脑脊液耳漏17例临床诊治分析
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南昌大学第一附属医院

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Diagnosis and treatment of 17 cases of cerebrospinal fluid otorrhea
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    目的:本文旨在分析脑脊液耳漏的病因,临床表现、探讨其诊断及治疗方法。方法:回顾性分析自2012年以来南昌大学第一附属医院耳鼻咽喉头颈外科收治的17例脑脊液耳漏患者的临床资料,其中男10例,女7例,成人15例,儿童2例,年龄4至85岁,右耳9例,左耳8例。17例中自发性脑脊液耳漏4例,内耳畸形2例,有头部外伤史6例,中耳乳突手术史者3例,有头颈部恶性肿瘤放疗史2例。其中采用岩骨次全切除术者7例,鼓室探查+前庭封闭术者2例,乳突切开+脑脊液耳漏修补术者7例。结果:1例患者经保守治疗成功,其余16例均在我院行一次手术修补成功,16例患者随访1年以上,1例患者随访3月以上,均无复发,其中2例患者术后切口愈合不良,1例为耳道切口,另1例为耳后切口,均经过局部换药治愈。结论:手术是治疗脑脊液耳漏的主要方法。手术成功的关键首先在于准确定位瘘口的部位,其次正确处理封闭瘘口,术后抗炎,降低颅内压对瘘口的修复也十分重要。

    Abstract:

    Abstact Objective: The study aimed to analysis the pathogenesis, clinical situation,diagnosis and surgical management of cerebrospinal fluid totrrhea. Method:17 cases with CSF otorrhea from june of 2012 to December of 2020 were reviewed. Result: The causes of CSF leak spontaneous in 4 cases,mastoid operation in 3 cases, head injuries in 7 cases, inner ear malformation in 2 cases. radiotherapy for head and neck cancer in 2 cases. 1case accepted conservative treatment, 16 cases were repaired sucssesfully once, including subtotal resection of temporal bone in 7 cases, tympanic exploration and vestibular closure in 2 cases with congenital malformation of inner ear, repair of cerebrospinal fluid leakage by mastoidectomy in 7 cases. Conclusion: Surgery was the main treatment of CSF leak. The key to successful operation is to locate the fistula accurately. It is also very important for the repair of fistulas to treat the fistulas correctly, to prevent postoperative inflammation and to reduce intracranial pressure.

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  • 收稿日期:2021-07-21
  • 最后修改日期:2021-09-02
  • 录用日期:2021-09-08
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