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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Management of spontaneous cerebrospinal fluid otorrhea.
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Management of spontaneous cerebrospinal fluid otorrhea.

机译：自发性脑脊液耳漏的处理。

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OBJECTIVES/HYPOTHESIS: To describe the surgical approaches and materials used to repair spontaneous cerebrospinal fluid (CSF) otorrhea of temporal bone origin. STUDY DESIGN: Retrospective case review at a tertiary academic medical center. METHODS: All patients presenting with spontaneous CSF otorrhea or rhinorrhea over a consecutive 8-year period were included. Clinic charts and operative reports were reviewed to obtain the clinical presentation, examination findings, diagnostic test results, intraoperative findings, operative technique, and postoperative follow-up. Surgical approach and materials used for repair were determined by the location of the defect(s) and surgeon preference. RESULTS: Seventeen patients underwent 19 operations for repair of spontaneous CSF otorrhea or rhinorrhea. The mean age was 61 years and the male to female ratio was 5:12. All female patients had a body mass index (BMI) greater than 30 mg/kg. The most common presenting symptom was otorrhea after a myringotomy or placement of a tympanostomy tube. A middle fossa craniotomy was used in 17 approaches. The most common defect sites were located over the tegmen mastoideum and tegmen tympani. Multiple materials were used in most repairs including allogenic bone cement and autologous materials. One patient had persistent otorrhea after a transmastoid approach and required a middle fossa craniotomy to repair a tegmen mastoideum defect. CONCLUSIONS: Spontaneous CSF otorrhea is uncommon and often not diagnosed until a myringotomy or tympanostomy tube is placed. The middle fossa craniotomy provides the best exposure for defects involving the middle fossa floor. Both alloplastic and autologous materials are highly successful in repairing the defect(s) responsible for CSF otorrhea. No infections of the alloplastic bone cement occurred in our series.
机译：目的/假设：描述用于修复颞骨起源的自发性脑脊液（CSF）耳漏的手术方法和材料。研究设计：在三级学术医学中心进行回顾性病例审查。方法：纳入所有连续8年出现自发性CSF耳漏或鼻漏的患者。回顾临床图和手术报告，以获得临床表现，检查结果，诊断测试结果，术中发现，手术技术和术后随访。手术方法和用于修复的材料取决于缺损的位置和外科医生的喜好。结果：17例患者接受了19例手术，以修复自发性CSF耳漏或鼻漏。平均年龄为61岁，男女之比为5:12。所有女性患者的体重指数（BMI）均大于30 mg / kg。最常见的症状是在开颅手术或鼓室置管后出现耳漏。在17种方法中使用了中颅窝开颅手术。最常见的缺损部位位于牛头筋膜和鼓膜鼓膜上。大多数修复中使用了多种材料，包括同种异体骨水泥和自体材料。一名患者在经乳突入路后出现持续性耳漏，需要进行中颅窝开颅手术来修复牛肩mast膜缺损。结论：自发性脑脊液耳漏是罕见的，而且通常要在置入子宫切开术或鼓室切开术后才能诊断。颅中窝开颅手术可为涉及中窝底部的缺损提供最佳的暴露。同种异体材料和自体材料在修复导致脑脊液耳漏的缺陷方面都非常成功。在我们的系列中没有发生异体骨水泥的感染。

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