| Objective: In recent years,the endoscopic skull base surgery has been improved significantly due to the angled endoscope,high-resolution indicator,precise navigation system,high resolution imaging and deeper understanding of anatomy.Thereinto,the diagnosis and treatment of cerebrospinal fluid leak has also made great improvement.This article,from the angle of diagnosis and treatment of cerebrospinal fluid leak,talks about the influence of diverse examinations and reconstruction methods.Methods: We adopted the clinical data of patients from 2018 to now who have experienced systematic examinations including CT,MRI,SPECT/CT and endoscopic inspection.The results of CT,MRI,SPECT/CT examinations are analysed and compared based on the standard of endoscopic examination.And the data of patients who underwent endoscopic skull base reconstruction surgery from 2007 till now are also collected.The success rates of different reconstruction methods are also compared.Results: A total number of 24 patients are analysed,the sensitivity of CT,MRI and SPECT/CT are respectively 68.75%,75%,93.8%,while the specificity of CT,MRI and SPECT/CT are respectively100%,100%,37.5%.The success rate of free tissue for 5 patients is 20%,and that of nasoseptal flap for 30 patientsis is 90%.Another 14 patients repaired with ethmoidal artery pedicled flap share the success rate of 100%.Conclusions: CT,MRI and SPECT/CT can show different aspects of skull base and cerebrospinal fluid leak respectively.A comprehensive assessment based on these different examinations can provide us with more accurate information,which can indicate where we should pay more attention to examine with endoscope.And SPECT/CT can be a complementary method when CT,MRI and endoscope failed to show it.For cerebrospinal fluid leak repair,especially for the complicated cases,vascularized flap works well with a high success rate.At the same,the ethmoidal artery pedicled flap can serve well as a replacement when the nasoseptal flap is unavailable. |
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