Preoperative locating diagnosis and transnasal endoscopic surgery for cerebrospinal fluid rhinorrhea in sella turcica region / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To discuss the preoperative locating diagnosis and transnasal endoscopic surgery for cerebrospinal fluid rhinorrhea in sella turcica region.METHODS All of the 22 patients with cerebrospinal fluid rhinorrhea had been located the position of leakage by means of high resolution computed tomography(HRCT),magnetic resonance imaging(MRI)and/or computed tomography cisternography(CTC)techniques,and then the skull base defects were repaired with fascia via transnasal endoscopic surgery.All the patients were followed up for 6 to 51 months.RESULTS Nineteen cases were successfully repaired by operation once and another patient was cured through reoperation.Two cases refused reoperation after failure of the operation and lost follow-up.No complications such as intra-cranial infection and hemorrhage were found during the perioperative period and follow-up.The main failure causes of operation were the necrosis of the repairing fascia,missing the real leakage,and the recurrence of malignant tumor.CONCLUSION It is a key step to locate leakage accurately before operation by means of CT and MRI.Transnasal endoscopic technique is the optimal choice for management of cerebrospinal fluid rhinorrhea in sella turcica region.