Abstract：
OBJECTIVE: To evaluate the efficacy of a nonabsorbable, synthetic graft for the reconstruction of spontaneous middle fossa (sMF) cerebrospinal fluid (CSF) leaks.
METHODS: Six adult patients (age ≥16 yr) who had sMF CSF leaks surgically repaired within an 18-month period at a single university hospital using synthetic, nonbiological, nonabsorbable graft (Neuro-Patch) and a retrospective control group of five patients undergoing multilayer MF repair with autologous grafts.
METHODS: MF repair through a combined transmastoid/MF approach using Neuro-Patch or multilayer autologous grafts.
METHODS: The incidence of postoperative leak within 6 months postoperatively was the main outcome measure; we also recorded the need for lumbar drain, additional hearing loss, length of inpatient stay, body mass index, previous meningitis, preoperative increased intracranial pressure, and age.
RESULTS: In the Neuro-Patch group, there was no postoperative CSF leak without the need for lumbar drain. We observed no additional hearing loss; patients were monitored for 2 days without any readmissions. Increased intracranial pressure (four of six), previous episodes of meningitis (two of six) or obesity (five of six) did not affect patient outcomes. Demographic and prognostic factors were the same for the control group. However, one patient needed lumbar drain postoperatively because of residual leak; lumbar drain was used in one more case (two of five cases), whereas three of five patients had to stay for longer than 2 days (5 d).
CONCLUSIONS: Our pilot study suggests the use of Neuro-Patch via combined transmastoid/MF approach as an effective technique with minimum, if any morbidity; it could be of particular benefit for patients with larger MF dura defects. A larger number of patients are required to strengthen the evidence.
METHODS: Six adult patients (age ≥16 yr) who had sMF CSF leaks surgically repaired within an 18-month period at a single university hospital using synthetic, nonbiological, nonabsorbable graft (Neuro-Patch) and a retrospective control group of five patients undergoing multilayer MF repair with autologous grafts.
METHODS: MF repair through a combined transmastoid/MF approach using Neuro-Patch or multilayer autologous grafts.
METHODS: The incidence of postoperative leak within 6 months postoperatively was the main outcome measure; we also recorded the need for lumbar drain, additional hearing loss, length of inpatient stay, body mass index, previous meningitis, preoperative increased intracranial pressure, and age.
RESULTS: In the Neuro-Patch group, there was no postoperative CSF leak without the need for lumbar drain. We observed no additional hearing loss; patients were monitored for 2 days without any readmissions. Increased intracranial pressure (four of six), previous episodes of meningitis (two of six) or obesity (five of six) did not affect patient outcomes. Demographic and prognostic factors were the same for the control group. However, one patient needed lumbar drain postoperatively because of residual leak; lumbar drain was used in one more case (two of five cases), whereas three of five patients had to stay for longer than 2 days (5 d).
CONCLUSIONS: Our pilot study suggests the use of Neuro-Patch via combined transmastoid/MF approach as an effective technique with minimum, if any morbidity; it could be of particular benefit for patients with larger MF dura defects. A larger number of patients are required to strengthen the evidence.
摘要：
目的：评估一种不可吸收的，用于重建自发性中窝（sMF）脑脊液（CSF）泄漏的合成移植物。
方法：6名成年患者（年龄≥16岁）在18个月内在一家大学医院进行sMFCSF泄漏的手术修复，非生物,不可吸收移植物（Neuro-Patch）和5例接受自体移植物多层MF修复的回顾性对照组。
方法：通过使用神经贴片或多层自体移植物的经乳突/MF联合方法进行MF修复。
方法：术后6个月内的漏发生率是主要结果指标；我们还记录了腰椎引流的需要，额外的听力损失，住院时间,身体质量指数,以前的脑膜炎，术前颅内压升高，和年龄。
结果：在Neuro-Patch组中，术后无脑脊液漏,无需腰椎引流.我们没有观察到额外的听力损失；患者被监测2天，没有任何再入院。颅内压升高（六个中的四个），先前的脑膜炎发作(6次中的2次)或肥胖发作(6次中的5次)不影响患者结局.对照组的人口统计学和预后因素相同。然而,1例患者术后因残余渗漏需要进行腰椎引流;1例(5例中2例)使用腰椎引流,而5例患者中有3例住院时间超过2天（5d）。
结论：我们的初步研究表明，通过经乳突/MF联合方法使用Neuro-Patch作为一种有效的技术，如果有任何发病率;它可能是特别有益的患者更大的MF硬脑膜缺损。需要更多的患者来加强证据。
方法：6名成年患者（年龄≥16岁）在18个月内在一家大学医院进行sMFCSF泄漏的手术修复，非生物,不可吸收移植物（Neuro-Patch）和5例接受自体移植物多层MF修复的回顾性对照组。
方法：通过使用神经贴片或多层自体移植物的经乳突/MF联合方法进行MF修复。
方法：术后6个月内的漏发生率是主要结果指标；我们还记录了腰椎引流的需要，额外的听力损失，住院时间,身体质量指数,以前的脑膜炎，术前颅内压升高，和年龄。
结果：在Neuro-Patch组中，术后无脑脊液漏,无需腰椎引流.我们没有观察到额外的听力损失；患者被监测2天，没有任何再入院。颅内压升高（六个中的四个），先前的脑膜炎发作(6次中的2次)或肥胖发作(6次中的5次)不影响患者结局.对照组的人口统计学和预后因素相同。然而,1例患者术后因残余渗漏需要进行腰椎引流;1例(5例中2例)使用腰椎引流,而5例患者中有3例住院时间超过2天（5d）。
结论：我们的初步研究表明，通过经乳突/MF联合方法使用Neuro-Patch作为一种有效的技术，如果有任何发病率;它可能是特别有益的患者更大的MF硬脑膜缺损。需要更多的患者来加强证据。
