PDF(Pubmed)
Abstract：
UNASSIGNED: Symptoms of temporal encephalocele or cerebrospinal fluid (CSF) leak causing middle ear effusion or otorrhea can be nonspecific and mistaken for other common diagnoses, leading to delays in diagnosis, failed treatments, and a risk of meningitis. This study sought to investigate the association between symptomatology and time to definitive surgical management.
UNASSIGNED: Retrospective cohort.
UNASSIGNED: Single tertiary care academic medical center.
UNASSIGNED: Adults treated surgically for temporal encephalocele or CSF leak. Revision cases were excluded.
UNASSIGNED: Chart review was performed to identify pertinent symptoms at presentation. Multivariable regression was performed to analyze the association between symptoms and time to definitive management.
UNASSIGNED: Otologic and related symptoms present prior to middle cranial fossa (MCF). Time between symptom onset and surgical treatment.
UNASSIGNED: Thirty-four patients had symptoms present a median of 15.5 months (interquartile range, 8-35 months; range, 1 month to 12 years) prior to surgery. The most common symptoms were subjective hearing loss in the affected ear (76.5%) and aural fullness (73.5%). Otorrhea was present in 55.9%, and 42.9% had a history of otorrhea after myringotomy with or without tube insertion. Meningitis occurred in 5 patients (14.7%). Only the absence of otalgia was statistically significantly associated with decreased time between symptoms onset and surgery (P = 0.01).
UNASSIGNED: Encephalocele and CSF leak were most commonly associated with aural fullness and hearing loss. Medical treatment for presumed Eustachian tube dysfunction or chronic ear disease were commonly observed. Patients had symptoms for a median of almost 1 and a half years prior to surgical management.
UNASSIGNED: Retrospective cohort.
UNASSIGNED: Single tertiary care academic medical center.
UNASSIGNED: Adults treated surgically for temporal encephalocele or CSF leak. Revision cases were excluded.
UNASSIGNED: Chart review was performed to identify pertinent symptoms at presentation. Multivariable regression was performed to analyze the association between symptoms and time to definitive management.
UNASSIGNED: Otologic and related symptoms present prior to middle cranial fossa (MCF). Time between symptom onset and surgical treatment.
UNASSIGNED: Thirty-four patients had symptoms present a median of 15.5 months (interquartile range, 8-35 months; range, 1 month to 12 years) prior to surgery. The most common symptoms were subjective hearing loss in the affected ear (76.5%) and aural fullness (73.5%). Otorrhea was present in 55.9%, and 42.9% had a history of otorrhea after myringotomy with or without tube insertion. Meningitis occurred in 5 patients (14.7%). Only the absence of otalgia was statistically significantly associated with decreased time between symptoms onset and surgery (P = 0.01).
UNASSIGNED: Encephalocele and CSF leak were most commonly associated with aural fullness and hearing loss. Medical treatment for presumed Eustachian tube dysfunction or chronic ear disease were commonly observed. Patients had symptoms for a median of almost 1 and a half years prior to surgical management.
摘要：
■颞叶脑膨出或脑脊液（CSF）渗漏导致中耳积液或耳漏的症状可能是非特异性的，并被误认为是其他常见的诊断，导致诊断延误，失败的治疗,和脑膜炎的风险。这项研究旨在调查症状学与确定手术治疗时间之间的关联。
■回顾性队列。
■单一三级医疗学术医疗中心。
■成人因颞叶脑膨出或脑脊液漏而接受手术治疗。排除修订病例。
■进行图表审查以确定出现时的相关症状。进行多变量回归分析症状与确定治疗时间之间的关联。
■在中颅窝（MCF）之前出现的耳科和相关症状。症状发作和手术治疗之间的时间。
■34例患者出现症状的中位数为15.5个月（四分位距，8-35个月；范围，手术前1个月至12年）。最常见的症状是受影响耳朵的主观听力损失（76.5％）和听觉饱满度（73.5％）。55.9%出现耳漏，有或没有插管的鼓膜切开术后有耳漏病史的占42.9％。5例（14.7%）发生脑膜炎。只有没有耳痛与症状发作和手术之间的时间减少有统计学意义（P=0.01）。
■脑膨出和脑脊液漏最常见的是与听觉丰满和听力损失有关。通常观察到对假定的咽鼓管功能障碍或慢性耳部疾病的药物治疗。在手术治疗前，患者的症状中位数为近1年半。
■回顾性队列。
■单一三级医疗学术医疗中心。
■成人因颞叶脑膨出或脑脊液漏而接受手术治疗。排除修订病例。
■进行图表审查以确定出现时的相关症状。进行多变量回归分析症状与确定治疗时间之间的关联。
■在中颅窝（MCF）之前出现的耳科和相关症状。症状发作和手术治疗之间的时间。
■34例患者出现症状的中位数为15.5个月（四分位距，8-35个月；范围，手术前1个月至12年）。最常见的症状是受影响耳朵的主观听力损失（76.5％）和听觉饱满度（73.5％）。55.9%出现耳漏，有或没有插管的鼓膜切开术后有耳漏病史的占42.9％。5例（14.7%）发生脑膜炎。只有没有耳痛与症状发作和手术之间的时间减少有统计学意义（P=0.01）。
■脑膨出和脑脊液漏最常见的是与听觉丰满和听力损失有关。通常观察到对假定的咽鼓管功能障碍或慢性耳部疾病的药物治疗。在手术治疗前，患者的症状中位数为近1年半。
