외상성 뇌척수액 비루의 경비강 재건

Other Titles
Transnasal Repair of Traumatic Cerebrospinal Fluid Rhinorrhea
Authors
김일만안병훈임만빈이창영손은익김동원Il-Man KimByung-Hoon AhnMan-Bin YimChang-Young LeeEun-Ik SonDong-Won Kim
Department
Dept. of Neurosurgery (신경외과학); Dept. of Otorhinolaryngology (이비인후과학)
Issue Date
2002
Citation
대한신경외과학회지, Vol.32(4) : 318-322, 2002
ISSN
1225-8245
Abstract
Objective:This study is aimed to evaluate the efficacy of transnasal repair of cerebrospinal fluid(CSF) rhinorrhea. Methods:Thirteen patients with traumatic noniatrogenic CSF fistulas were included in the retrospective analysis. High-resolution thin-section computed tomographic cisternography was helpful in localization of the CSF leakage site. The most frequent leakage site was the sphenoid sinus. The transnasal approach(TNA), comprised of endonasal endoscopic surgery(EES) or transseptosphenoidal surgery(TSS), was mainly used for smaller fistulas. Total or selected ethmoidectomy depended on the localization of the leakage. Wide sphenoidotomy enabled detection and repair of CSF leaks from the sphenoid cavity. Three patients also underwent transcranial approach(TCA) because of the large or multi-fragmented bony defect and the need for further exposure for repair. Five patients developed ascending meningitis in the preoperative period with antibiotic prophylaxis. Results:Twenty-five leaks were initially repaired using one of three techniques:EES alone in eight patients, EES plus TCA in three, and TSS alone in two. Ten patients who solely underwent the TNA did not experience the complications of the traditional TCA. One recurrent sphenoid fistula was successfully treated by TSS. After a follow-up from 12 to 88 months(mean 32.7), the overall success rate for 25 CSF fistulas was 100%. Conclusion:The transnasal repair is a safe, successful, and alternative approach for the surgical repair of traumatic CSF rhinorrhea, and also could be combined to TCA.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/39199
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학)
Keimyung Author(s)
김엘; 임만빈; 이창영; 손은익; 김동원; 안병훈
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