内镜下经鼻蝶窦入路手术治疗PitNET后出现假性脑脊液鼻漏：一例病例报告及文献复习
Pseudo-cerebrospinal fluid rhinorrhea following endoscopic endonasal transsphenoidal surgery for PitNET: a case report and literature review.
文献信息
| PMID | 42889207 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Guotao Peng |
| 作者单位 | Department of Neurosurgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China. |
| 期刊 | Frontiers in surgery |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 假性脑脊液（CSF）鼻漏被定义为模拟真性脑脊液漏的非脑脊液性鼻腔分泌物，是一种罕见但具有临床意义的并发症，可能导致不必要的积极治疗。方法：我们报告一例64岁男性，在内镜下经鼻切除复发性垂体神经内分泌肿瘤（PitNET）后出现体位性清亮鼻腔分泌物。葡萄糖氧化酶试验阴性，影像学显示颅底重建完整。鼻内镜检查显示双侧结痂和脓性分泌物，无脑脊液漏证据。结果：该情况被诊断为血管运动性鼻炎。保守治疗——包括鼻腔清创、抗生素治疗、局部糖皮质激素和盐水冲洗——使症状完全缓解。结论：本病例强调了区分假性脑脊液鼻漏与真性脑脊液鼻漏以避免侵入性干预的重要性。
英文摘要
Pseudo-cerebrospinal fluid (CSF) rhinorrhea, defined as non-CSF nasal discharge mimicking true CSF leakage, is a rare but clinically significant complication that may prompt unnecessary aggressive treatment. We report a case of a 64-year-old man who developed positional clear nasal discharge after endoscopic endonasal resection of recurrent pituitary neuroendocrine tumor (PitNET). Glucose oxidase testing was negative, and imaging demonstrated intact skull base reconstruction. Nasal endoscopy revealed bilateral crusting and purulent secretions without evidence of CSF leak. The condition was diagnosed as vasomotor rhinitis. Conservative management-including nasal debridement, antibiotic therapy, topical corticosteroids, and saline irrigation-led to complete symptom resolution. This case underscores the importance of differentiating pseudo-CSF rhinorrhea from true CSF rhinorrhea to avoid invasive interventions.