手術時副損傷による鼻性髄液漏
1989 年 32 巻 5 号 p. 419-428
詳細
1989 年 32 巻 5 号 p. 419-428
We recently encoutered a case of cerebrospinal fl uid rhinorrhea (CSF) caused by an injury occurring during operation for chronic sinusitis and nasal polyps. Treatment of this case was difficult.
The case was a 34-year-old male who had undergone total radical sinusedomy for right chronic sinusitis. After removal of the pack, CSF leakage was observed. The CSF was improved by insertion of gelfoam and compression with a tampon, but it became worse again after subsequent operation for correction of the deviated nasal septum and radical operation for left sinusitis. Four months after the operation on the left sinusitis, the patient was referred to our Department. Closure of the wound leaking CSF was attempted three times using a fascia, gelfoam and fibrin glue; success was finally achieved after a 3rd operation.
Four openings were the source of the CSF, with the major one located in almost the center of the roof of the ethmoid sinus and the others located in the roof of the olfactory issure region (anterior and posterior) and anterolateral region of the roof of the ethmoid sinus.
