创伤性和非创伤性脑脊液鼻之间的临床特征和手术结果
Ru Tang1, Shi-Yao Zhang1, Jia-Yao Zhou1
1Department of Otolaryngology Head and Neck Surgery Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China.
World journal of otorhinolaryngology - head and neck surgery
|September 11, 2025
概括
与非创伤病例相比,创伤性脑脊液 (CSF) 鼻具有较高的脑膜炎和多焦点缺陷风险. 手术结果仍然相似,复杂的创伤性泄漏的有效重建.
科学领域:
- 神经外科 神经外科
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 头骨底部手术 头骨底部手术
背景情况:
- 脑脊液 (CSF) 鼻是脑脊液从头骨腔流入鼻腔的情况.
- 区分创伤和非创伤病因对于适当的管理和预测结果至关重要.
- 创伤性CSF泄漏,特别是阳性泄漏,可能会带来更高的脑膜炎等并发症风险.
研究的目的:
- 为了比较创伤性与非创伤性脑脊液 (CSF) 鼻患者的临床特征和手术结果.
- 在CSF鼻患者中识别与脑膜炎相关的风险因素.
- 评估不同类型的CSF泄漏手术方法的有效性.
主要方法:
- 对2007年至2022年期间入院的143名CSF鼻患者 (94名创伤性,49名非创伤性) 的回顾性分析.
- 临床特征的比较,包括缺陷的位置和脑膜炎的流行率.
- 对手术结果的分析,包括手术方法和血管化移植的使用.
主要成果:
- 脑膜炎在创伤组中明显更为普遍 (p=0.012).
- 多焦点缺陷在创伤病例中更常见,而状缺陷与非创伤性泄漏有关.
- 阳性创伤,男性性别和肺炎是脑膜炎的独立风险因素.
- 在创伤病例中,内镜结合外部方法和血管化移植更频繁地使用 (p<0.05).
- 成功率很高,在各组之间没有显著差异 (100%对97.9%).
结论:
- 创伤性脑脊髓鼻,特别是阳性鼻,与更高的脑膜炎和复杂缺陷率有关.
- 在创伤性CSF鼻中,内镜结合冠状外外术方法与血管化的片对复杂的头骨基部重建有效.
- 尽管复杂性增加,但创伤性和非创伤性CSF鼻的手术结果是可比的.
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