Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years
Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years
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DOI：
10.1016/j.otohns.2008.12.060
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发表时间：
2009-06-01
影响因子：
3.4
通讯作者：
Kennedy, David W.
中科院分区：
文献类型：
--
作者：
Banks, Caroline A.;Palmer, James N.;Kennedy, David W.
目的：脑脊液（CSF）漏的内镜修复已成为常规方法。本研究描述了一个大型系列超过21年的内镜下闭合，重点是管理，手术技术和长期outcome.Study设计：图表review.SubJECTS和方法：脑脊液漏患者治疗的资深作者和宾夕法尼亚大学从1987年至2008年。数据包括体重指数（BMI）、病因、缺损部位、移植物材料、是否存在脑膨出、腰椎引流、脑膜炎病史、颅内压。复发结果：共识别出193例病例。166例患者随访1个月至9年（平均21个月）。77例患者（40%）的病因是自发性的。外伤性109例（56%），先天性7例（4%）。自发性脑脊液漏患者的平均BMI（35）高于外伤性（30）和先天性（23）患者（P < 0.001）。最常见的缺损位于蝶骨（n = 62，32%）和筛骨（n = 60，31%）。初始成功率为91%（n = 176），总成功率为98%（n = 190）。结论：在这个大型系列中，总成功率（98%）和低发病率支持内窥镜方法作为CSF泄漏闭合的标准护理。(C)2009年美国耳鼻咽喉头颈外科学会基金会。All rights reserved.
OBJECTIVE: Endoscopic repair of cerebrospinal fluid (CSF) leaks has become a routine approach. This Study describes endoscopic closure of a large series over 21 years, focusing on management, surgical technique, and long-term outcomes.STUDY DESIGN: Chart review.SUBJECTS AND METHODS: CSF leak patients treated by the senior author and at the University of Pennsylvania from 1987 to 2008. The data included body mass index (BMI), etiology, defect location, graft material, presence of encephalocele, lumbar drain, history of meningitis, intracranial pressure. recurrence. and follow-up.RESULTS: A total of 193 cases were identified. Follow-up ranging from I month to 9 years (mean 21 months) was available V 41 on 166 patients. The etiology was spontaneous in 77 patients (40%). traumatic in 109 (56%), and congenital in 7 (4%). The average BMI of spontaneous CSF leak patients (35) was greater (P < 0.001) than both traumatic (30) and congenital patients (23). Defects were most commonly located in the sphenoid (n = 62, 32%) and ethmoid (n = 60, 31%) The initial success rate was 91 percent (n = 176) and overall success rate was 98 percent (n = 190).CONCLUSION: The overall success rate (98%) and low morbidity in this large series support endoscopic approach as standard of care for CSF leak Closure. (C) 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.