Clinical Analysis Of Repair Of Cerebrospinal Fluid Rhinorrhea

Objective:To explore the indications,surgical techniques and the choice of repair materials of cerebrospinal fluid rhinorrhea(CFR)various repair,and summarize the surgical experience of CFR.Methods17 patients with CFR in our department were included in the review between January 2013 to Augest 2017.Their clinical data and the follow-up materals were reviewed and analyzed.We classified the inducing factors of all the patients and discribed the location of the leakage site and the result of the HRCT and MRI were compaired to manisfsted the veracity of the examinations in diagnosing CFR.Moreover,location of the leakage site,efficiency and complications of patients of transcranial repair and endoscopic transnasal repair were compaired.Results:Of all the 17 CFR patients,12 patients(70.6%)were caused by accident trauma.And in the 12 trauma caused CFR patients,9 patients(75%)were with frontal sinus,11(91.9%)were with ethmoidal cellules,2(8.33%)with single sphenoid sinus and 8(66.7%)were with both frontal sinus and ethmoidal cellules.17 patients were performed HRCT for paranasal sinus,of whom 16 were diagnosis with explicit leakage sites.16 patients were performed MRI+DWI for paranasal sinus,of whom all were diagnosis with explicit leakage sites.16 patients were performed MRI and HRCT for paranasal sinus,ofwhom all were diagnosised with explicit leakage sites.The accuracy rate of HRCT,MRI and combination of HRCT and MRI is 94.1%,93.75 % and 100% respectively.7 of the 8transcranial repair patients repaired the leakage site at once and 1 underwent the operation twice until the lekage sites were successfully repaired.8 of the 9 endoscopic transnasal repair patients repaired the leakage site at once and 1 patient became infected after the operation and failed to get well from the infection.The success rate of transcranial repair and endoscopic transnasal repair is 87.5% and 88.89% respectively.all of the patients were followed up at least 3-4years with no recrudesce.Conclusion:Accident trauma is the most common cause for CFR.The most common region of CFR is frontal sinus and ethmoidal cellules,the least common region is single sphenoid sinus.The accuracy of HRCT and MRI were both high with no difference in diagnosing CRF,and the combination of HRCT and MRI in diagnosing the CFR is benificial to estimate the constuction around the leakage site.Transcranial repair and endoscopic transnasal repair are both effective to repair the CFR.The principle of choosing the operation pattern depends on the position,number,size of the leakage sites and the conditon around them.No matter which way you choose to repair,the repair materials should be the first choice of autologous tissue.