Clinical diagnosis and treatment analysis of spontaneous cerebrospinal fluid otorrhoea
Objective:To investigate the clinical features,imaging findings,surgical methods,diagnostic and treatment experience of spontaneous cerebrospinal fluid otorrhoea.Methods:The clinical data of 11 patients with spontaneous cerebrospinal fluid otorrhoea treated surgically at our hospital from May 2018 to May 2023 were ret-rospectively analyzed.The medical data included medical history,imaging data,leak location,surgical repair method,treatment effect and postoperative follow-up.Results:Among the 11 surgical patients,4 patients were initially diagnosed with secretory otitis media,1 was initially diagnosed with purulent otitis media,and 5 patients had a history of meningitis or presented because meningitis as the initial diagnosis.There were 2 cases of cerebro-spinal fluid leakage repaired through the ear canal pathway and 9 cases of cerebrospinal fluid leakage repaired through the mastoid pathway.During the operation,leaks were located in the stapes floor plate in 4 cases,sinus meningeal angle in 1 case,posterior cranial fossa combined with middle cranial fossa in 1 case,middle cranial fossa in 4 cases,and labyrinthine segment of the internal auditory canal and facial nerve canal in 1 case.Ten patient was successfully repaired,and another patient developed intracranial hypertension after surgery,with symptoms allevi-ated by a lateral ventriculoperitoneal shunt.Postoperative follow-up ranged from 6 months to 4 years,and there was no CSF otorrhoea and meningitis recurrence.Conclusion:The incidence of spontaneous cerebrospinal fluid otorrhea is low,the clinical symptoms are atypical,and the rate of delayed diagnosis or missed diagnosis and mis-diagnosis is high.Surgery is currently the preferred treatment for spontaneous cerebrospinal fluid otorrhoea,and satisfactory results are usually achieved;During diagnosis and treatment,it is crucial to be vigilant for intracranial hypertension to prevent serious complications and irreversible damage.
万方数据
维普
