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目的:探讨经蝶脑膜脑膨出致脑脊液鼻漏的诊断及经鼻内镜下修补的可行性,总结修补的成功经验。方法:鼻内镜下切除经蝶脑膜脑膨出3例,并以肌肉、筋膜、人工硬膜等填塞致脑脊液鼻漏的颅底缺损部位。结果:3例患者均一次手术治愈,其中1例术后并发颅内感染(脑膜炎),余均无并发症发生,随访6个月~3年,仅1例因医源性原因于术后半年复发,二次修补成功,余无复发。结论:经鼻内镜手术治疗经蝶脑膜脑膨出所致脑脊液鼻漏是可行的,并且是微创的、安全的。
Objective: To investigate the diagnosis of cerebrospinal fluid rhinorrhea caused by transsphenoidal encephalocele and the feasibility of repair by nasal endoscopy, and to summarize the successful experience of repair. Methods: Three cases of transsphenoidal encephalocele were excised by endoscopic surgery, and the skull base defect site of cerebrospinal fluid rhinorrhea was filled with muscle, fascia and artificial dura mater. Results: All the 3 patients were cured by one operation. Among them, 1 patient had intracranial infection (meningitis) after operation. All the patients were followed up for 6 months to 3 years. Only 1 patient was cured due to iatrogenic reason Half a year recurrence, secondary repair success, I no recurrence. Conclusion: Nasal endoscopic surgery for the treatment of transsphenoidal encephalocele cerebrospinal fluid rhinorrhea is feasible, and minimally invasive and safe.