鼻中隔膜黏膜瓣在脑脊液鼻漏鞍区重建中的应用进展

Application Progress of Nasal Septum Mucosal Flap in the Reconstruction of Sellar Region of Cerebrospinal Fluid Rhinorrhea

摘要: 目前经鼻内镜下手术的应用在临床中越来越得到重视，但脑脊液的鼻漏是常见并发症，术前充分评估、术中仔细操作及恰当处理是避免术后脑脊液漏发生的关键，而对发生术后脑脊液漏的患者，需采取恰当的治疗措施。其中，垂瘤术后鞍区修补可选择的方法之一，是利用颈内动脉系统的筛动脉为蒂，以筛脉为蒂的NSF，利用健康的、未被手术破坏的NSF和鼻下鼻道黏膜，在经蝶垂体瘤手术已破坏鼻中隔后动脉的情况下，对鼻腔内隔膜膜瓣NSF (Nasoseptal flap)进行修补。达到修复颅底血管粘膜瓣的作用，经蝶垂体瘤手术已破坏鼻中隔膜。

Abstract: At present, the application of transnasal endoscopic surgery has been paid more and more attention in clinic, but cerebrospinal fluid rhinorrhea is a common complication. The key to avoid postoperative cerebrospinal fluid leakage is full preoperative evaluation, careful operation and appropriate treatment during operation. For patients with postoperative cerebrospinal fluid leakage, appropriate treatment measures should be taken. Among them, one of the optional methods for sellar region repair after prolapse tumor surgery is to use the ethmoid artery of the internal carotid artery system as the pedicle, the NSF pedicled with the ethmoid vein, and the healthy NSF and subnasal nasal mucosa that have not been damaged by surgery to repair the nasal septal membrane flap (NSF) under the condition that the posterior nasal septal artery has been damaged by transsphenoidal pituitary tumor surgery. To repair the skull base vascular mucosal flap, transsphenoidal pituitary tumor surgery has destroyed the nasal septum.