诊治经验,验证开颅手术治疗脑脊液鼻漏的效果。

方法

回顾性分析北京天坛医院2012年10月至2014年07月63例开颅手术治疗脑脊液鼻漏的临床资料,术前均采用CT脑池造影进行定位,53例采取冠切开颅,单侧15例,双侧38例,6例采取经眉弓入路,4例采取额颞断颧弓入路。

结果

63例脑脊液鼻漏患者行开颅手术治疗,2例手术修补失败,成功修补61例,手术治愈率97%(61/63)。

结论

脑脊液鼻漏的开颅手术治疗是一种安全、有效的治疗方法,具有鼻内镜不可替代的作用。

Objective

To summarize the experience of cerebrospinal fluid rhinorrhea repaired by transcranial approach.

Methods

Clinical data were analyzed retrospectively of 63 cases of cerebrospinal fluid (CSF) rhinorrhea treated by transcranial approach from October 2012 to July 2014 in Beijing Tiantan Hospital all patients were under CT cisternography for positioning before operation.53 patients were under coronal craniectomy, 15 patients were under unilateral craniectomy, 38 patients were under bilateral craniectomy, 6 patients were under supraorbital approach, 4 patients were under frontotemporal zygomatic approach.

Results

CSF rhinorrhea resolved after initial surgery in 61 of 63 patients, giving a success rate of 97%. 2 cases were failed.

Conclusion

Cerebrospinal fluid rhinorrhea repaired by transcranial approach is a reliable and effective method with an irreplaceable role of endoscopic.

[1]
Wertheim I, Fleischhacker D, Mclachlin CM, et al.Pseudomyxoma peritonei: a review of 23 cases[J]. Obstet Gynecol,1994,84(1):17-21.
[2]
Ceelen WP, Hesse U, De Hemptinne B, et al. Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer[J]. Br J Surg, 2000, 87(8):1006-1015.
[3]
Shapiro JF, Chase JL, Wolff RA, et al. Modern systemic chemotherapy in surgically unresectable neoplasms of appendiceal origin: a single-institution experience[J]. Cancer,2010,116(2):316-322.
[4]
Vergote I, Trope CG, Amant F, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer[J].N Engl J Med,2010,363(10):943-953.
[5]
Lee JK, Song SH, Kim I, et al. Retrospective multicenter study of a clinicopathologic analysis of pseudomyxoma peritonei associated with ovarian tumors(KGOG 3005)[J]. Int J Gynecol Cancer,2008,18(5):916-920.
[6]
Miner TJ, Shia J, Jaques DP, et al. Long- term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy[J]. Ann Surg,2005,241(2):300-308.
[7]
朱海波,赵锦,吕刚.脑脊液鼻漏的开颅手术治疗[J].中华神经外科杂志,2012,28(11):1154.
[8]
Spetzler RF, Wilson CB. Management of recurrent CSF rhinorrhea of the middle and posterior fossa[J]. J Neurosurg,1978,49(9):393-397.
[9]
Nandapalan VI, Watson ID. Beta- 2- transforrin and cerebrospinal fluidrhinarrhea[J]. Clin Orolargugal, 1996, 21(3):259-264.
[10]
Jones NS, Becker DG. Advances in the management of CSF leaks[J].Brit Med J,2001,322(7279):122-123.
[11]
Jayakumar PN, Kovoor JM, Srikanth SG, et al. 3D steadystate MR cisternography in CSF rhinorrhea[J]. Acta Radiol,2001,42(6):582-584.
[12]
Kelley TF, Stankiewicz JA, Chow JM, et al. Endoscopic closure of postsurgical anterior cranial fossa cerebrospinal fluidleaks[J].Neurosurg,1996,39(4):743-746.
[13]
Fliss DM,Zucker G,Cohen JT.The subcranial approach for the treatment of cerebrospinal fluid rhinorrhea: a report of 10 cases[J].J Oral Maxilofac Surg,2001,59(10):1171-1175.
[14]
徐立权,徐伟,徐荣.前颅底硬膜外、硬膜下联合入路治疗外伤后迁延性脑脊液鼻漏临床分析[J]. 实用神经疾病杂志,2005,8(5):4-5.
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