经鼻内外联合径路修复额窦脑脊液鼻漏

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1、万方数据·932·生堡塑丝匡堂苤查2Q!Q生里旦箜!鲞箜仝塑￡鱼垫』丛鲤盟塑!亟苎盟堕堡堕至Q!Q：yQ!：!：盟Q：窆·临床研究．经鼻内外联合径路修复额窦脑脊液鼻漏杨钦泰叶进刘贤张革化李源I摘要】目的总结经鼻内镜联合鼻外额窦开窗径路修复额窦脑脊液鼻漏的手术经验。方法回顾性分析自1996年至2009年中山大学附属第三医院收治的17例接受额窦脑脊液鼻漏修复术患者临床资料，重点分析经鼻内外联合径路修复术式的适应证、手术效果及关键技术。结果17例患者中，9例首选经鼻内外联合径路修复均一次性成功，另外8例首选单纯经鼻内镜径路修复，其中5例修复成功，3例失败，失败病例

2、再次经鼻内外联合径路修复成功。本组总共12例患者采用联合径路成功修复，术后恢复快，并发症少，颜面部瘢痕不明显。随访6个月至10年，无脑脊液鼻漏复发。结论采用经鼻内外联合径路修复额窦脑脊液鼻漏不但可以弥补单纯经鼻内镜下操作的困难和不足，而且比单纯外径路微刨，操作简单精细，有助于提高瘘口修复的成功率。【关键词】额窦；脑脊液鼻漏；内镜检查；耳鼻喉外科手术I中图分类号】R651．15【文献标志码】A【文章编号】1671—8925(2010)一09—932--04Treatmentoffrontalsinuscerebrospinaifluidrhinonrheav／

3、acombinedtransfrontalandintranasalendoscopicapproachesYANGQin-tai,YE五亿LIUXian,ZHANGGe-hua,LIYnan．DepartmemofOtorhinolaryngology肌口dandNeckSurgery,孤砌AffiliatedHospital,SUNYo∞-senUniversity,Guangzhou510630,ChinaCorrespondingauthor：ZHANGGe-hua,Email：gehuazhang@hotmail．com【Abstract】Obje

4、ctiveTosummarizethesurgicalexperiencesoftreatingthefrontalsinuscerebrospinalfluidrhinorrhea(FS-CSFR)v／acombinedtransfrontalandintranasalendoscopicapproaches．MethodsWeretrospectivelyanalyzedtheclinicaldataof17patientswithFS-CSFR,receivedsurgeryinourhospitalfrom1996to2009，withemphasi

5、sonpostoperativecomplications，clinicaloutcomesandkeytechnologyinvolvedinsurgeryv／acombinedtrans仔ontalandinwanasalendoscopicapproaches．ResultsOfthe17patients，9weresuccessfullyrepairedafter1surgeryviacombinedtransffontalandintranasalendoscopicapproaches；theother8wereinitiallytreatedb

6、yendoscopicintranasalapproachalone，ofwhich5(62．5％)Weresuccessfuland3failed．Andthen，the3patimatssubsequentlyunderwentthesurgeryv／acombinedtmns疗ontalandintranasalendoscopicapproachesandsucceeded．These12patientswitllFS-CSFP．,performedsurgeriesv／acombinedtransfrontalandintranasalendosc

7、opicapproachesweresuccessfullyrepairedwithquickrecovery,mildcomplications，andnosignificantfacialscars．Followupwasperformedfor6to10YandnoCSFRrecurrenceWasnoted．ConclusionSurgeryv／acombinedtransfrontalandintranasalendoscopicapproachesoffersadvantagesnotonlyinovercomingthedifficultyan

8、ddefectsofintranasalendosc