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利用自体下鼻甲游离粘膜对18例分别位于筛骨顶、嗅裂和蝶窦的较小之硬脑膜缺损在鼻内窥镜下进行修补。11例脑脊液漏并发于鼻窦手术,6例由面中部外伤引起,一例为自发性。脑脊液漏位于筛窦顶前11例,筛窦顶后2例,嗅裂2例和蝶窦3例。手术修补的原则是在鼻内窥镜下清晰地暴露脑膜缺损灶。为了达到此目的需切除部份或全筛骨,对位于蝶窦处的漏则行后筛窦切除并蝶窦前壁扩大开窗术。确定脑膜缺损灶后,去除其周围粘膜以形成新鲜创面;然后在下鼻或中鼻甲处取游离粘膜一块,其移植片内面以剪刀修整剪平,彻底止血
Eighteen patients with inferior dura defects at the apical ethmoid, olfactory fissure and sphenoid sinus were repaired under nasal endoscopy using the free mucosa of the inferior turbinate. 11 cases of cerebrospinal fluid leakage complicated by sinus surgery, 6 cases caused by midface trauma, an example of spontaneous. Cerebrospinal fluid leakage in the top of the ethmoid in 11 cases, 2 cases of ethmoid apophysis, olfactory fissure in 2 cases and sphenoid sinus in 3 cases. The principle of surgical repair is clear exposure of meningeal lesions under nasal endoscopy. In order to achieve this goal, some or all of the ethmoid bone should be excised, the posterior ethmoid sinus resection and the anterior wall of the sphenoid sinus enlargement and fenestration should be performed on the leak at the sphenoid sinus. Determine the meningeal lesions, remove the surrounding mucosa to form a fresh wound; then in the lower nasal or middle turbinate to take a piece of free mucosa, the inner surface of the graft trimmed with scissors cut, completely hemostatic